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These days, many healthcare organizations are turning to outsourcing for their (RCM) revenue cycle management help. The most common reason healthcare organizations outsource RCM is because of lost or denied claims and the lack of time to remedy these claims.
Because of all the rules surrounding where you send your claims and how to fill them out, it’s not uncommon for one to get lost in the shuffle or accidentally sent to the wrong place. This is where revenue cycle management helps your company.
Some estimates put the amount of money lost due to administrative inefficiencies at $63 billion per year! That means that your practice could be leaving a significant amount of money on the table every year because of inefficient processes that lead to lost or denied claims.
The biggest causes of those rejected claims are:
- insufficient patient information collection when scheduling visits
- inadequate insurance verification prior to services being rendered
- incorrect ICD-10 coding
- and billing errors (such as services billed under an invalid code).
Another thing that leads to these wastefully rejected claims? You guessed it – manual medical billing processes!
Managing Revenue Cycle is a Full-Time Job
Many practices and hospitals outsource RCM because their staff members are simply too busy to take on additional tasks. It can be challenging for many practice owners to keep track of all the moving parts that go into managing revenue cycle. Outsourcing RCM functions can relieve some of the stress associated with this responsibility. When you hand off RCM tasks to an outside company, staff members are free to focus on clinical duties. After this they’re also able to help with customer service and other important tasks within your office.
When you hand off RCM tasks to an outside company, staff members are free to focus on clinical duties. After this they’re also able to help with customer service and other important tasks within your office.
Here are a few ways outsourcing Revenue Cycle Management helps your practice:
- Staff members have more time to dedicate to patients and customer service, rather than spending precious labor hours on billing or collections.
- It frees up resources that you can use more efficiently in other areas. For example, a practice may be able to purchase much-needed equipment instead of hiring additional staff to handle billing and collections duties.
- You’ll see an increase in paid claims (and improved cash flow) that a team of RCM experts can accomplish for you in a quick and efficient manner.
Before you commit to any type of outsourcing, your practice should make a decision about what exact aspect of RCM you want to outsource, according to Healthcare Dive.
These are the different types of services that can be outsourced:
- The entire RCM process
- Only parts of the process
- Specific functions like coding and billing
When deciding what aspect of RCM you want to outsource, consider what would be best for your practice and the cost associated with each. Also consider how you’re going to integrate that service into your practice by asking questions such as:
- What is their experience in this field?
- How will my data be secured?
- What’s the process to transition from an internal system to an outsourced service provider?
- What kind of reporting will be provided?
A smooth transition is one of the most important factors for successful outsourcing. In fact, it should really be considered a prerequisite to any outsourcing process.
Most RCM vendors state that the actual implementation process takes up to four weeks. That may not sound like a lot, but you need to be prepared for this by training your staff. Training on new processes and making sure that you have enough people available during that first month is essential. Designate who can answer questions from the vendor, help them train their staff in your practice and make sure that your data is secure throughout the transition.
RCM consultants are valuable resources because they’re experts in their fields. They can help you determine if outsourcing will actually benefit your practice. They can also identify the areas that will benefit most from outsourcing so you don’t waste money. In addition to helping with a specific task or project, consultants can help with project management, change management and implementation. If you have an internal team already, consultants can also work alongside them to ensure smooth transitions and access to new skills and expertise.
If you’re ready to outsource your RCM needs, contact Cora Behavioral Health Solutions, where our experts have a combined 30+ years’ experience in the field. Visit www.corabhs.com.