Outsourcing your clinic’s billing RCM services is a personal decision that can offer many upsides, including minimal disruption during industry changes, more consistent results, higher collections, and extra time with which to focus on your patients.
The Healthcare Financial Management Association (HFMA) defines Revenue Cycle Management (RCM) as “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” As compliance requirements increase and payers intensify their scrutiny of claims, more providers are turning to revenue cycle management by third parties, and the benefits of such a symbiotic relationship are beginning to shine through.
RCM is the cornerstone of a practice’s financial health and well-being, and unfortunately it is also, more often than not, absent within the core competencies of a practicing DC. As most chiropractors would rather be focused on their patients, outsourcing RCM management can not only be a valuable addition to the overall strategy of your business, but it can provide you with additional time to apply towards your patients.
Investing in a Better Return
In-house RCM can be costly as internal inefficiencies, insufficiently knowledgeable staff members, denied claims, and costly processing take a bite out of a practice’s bottom line. Outsourcing can provide much needed peace-of-mind by offering an option that secures the expertise and technology necessary to skillfully handle all aspects of revenue cycle management. This includes billing, collections, corrections, and accounts receivables. Outsourcing RCM also offers streamlined and efficient revenue management, and delivers key practice insights without requiring the provider to make large up-front technology and staffing investments.
Is Your Practice a Good Candidate for Outsourcing?
Simply because an option is available, that does not always make it required or even necessary to adopt. But if any of the following are true, then it might be time to look at outsourcing the RCM duties of your business.
- Are you suspicious that your collections are lower than they should be?
- Do you have conflicts or issues with your biller or billing department?
- Are you struggling with repeated claim rejections?
- Do you have high staff turnover?
- Is your financial ability to update your billing technology limited?
- Is your in-office billing expertise limited?
- Are you a new provider with enough on your plate already aside from billing?
- Do you feel unprepared to deal with software and technical issues?
- Are you more interested in keeping a close eye on treating your patients than every miniscule detail of your business?
- Are new value-based payment models rendering your current legacy technology inadequate?
- Do you feel like you have a limited grasp on the true financial health of your practice?
A Better Return on Investment
In general, outsourced revenue cycle management results in a 5-15% increase in the amount a chiropractor can collect. This can make a huge difference in the health of a practice, both for new, growing practices and long-enduring, sustainable ones. The benefits of outsourcing often overshadow those of keeping a single staff member or department under your own roof.
- Outsourcing your RCM can reduce expenses along with improving collections. Instead of training and retraining in-house billers, outsourcing removes the training requirement so that you can focus on running your practice.
- Outsourcing your RCM can provide vastly improved analytics. A medical billing provider should be able to offer highly detailed performance reports and statistics on your unique practice’s billing operations. And this information is provided without the need for in-office technology, time spent scouring your billing history, or prodding your biller or billing department for much-needed insight.
- Outsourced companies also thrive by consistently providing good results. You should be able to count on a third party to hit consistent goals and improve on your collections, income, error reduction, and speed of payments. In addition, some of these companies are skilled in identifying denial trends and targeting these areas to help you prevent them in the future.
- Tired of trying to keep up with new industry changes? An expert 3rd party can help you seamlessly adjust to new mandates, ensuring compliance and minimizing disruption to your practice.
- Less time focused on billing frees you up for more time to focus on your patients, foster referral and retention programs, keep up with your continuing education, and streamline your practice flow. Less time spent on billing translates directly to more time focused on areas of the practice that help you connect with your patients and generate revenue.
Outsourcing places the healthcare medical billing expertise outside of your duties, and all of the concerns that go with can be blissfully offhanded to a third party. On the other hand, if you have a longstanding, effective, and reliable in-house billing staffer, outsourcing your RCM may be an unnecessary step. Plus, not all RCM services are created equal. Know if they have procedures in play to follow up with third party carriers and patients or do they just send out the claims. Make sure they are incentivized on obtaining a good collection rate for your practice.
How you manage your RCM is a personal decision, and requires many factors be taken into consideration, including your in-house expertise, current legacy system, ability to upgrade and maintain your technology, your need for detailed analytics, and your current consistency and collection rates. But as the complexity of coding is set to hike in the wake of ICD-10, it may be time to take a look at your current RCM setup and consider transferring that weight to an expert 3rd party so that you can refocus your efforts on your patients, your practice, and your peace of mind. Do you want to learn more about solutions for managing your RCM? Visit our billing page to see if we can help.