Revenue Cycle Management (RCM) is one of the most challenging and complicated parts of running a healthcare practice. Understanding the intricacies of maintaining net collections and adhering to code standards is a full-time challenge.
Outsourcing to a third-party RCM partner can be hugely beneficial when it comes to running a successful healthcare practice. This blog breaks down what you and your practice can optimize if you hire a third-party medical billing provider.
PHI Security and Risk Mitigation
When you work with revenue cycle management industry leaders, rest assured that top-of-the-line security precautions are in place for you and your patients. These safety precautions ensure that electronic health records (EHRs) and payment information are secure from outside parties.
The purpose of having top-of-the-line security precautions is to protect your patient’s information from cyber threats and attacks. Before hiring any third-party billing company, be sure to ask what protocols they put in place to ensure sufficient threat protection, how they mitigate risk, and how they maintain HIPAA compliance.
Patient Engagement for Better Cash Flow
When you work with an RCM partner that can engage with patients directly, you have a higher chance of preventing scenarios where patient accounts are past 120 days or are sent to a collection agency.
When working with a third party, pre-appointment communication and a patient portal are frequently included in the spectrum of services provided. Patients will not only be aware of any upfront cost before the procedure, but they will also have access to this portal and be able to pay their bills without any hassle of waiting on hold. With a patient portal, clients can access their bills and information whenever it is convenient for them.
Partnering with a third-party medical billing provider means bringing on board an experienced team with proper infrastructure in place to manage large claim volumes. Hiring a third party also ensures that you will have certified, successful professionals with the right expertise to help you improve your cash flow.
Cost of Medical Billing
Running a healthy medical practice requires being profitable. Like any healthy business, you should assess your costs and expenses at least once a quarter. By doing this, you can gain a better understanding of where your money is going and how to better spend it.
Many practices who take their first look into hiring a third-party billing company often believe that outsourcing is more expensive than in-house billing. While in some cases this may be true, it is most often not the case.
When weighing different options, you should consider all aspects of both in-house and outsourced billing. Before choosing an in-house option, you should consider the time and cost it will take to hire professionals knowledgeable enough to meet the requirements of your practice. You should also include costs such as training, salaries, benefits, sick time, and other human resources costs.
When all costs and fees are considered, hiring a third-party medical billing service provider can end up more cost-effective than making the commitment to hiring an in-house medical billing team.
Reporting and Additional Insights
Detailed reporting provides vital information for your healthcare facility; it is an essential part of maintaining and understanding your cash flow. Reports are integral because healthcare executives, CFOs, administrators, and collectors use the KPIs to determine the financial stability of their respective departments. To understand the overall cash flow and health of your practice, you need robust reporting that’s both accurate and comprehensive.
With a reputable third-party medical billing service provider, like CBS Medical Billing, you will receive detailed reports that are customized for you and your practice. By having accurate reports on hand, your practice and staff can be confident when it comes to making decisions that affect your company’s bottom line.
The goal of outsourcing your RCM needs is to have peace of mind. While you take care of patients, your billing partner takes care of your revenue cycle and saves you the manpower that would have otherwise been redirected from patient care.
Comprehensive Denial Management Strategies
Having a poorly developed denial management strategy can tip your medical practice to the brink of a financial crisis. In order for an in-house team to be successful at claim denial management, the proper training and education towards understanding the ever-complex clinical documentation is a must. Considering just how stringent the reimbursement environment is, a traditional, unstandardized approach to denial management will not suffice.
A third-party medical biller will likely have a strict, comprehensive, systematic approach to denial management. With the latest software and technology, outsourced revenue cycle teams can tackle the whole lifecycle of a claim. Your practice can leverage these technologies to improve your denial overturn rate and prevent denials from happening in the future.
Credentialing Process
The Affordable Care Act has substantially increased physician credentialing requirements for Medicare and Medicaid enrolment in the past year. The motivation is the reduction in fraud and abuse.
This means that physician credentialing is a requirement by the federal government, state government, and other accreditation agencies. The downside to the ACA is that the credentialing process is both laborious and lengthy.
Often, your staff might not be up to the challenge or have limited experience in the credentialing process. Bringing in a third-party medical billing provider means you can leverage their expertise in credentialing.
Optimize RCM with a Medical Billing Professional
When you opt for a third-party medical billing company, you can expect better risk management, an increase in cash flow, less administrative overhead costs, and a team of experts to guide you through the revenue cycle management process. You should also notice a healthier bottom line and an improvement in patient satisfaction and experience.
At CBS, we provide comprehensive revenue cycle management services curated to help you improve your current revenue cycle and patient experience while boosting your bottom line. We are committed to streamlining and expediting your billing. Reach out to our team today!
