Should you outsource physician billing and all your revenue cycle management tasks? What is the point of outsourcing? These are big questions many practices face today. Running the business end of practicing medicine sometimes proves frustrating for physicians. Even if you have excellent medical staff, it’s occasionally typical to experience inefficiencies in revenue cycle management (RCM), resulting in financial losses.
Revenue cycle management has a significant impact on your bottom line. Fail to do it well, and ultimately you may find it challenging staying in business. For many practices, outsourcing revenue cycle management offers an excellent opportunity to boost their bottom line. Each practice must consider its unique situation – Specialty, overall financial health, experienced billing staff, and more. Based on these factors, decide what works best for them- in-house or outsourced RCM.
The Benefits of Outsourcing Revenue Cycle Management
As you’re weighing the pros and cons of outsourcing RCM, here’s a look at the benefits of outsourcing revenue cycle management to consider:
Benefit #1 – Big Cost Savings and Increased revenue
Outsourcing your revenue management saves costs and increases your collection rates. Just consider a hypothetical cost analysis presented by Physicians News Digest. Staff costs are one of the most significant expenses of running a practice. Having medical billing and coding staff in-house often costs far more than outsourcing physician billing and coding.
Medical billing services have certified coders and experienced billing staff who understand how to maximize your revenue and minimize rejections and denials. As a result, they reduce existing backlogs and bring the insurance AR up to date. They also offer tools to manage patient receivables, such as calling your patients rather than ship the balances to a collection agency.
Benefit #2 – Focus Your Time on Your Patients for Improved Patient Experience
Focusing on your patients and providing them with the best care possible is every provider’s ultimate goal. When you outsource your RCM, you have the chance to put all your focus on what you do best – provide patient care. Having your RCM handled by experts also improves the overall patient experience. Patients often complain about billing errors, and reducing those errors and claims denials offers patients a better experience and greater patient engagement. Taking the heavy administrative load off your staff also gives them (and you) more time to spend caring for patients.
Benefit #3 – Dedicated, Experienced Billing and Coding Staff
For smaller practices, staff members juggle different tasks. Multitasking means your staff isn’t as skilled in billing and coding as you’d like. Billing and coding practices change regularly, too, and staying up-to-date on the latest changes is key to reducing denials and costly errors. Outsourcing physician billing and coding to well-trained professionals minimize the chance of errors, denials, or even HIPAA violations due to inadequately trained staff. Meaningful use/MIPS/MACRA is generally handled for you when you outsource.
Benefit #4 – Enhanced Transparency and Consistency
When you outsource your RCM, your partner will be able to provide you with comprehensive performance reports and dashboards. These analytics let you keep track of your billing operations and performance without the need for micromanagement. The outsourced company is generally adept at performing services like coding, scrubbing, claims management, denials, appeals, timely follow-up, patient statements. You can count on consistent results when outsourcing these tasks.
Benefit #5 – Increase Efficiency and Accuracy
Ensuring your billing processes are efficient and accurate is critical to your practice’s sustainability. Past-due payment claims that have been disregarded, or incorrect coding practices leading to denials may negatively impact your practice’s cash flow. Outsourcing your revenue cycle management to a reputable company keeps your processes efficient and accurate, increasing your day-to-day cash flow.
Benefit #6 – Stop Constantly Retraining Your Staff to Handle Billing and Coding Changes
Keeping up with the latest rules and regulations from the government and other payers can be difficult because they’re constantly changing. This means you spend a lot of money retraining your staff members if you’re using in-house billing and coding professionals. Of course, failing to train your staff results in higher claim denials and a hit to your bottom line. Outsourcing your billing and collections ensures you don’t have to retrain your staff, saving extra time and work for other important clinic operations. Outsourcing to well-trained professionals ensures your billing and coding have less chance of errors and denials, boosting your practice’s revenue.
Benefit #7 – Enjoy a Higher Clean Claims Rate
Clean claims are those that are perfect – zero mistakes without the need for any extra information or corrections. These types of claims have no chance of being denied. If you want to boost your practice revenue, you need to ensure you have a higher clean claims rate. It is advantageous to outsource your medical billing to well-trained, qualified specialists who understand how critical it is to submit clean claims every time. You’ll reduce the occurrence of human error, enjoy a higher clean claims rate, and appreciate the boost in practice revenue as a result.
Drawbacks to Outsourcing Revenue Cycle Management
Of course, it’s critical to weigh both the pros and cons of outsourcing RCM before making your final decision. Outsourcing RCM does come with a few drawbacks to keep in mind:
Drawback #1 – You Lose Control
Another potential drawback of outsourcing RCM is that you’ll lose control over this process. Nevertheless, your vendor’s services will keep you informed about your finances’ current status.
Drawback #2 – Less personal
Your staff and patients have to deal with a third-party company. Although you will be in control of the billing process, a good partner will keep you updated with your finances through regular reports.
Drawback #3 – Possible Hidden Fees – It’s essential to read the fine print of a contract to look for hidden costs. Check for fees like canceling service fees, report generation fees, fees for setting up services, or extra costs for printing your statements.
It’s easy to see that the benefits like cost savings, increased collection rates, dedicated billing staff, far outweigh the drawbacks of outsourcing RCM. The cons are often mitigated by choosing the right vendor.
Of course, outsourcing does not work for every practice. It is important to consider your clinic’s unique needs and determine if outsourcing medical billing is the right option for you.
If you decide that outsourcing RCM is the right choice for your practice, let us know. We will be happy to help you learn more about our RCM services to boost your practices’ revenue.