Outsourcing Revenue Cycle Management
RCM Outsourcing Will Help Your Practice Succeed
There is no silver bullet when it comes to Revenue Cycle Management (RCM). It’s not like you can click a button on an RCM application and improve the financial health of your organization. Successful RCM requires a clear strategy and a team that can deliver on the vision and goals your organization strives for.
As you already know, maintaining an in-house team is becoming increasingly difficult, especially in the current healthcare environment. Revenue Cycle Management has become a business specialty, very much the same as Orthopedics is a specialty in healthcare.
PRL specializes in RCM, it’s all we do and we do it exceptionally well. Many healthcare professionals are turning to RCM outsourcing to improve their financial health so they can focus on the value-based care initiatives that are core to their mission. Continue reading to consider how outsourcing your RCM will benefit your healthcare organization.
Improve the Patient Experience
An outsourcing partner will certainly enable your practice to focus on a better patient experience. Your providers and staff won’t have to keep tabs on all the different RCM processes built into the patient experience. Instead, they can focus on delivering the highest standard of care to patients. When you choose to work with an outsourcing partner, they will prioritize patient experience because it is an increasingly important piece of the RCM puzzle.
An outsourcing partner can help increase your net collections, especially with patient self-pay. Patients today are healthcare consumers who are turning to alternative payment models as the healthcare industry continues to evolve. This will give your patients more flexibility and options when it comes to paying their balance. Additionally, an outsourcing partner can help your patients through a call center and online portals. They can take billing questions, explain financial responsibility to patients, and assist with financial counseling.
All of this works in tangent to make it easier for patients to pay their bills. This will make their encounter with your practice and providers more meaningful. Happier patients are much more likely to pay their bills on time and in full. That will go a very long way in improving your financial performance.
Reduced Billing Errors
One of the most common complaints we hear from providers is managing documentation. With all the different codes and rules out there, it is difficult for back-office staff to keep track of capturing every patient encounter. To make matters more difficult, ICD-10 and CPT codes are constantly changing. As any practice manager knows, improper coding is the leading cause of denied claims.
When you work with an outsourcing partner, they can help your practice manage the documentation portion of RCM. They will provide your staff with education and training resources to stay on top of new rules and regulations. An outsourcing partner can help you proactively identify documentation errors such as incorrect fields or improper codes. Oftentimes, they will perform an internal audit to identify deficiencies and then develop remediation plans. When documentation and coding errors are fixed, your bills will be more accurate. That will speed up the claims submission process, prompt faster patient payment, and stabilize your cash flow. A provider working with an outsourcing partner won’t have to worry about regulations, changing payer policies, or compliance.
Better Staff Management.
There is a growing problem with burnout and high staff turnover in healthcare today. Your staff has too much to do and too little time. Oftentimes, managing RCM becomes the priority for staff and providers because it is so cumbersome. When that happens, the quality of patient care declines. Combine that with increasing regulations and upkeep of the RCM process and you wind up with the staffing issues that plague many practices today.
Working with an outsourcing partner can free up your staff resources. Your partner can take care of the day-to-day RCM activities like billing, managing claims, registration, and patient-facing billing services. Meanwhile, an RCM partner can use their expertise to help guide your existing staff on critical RCM activities. Outsourcing can also help you reduce your staff overhead. You won’t need to hire and retain as many staff members to manage RCM. There are even outsourcing partners who will train and manage practice staff as if they were their own employees.
No matter what staffing management challenges you face, an RCM outsourcing partner can certainly help you. That way, your staff and providers can focus on patient care.
Accelerated Cash Flow
The biggest reason many practices seek an outsourcing partner has to do with financial performance. Practices that want to outsource typically struggle with maintaining their cash flow. All sorts of RCM processes can break down and prevent you from maximizing your collections, whether from patients or payors. Then there are situations like when your staff goes on vacation. Who manages RCM processes while they’re gone? RCM Function is affected and your claims will have to wait until the staff member returns.
An outsourcing partner can help fix this problem. They will ensure a steady revenue stream and enhance your cash flow by minimizing disruptions to the billing process. Remember, your RCM outsourcing partner is always operating for you, even when you or your staff members are out of the office. It provides peace of mind no matter what is happening around you.
Managing Your A/R
Many practices struggle to reduce their aging A/R. This particular challenge has grown in recent decades as revenue management and billing processes increase in their complexity. An outsourcing partner has the resources on hand to manage your A/R. There are designated teams who follow up on A/R settlements from insurers. They can spearhead your claims submission process and reduce the time it takes to receive reimbursement following a submission. Denied claims are another challenge that an outsourcing partner can help resolve. Oftentimes, denials are caused by human errors, improper codes, or existing documentation problems. Your outsourcing partner has the means to proactively identify the cause of your denials while improving your overall clean claims rate.
Technological capability often has much to do with this. Your outsourcing partner has systems and technology in place to ensure clean claims. Most RCM companies will utilize a rules engine that verifies the accuracy of your claims. There are other applications and tools that they use too that can help reduce your aging A/R. Increasingly, RCM companies are integrating the patient experience into their A/R strategy with call centers and online billing. Prompting patients to pay using a well-developed platform will increase payments to your practice.