How to Know When It's Time to Consider Revenue Cycle Outsourcing

The term “outsourcing” is one that carries some fear for many small practices. It implies a loss of control or autonomy which, for an independent physician group, does not pair well with the desire to go into private practice in the first place.

However, today’s healthcare environment presents many unique challenges that can get in the way of independent practices’ ability to remain profitable without making sacrifices to care quality or work/life balance. As such, revenue cycle management services provided by trusted billing companies like eMDs have increased dramatically in popularity.

Here are a few warning signs at your practice that might signal to you that you could benefit from RCM services.

Your Staff Works Too Much

Providing high quality care during regular office hours is tough enough. Doing so while trying to keep abreast of all of the back office work to keep your cash flowing is, these days, nearly impossible. If you have billers, office managers, and/or providers that are staying at their desks for hours after the doors close, or are bringing crates of claim forms home with them when they leave, it may be a sign that your office could benefit from partnering with an RCM services provider.

By utilizing RCM services, much of that back office busywork keeping your staff from leaving the office can be offloaded to experts who can address it while you go home to dinner with your families.

Your Cash Comes In Too Slowly

Whether it comes from patients paying their outstanding balances or insurance companies reimbursing you for your services, your office is paid for its services mostly well after those services are rendered (and well after the costs for providing those services are incurred). Therefore, getting paid back quickly is extremely important to remaining profitable.

Take a look at your Accounts Receivable to get an idea of just how quickly you are being paid. How much of your AR is less than 30 days old? How much is over 90 days old? RCM services exist to accelerate those payments and minimize the length of time your AR stays AR before it becomes cash in your pocket.

Your Rejections And Denials Are Too High

Claim rejections and denials speak to a great many issues that may be present in your practice. For one, rejected or denied claims are not paid, so they are money left on the table. Second, rejections and denials could speak to a lack of staff expertise or a need for staff training. Finally, rejections and denials require time to correct and resubmit – the more you have, the more time your practice spends correcting them.

The good news in this case is that RCM services can help with all of these potential problems. If your rejection and/or denial rates are high, the experts providing your RCM service can maximize claim accuracy and, thus, minimize your rejection and denial numbers. Further, as discussed above, they can collect your money quickly as well as work those claims that are rejected on your behalf, taking the time burden off of your practice’s plate.

RCM services are on the rise in healthcare right now, and for good reason. By adopting RCM services from a reputable organization, you can improve your bottom line while also streamlining productivity in your office. If you take a look at your staff productivity, payment velocity, and rejection rates, you may determine that RCM is right for you.