There are more reasons to outsource your revenue cycle management today than ever before. Stringent regulations, escalating costs, and the shift to value-based reimbursement models have each helped to saddle physicians with heavy burdens. Because of their high-deductible health plans, there are more patients who are responsible for their out-of-pocket costs than there had been a decade ago. These patients are more difficult to collect from than from institutional payers. Due to the drastically reduced rate of collection from patients than from other payers, healthcare organizations are spending increasingly more time and money chasing after self-pay accounts. Practices have to step up their efforts in an effort to manage their revenue cycles in order to survive.
You can unload some of the hassles of documentation and data-related work, however, by outsourcing the management of your revenue cycle to a competent third party. This will allow you and your staff the opportunity to get back to concentrating on doing what you do best: providing the highest quality of care that you can for your patients. When you are not bogged down with administrative tasks, you can increase the amount of time that you and your staff spend meeting with patients face-to-face, or you can increase the number of patients who you see, and this means an uptick in revenue.
Additionally, there are more benefits to outsourcing than just freeing up yourself and your staff to focus on patient care. Another major benefit from outsourcing revenue cycle management is that you can cut down on the costs associated with maintaining and overseeing an in-house billing staff. Consider how much it costs to ensure compliance, install hardware and software, maintain a server, manage upgrades, train a staff, and then maintain its members’ certifications.
Then, of course, there are the occasional expensive technical difficulties that can sneak up to hijack productivity. Eliminating these exorbitant expenses will increase profit. By outsourcing, you will no longer have to worry about falling behind on claims processing due to in-house staff turnover or employee absences. Also, the office space that you have dedicated to housing your billing staff can be re-purposed. Instead of allocating a set number of square feet to chasing earned yet uncollected dollars, you can remodel that space into new patient rooms which can then be used for directly generating revenue.
In today’s litigious society, the pressure is high for practices to maintain the most recent knowledge of all state, federal, and carrier requirements. While staying current is a full-time job in and of itself, failure to do so can expose your business to liability for costly compliance deficits. These deficits can then become severely detrimental to both revenue and cash flow as the medical economics landscape continues to rapidly evolve in highly complicated ways.
Few providers possess the talent, capital, and IT savvy to keep up with all of these issues. Rather than trying, it is far better to hire professionals to do all of that for you. Third-parties who are solely dedicated to staying up-to-date with regulations have successful compliance policies which can mitigate expensive risks to your practice. While they focus on keeping abreast of trends related to security and compliance, you can focus on more important things, such as actively building your practice.
Staffed by experts, your third-party compliance professionals should be able to supercharge your efforts to manage your revenue cycle and accelerate payments. If your third-party employs highly-experienced healthcare revenue management personnel, these professionals will have specialized experience in submitting claims and possess greater training and expertise than would be possible for the members of your in-house billing staff. Increased knowledge about regulatory, compliance, coding, and administrative issues will also mean reduced costs for you due to errors and late submissions. With a more sophisticated understanding of the collections process, outsourcing can provide access to systems which can actively and aggressively pursue rejections and denied claims and should be able to bring in revenue that you would have been otherwise unable to collect.
Being able to successfully counter rejections and denials is essential if you do not want to lose possible revenue. Otherwise, the sad reality is that at least half of all denied claims typically fall by the wayside. Why expose yourself to the risk of lost revenue, decreased reimbursements, and a collection process that drags on and on? You can significantly speed up your collections by outsourcing to a third-party.
Furthermore, third parties may be able to tap into support for HIPAA. This means you can forego hiring an expert on your own.
You may worry about the risks of entrusting the management of your revenue cycle to an outsourced group. Perhaps you fear that you will have less control over day-to-day operations by sending out these administrative tasks. These fears, however, are groundless if you pick experienced professionals. Choosing the right company is key. The best group can actually enhance the control that you have over your business.
Although its staff members will not make decisions for you, they can provide you with helpful, accurate data, and unbiased advice. By keeping you well-informed, a third-party revenue management team can assist you in making wiser decisions related to your business. This is especially true if you choose a proficient organization with billing tools that provide data analytics.