The decision to outsource revenue cycle management requirements or maintain an in-house team for it is completely up to your medical practice. Choosing the right one for you comes down to the revenues obtained at the end of the cycle.
To ensure that your medical practice gains maximum benefits, these are the parameters to gauge before choosing to outsource your revenue cycle process:
1. Patient Care
Your medical practices may be unable to recruit and make office space for a dedicated team of medical billers and coders. Therefore, you might burden your physicians with the responsibility of maintaining the revenue cycle process. These administrative responsibilities then become a distraction for your physicians, causing them to provide substandard patient care. This ultimately causes patient dissatisfaction, which results in dwindling revenues in the long run. Unless your medical practice employs a dedicated team of in-house medical billers and coders, outsourcing RCM requirements to a third-party provider is a better option. Renowned outsourcing companies offer RCM services that enable your physicians to fix their focus on rendering better medical services to patients. If your patient’s care is of primary concern, it may be better to outsource your RCM requirements.
2. Financial Investments
Maintaining an in-house RCM team is more financially demanding than outsourcing. This is because the in-house team of billers and coders need office space, infrastructure, payroll, and other employee benefits to be interested in taking on the work. Most of these costs are cut down when outsourced to established RCM providers. These third-party companies will already have advanced infrastructure and large spaces for their employees to work out of. When you outsource revenue cycle management services for your medical practice, you can immediately access professional medical billers and coders instead of investing your time and money into searching for reliable hires. Therefore, outsourcing saves money for your medical practice in the bigger picture.
3. Cash Flow
On recruiting an in-house team to maintain the revenue cycle, your medical practice must also ensure that your staff gets their employee benefits. Casual leaves, sick leaves, and other forms of employee holidays are a part of these benefits, which cause delays in the RCM process. This affects the consistency of cash flow for your healthcare practice, thus disrupting revenues. Choosing to outsource revenue cycle management prevents such breaks in the revenue cycle, since renowned third-party RCM providers maintain large teams of working professionals. These employees work in shifts and substitutes are always available to cover the employees who are on leave. This ensures 24/7 revenue cycle services, which guarantees incoming cash flow for your medical practice throughout the year.
Industry regulatory standards go through changes and improvements frequently. Billers and coders must stay abreast of these changes with regard to HIPAA compliance, coding compliance, etc. If your medical practice chooses to maintain in-house staff, they must go through regular training to keep themselves up-to-date with these recurring compliance modifications. It might become difficult to stay updated on compliance issues when you have to take care of the entire RCM process. In the case of renowned third-party providers, they have a large workforce that is systematically trained to stay on top of contemporary payer policies and industry regulations. This decreases the chances of compliance issues arising for your medical practice, thus guaranteeing timely reimbursements.
5. Skilled Professionals
Your medical practice must recruit expert medical billers and coders to carry out in-house RCM processes efficiently. Recruiting such experts can prove to be challenging since there might be a lack of skilled billing and coding professionals in the area where your medical practice is set up. This causes many medical practices to recruit average professionals, who might end up making billing and coding errors. These errors might range from failing to verify patient medical information to delaying the submission of claims. When you outsource revenue cycle management services to renowned RCM outsourcing companies, they can ensure error-free RCM processes are in place. These companies are usually established in various locations around the world. They recruit highly skilled professionals hailing from different geographical locations, thus consistently rendering clean claims. They also strategically handle claims denials within the set deadlines. This decreases the possibility of losing revenues due to a lack of effective staff or their inability to render clean claims and manage denials.
To outsource revenue cycle management or not is a decision that will affect the financial health of your medical practice. Though recruiting in-house staff to carry out the RCM process enhances data security and transparency, most renowned third-party RCM providers can also guarantee optimal data security and transparency for your medical practice. They can ensure that you have complete control over your revenues, even if they are not set up in a location near you. Thus, your medical practice can weigh the advantages and disadvantages of choosing either option and pick the one that promises complete reimbursements within the shortest period of time.