Why You Should Outsource Revenue Cycle Management

Why You Should Outsource Revenue Cycle Management

For any healthcare practice, the ability to deliver high-quality care to each of your patients centers on air-tight management of your revenue cycle. Operating on a shoe-string budget may be fine in some sectors of the economy, but you cannot be worried about your bottom line when you’re seeing to the needs of the people who come to you for life-altering care.

By outsourcing your billing services to a third party, such as Healthcare Revenue Group, you’re able to exercise your expertise in your field while we ensure there are no gaps in your finances. The complexity of today’s healthcare market requires an expertise all its own, and we’re here to work with you closely to grow your practice at a pace that is comfortable for you.

What Is Revenue Cycle Management?

In essence, RCM is a procedure for maintaining and accessing data about every one of your patients’ cases throughout the relationship you have with them. This includes collecting information about insurance coverage, establishing copayments, coding claims and billing.

Errors made early in the process tend to create numerous problems down the line. For that reason, it is imperative that effective intake procedures be established and meticulously followed with each new patient, and each visit.

Typical aspects of an effective RCM strategy include:

  • Pre-Registration - Collecting information about a patient’s medical history and insurance coverage prior to their arrival.
  • Registration - Collecting additional information to meet or exceed regulations and establish a medical record number.
  • Utilization Review - An assessment of which services or interventions may be required in a patient’s case.
  • Charge Capture - Noting which medical services have been provided in order to create a billable list of services.
    • Coding - Converting services into codes used under ICD or CPT guidelines.
  • Claim Submission - Billing insurance companies for services and supplies used in treatment.
  • Patient Collections - Determining the portion of billable services for which the patient is directly responsible, and collecting these payments.
  • Remittance - Applying successful payments to account balances, and rejecting unsuccessful payment attempts.
  • Third-Party Follow-Up - Collecting payments from insurance payers.

As many of these elements can be accomplished with centralized software—that may even perform some of them automatically—results in time saved for your organization, and a better outcome for your bottom line.

Outsourcing Is Necessary for Most Organizations

Maintaining a staff that can effectively handle all the elements of RCM puts a significant strain on your resources. This staff must also be responsible for tracking all the changes that come along in regulations and according to the specific language of your various contracts with insurance providers. The task is herculean, and the most effective way to get this work done without costly errors is to outsource it to a team of experts.

Even large hospital organizations are recognizing the value in moving these tasks off site, where data can be analyzed for gaps in efficiency, and new operating procedures can be implemented that reduce claims denials, increase the value of contracts with existing insurance partners, and expand their network to include new payers that help grow the patient base in ways that make sense for the particular organization.

Choosing a Revenue Cycle Management Partner

Not all companies that offer healthcare billing services work the same. For example, Healthcare Revenue Group offers special expertise in podiatry and audiology, while also handling less specialized medical practices. The company you partner with should understand the needs of your specialization and have the bandwidth to carefully consider your specific needs, given the current size of your practice.

A few questions to ask of a potential RCM partner include:

  • How do you manage claim denials?
  • Will you train our employees in the use of the systems you design?
  • Can you help with our practice’s specifically identified pain points? How?
  • How does your contracting compare to other companies?
  • What do you do with the data you collect from our practice?

These questions are important to determining the value of the relationship you’re about to establish. At Healthcare Revenue Group, we design software systems that are specifically tailored to the needs of your practice, making it easier for your employees to input data effectively. We do not require a long-term contract, and instead stand on the value we provide on a daily basis to ensure that our relationship can be a productive one for the long term. We analyze the data we collect and meet with you at regular intervals (of your choosing) to recommend changes in procedure, new insurance partnerships, and more that can help you grow your business.

Contact Healthcare Revenue Group today to discuss how we can help you make your medical practice flourish!

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