6 Easy Steps To Outsource RCM Billing And Improve Patient Care Quality

The success and sustainability of a medical practice is purely driven by the quality of patient care. Competence and Focus together govern that quality. However, several organizations, especially in the US, are reeling under the load of trapped revenue. The stress around claim denials, overdue bills often leave the staff and owners overwhelmed and take their focus away from care and delivery. Is that the situation with you, as well? Consider outsourcing the revenue cycle management.

“At most organizations, scenario planning focuses on the necessary operational responses to ensure business continuity. Few of these plans address the ability or bandwidth of employees to focus on their work,” says Brian Kropp, Distinguished Vice President, Research, Gartner.

Outsourcing medical billing allows you to achieve optimum accuracy and efficiency in your revenue cycle. However, the success of your outsourcing decision will be defined by the competence of your partner andthe engagement process.

We’ve identified some of the Critical areas that need a fix to ensure your outsourcing experience turns out smooth and profitable.

Command At Technology That Supports Your Need

Your outsourcing partner must be a pro at using technology and automation in medical coding and billing. A complete automation may still be a thing of the future, yet some of the functions must employ a basic degree of automation to quickly resolve claim issues and receive payments, etc. This includes tools for denial management, payment acceleration, and bill submission.

Information Safety And HIPAA Compliance

A medical practice is a goldmine of critical patient information. During outsourcing medical billing or when you outsource DME billing services, your business is at risk of providing an access to this goldmine to strangers. This concern is valid and understandable. A reliable partner, that is HIPAA compliant, and has had a proven track record of delivering medical billing services with a judicious use of data, is the one you could rely on. In addition to compliances, your vendor’s command towards managing data hacks and sensitive handling of data (through effective staff training) also make a difference.

Length Of Combined Experience In The Industry

There can hardly be a substitute to evidence-based learning. A combined experience of more than 10 years translates into expertise, and hence an advantage for you -when you decide to partner with such a vendor. A vendor that has worked through several specialities in the medical industry would understand the ins and outs, the nitty gritties that arise out of specific departments. The challenges of a cardiologist, for instance, may differ from that of an ophthalmologist. Even as medical billing processes are the same -a domain expert will know the vulnerabilities and tough spots of the claim submission journey etc, in advance and hence, effectively mitigate them beforehand.

Specialization Including Payor Mix, Provider Count And Locations

The domain expertise, as discussed above, may not always confine to the medical specialties. For an outsourced RCM vendor or expert outsourced DME billing services, it may go beyond. Factors such as payor mix, geographies and provider count -can determine the success ratio of code and reimbursements. You can improve your payer mix by haggling better fees, for instance. Your bottom line is impacted significantly by knowing and managing your payor mix.

Scalability And Flexibility Vendor Can Provide

A good vendor will always try to fulfill your needs and satisfy your dynamic business needs. In terms of scalability, flexibility, and engagement, an above average vendor will happily stretch beyond what they can deliver in a given amount of time and cost. In the face of rising load of claims, or frequent need of AR calling, training etc, your vendor must act as your extended team and proactively manage the load to clear off the backlog. Such a vendor will be more focussed on retaining your trust and relationship and hence, go against the odds.

Support System And Services

A support team should be process driven and not person driven. They should be totally objective and transparent in their processes when it comes to building an RCM support pipeline for you. Organizations that do not put too much load on a single person do a better job in the long-run and hence, deliver more efficiently through delegation.

Summing Up:

Healthcare organizations need to manage their revenue cycle effectively, and outsourcing can make this possible. When you outsource your RCM, you can minimize the stress on your staff. Having RCM services contracted out can help you reduce overhead, improve cash flow, and free up your time for more valuable activities. By carefully selecting your RCM provider, you can significantly improve the performance of your organization and fetch manifold benefits. Outsource DME billing services or Medical Billing today!