RCM Outsourcing Very Significant to Achieve Economic Viability

RCM Outsourcing Very Significant to Achieve Economic Viability

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Many physicians feel tremendous economic pressure while addressing the concerns of declining reimbursement and rising operating costs. Relying upon a third party to manage your entire revenue cycle can prove beneficial to achieve economic viability. In the current scenario, outsourcing medical billing has a greater significance. Recently, we saw the Black Book Market Research survey that revealed revenue cycle management (RCM) outsourcing is strongly favored by healthcare providers. Let’s see how RCM outsourcing is much more crucial today to achieve economic viability.

When you utilize medical billing services, you can significantly reduce personnel costs and/or redirect personnel resources to core activities, improve collections and maximize revenue. Here is how RCM outsourcing addresses three major challenges in the current healthcare scenario. 

Difficulty to keep up with the collections – As per the benchmarking data collected by the Medical Group Management Association (MGMA), the average multispecialty practice has almost 17 percent of all accounts receivable (A/R) over 120 days. As the accounts age, it will be harder to collect them, which will adversely affect financial stability. Considering this, the American Academy of Family Physicians recommends keeping the number of accounts in the 120-day bucket below 12 percent. This implies that your staff will be required to dedicate more time to enhance your collections, which may not be possible amidst other core activities. RCM outsourcing can ease your burden and help you obtain your collections quickly.

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Growing Importance of EHR – With most practices implementing electronic health records and relying upon electronic billing, it is very important to train your staff to keep abreast of the changes in EHR and practice management systems. This is crucial to meet the quality standards and qualify for the insurerbased financial incentives. However, that too is time-consuming and involves increased expenses. RCM outsourcing is a more viable solution as you have access to the service of well-trained professionals in this matter.

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Use of ICD-10 Medical Coding – The massive expansion of codes and hyperspecificity makes ICD-10 coding challenging and complex. Even if you are using any code-mapping technique, the service of experienced ICD-10 coders is invaluable in ensuring the accuracy of your codes and avoiding unnecessary loss in revenue. Providing training to your staff may not be a viable option since these codes are being used for the first time and it requires full-fledged training that may be beyond your budget. Relying upon a medical billing and coding company that provides the service of ICD-10 ready certified coders is a better alternative.

Tips to Find the Right Vendor 

Review The Potential Benefits of Outsourcing – You should make a thorough assessment of your revenues and expenses, compare your physician productivity to industry standards, see whether you are maximizing the revenue for the

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services rendered and check the cost of maintaining updated technology and qualified staff vs. paying a third party. This will help you understand the economic benefits of outsourcing and choose a suitable vendor.

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Assess Technology – Many practices outsource their RCM tasks to gain access to quality data and efficient reporting. Assess your technology and check whether the outsourcing company can fill the existing technological gaps. A company with advanced technology and trained personnel can help you analyze poor performance data and highlight problems that need to be addressed.

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Good Coding Expertise – While choosing your outsourcing partner, look for professional and certified (preferably AAPC-certified) coders who are not only aware of the latest coding practices, but are also experienced in the appeals process and familiar with processes and procedures that are specific to your specialty.

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Thorough Research – Before choosing a billing company, visit the site in person and talk to or visit other practices that use their services.

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Be Specific on Your Agreement – The outsourcing cost is typically based on a percentage of collections. While making a contract/agreement with your outsourcing partner, make clear what exactly the fee covers and the delineation of responsibilities between you and them.

www.outsourcestrategies.com

800-670-2809