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How do you know if outsourcing RCM services is right for your practice?

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Outsourcing revenue cycle management (RCM) services can be a strategic decision for many medical practices that want to improve their cash flow, reduce administrative burdens, and focus on patient care. However, outsourcing RCM is not a one-size-fits-all solution, and it requires careful evaluation of your practice's needs, goals, and expectations. In this article, we will discuss some of the key factors that can help you decide if outsourcing RCM services is right for your practice.

本文章的要点总结

Centralized administrative processes:

By centralizing admin tasks, you free up medical staff to focus on patient care. This strategy can streamline operations and improve overall efficiency.### *Monitor initial performance closely:Keep a vigilant eye on your RCM partner during the first 120 days. Early issues can be detected and addressed before they escalate into major problems.

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1 Benefits of outsourcing RCM

Outsourcing RCM services can offer several benefits for your practice, such as access to specialized expertise and technology. This can give you access to a team of professionals with the skills, knowledge, and tools to handle complex billing and coding processes, while also helping you comply with regulatory requirements and optimize your reimbursement rates. Moreover, outsourcing RCM can help you reduce overhead costs and risks by eliminating the need to hire, train, and manage in-house staff, as well as investing in software and hardware. It can also improve performance and accountability by allowing you to monitor and improve key performance indicators, such as days in accounts receivable, collection rate, denial rate, and net revenue. Additionally, it enables you to hold your RCM partner accountable for meeting expectations and delivering high-quality service.

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Rogerio de Lima Marinheiro

SAP HCM Payroll Lead | Payroll, Benefits, HR Ops Functional Lead | HR Compliance, Shared Services, BPO
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Speaking for the country I live (Brazil). In recent years we saw a lot of new medical and dental clinic chains appearing in small and medium size cities. One of the common approach they have is a centralized administrative process that takes care of Patient scheduling, Client invoicing, Equipment maintenance, Marketing / Branding, Supplies management, leaving time for doctors and dentists do what they can do best: Take care of patients! For those familiar with large corporations we are seeing that RCM for these cases is just another letter rearrangement for acronym SCM - Supply Chain Management and its support flows. The same way as implement a good SCM strategy helps large corporations, implement a RCM strategy helps support small orgs.

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Seth Turnoff

SEARCHLESS Patient Acquisition | Healthcare DTC | Mustache Owner
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When you [effectively] outsource your RCM, you: can reduce your payroll, payroll taxes and employee benefits, increasing practice profitability. Depending on your situation, you also may gain expensive office space that was otherwise taken up by your RCM department. Converting office space into exam space or revenue-generating activities, you wil also increase profitability.

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2 Drawbacks of outsourcing RCM

Outsourcing RCM services can also have some drawbacks for your practice, such as a loss of control and visibility over the revenue cycle. You may feel less involved and informed if your RCM partner does not communicate well or provide timely and accurate reports. Additionally, there can be potential conflicts and misunderstandings between your practice and the RCM partner due to different expectations, goals, and cultures. Furthermore, outsourcing RCM can be a long-term commitment that requires a contract and fees for services, as well as hidden or additional costs like setup fees, cancellation fees, or extra charges. Data security, privacy, and compliance may also be an issue if your RCM partner does not follow industry best practices and standards.

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Seth Turnoff

SEARCHLESS Patient Acquisition | Healthcare DTC | Mustache Owner
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You're not going to put your practice's financial control in the hands of just ANYONE. Making sure that your partner is competant, has a demonstrated understanding of your specialty, exceptional communication and can become an asset outside of billing should all be considerations.

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3 Questions to ask before outsourcing RCM

Before you decide to outsource RCM services, it's important to ask yourself and your potential RCM partner some questions. What are your main pain points and goals for your revenue cycle? How much are you currently spending on in-house RCM operations, and how much can you save or gain by outsourcing RCM? You should also consider how you will measure the success of outsourcing RCM, as well as how you will ensure a smooth transition from in-house to outsourced RCM. Furthermore, it's essential to consider how you will communicate and collaborate with your RCM partner, and what security and privacy policies and protocols will be in place. Lastly, how will you protect your data and comply with the relevant laws and regulations when outsourcing RCM?

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Seth Turnoff

SEARCHLESS Patient Acquisition | Healthcare DTC | Mustache Owner
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Have them share insights on their performance metrics on AR over 90s, charge capture, collection rates, and denial managment protocols. Familiarize yourself with what your current program results are so you can not only measure their stated performance, but how they answer the questions.

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4 Tips for choosing an RCM partner

When considering outsourcing RCM services, it’s important to look for an RCM partner that can meet your needs, goals, and expectations. You should seek a partner with experience and expertise, evidenced by credentials, certifications, and references. Additionally, look for a partner that uses the latest and best technology to streamline and automate your billing and coding processes. Furthermore, you should ensure that the partner provides you with a dedicated account manager and a responsive customer service team. Lastly, transparency and accountability are key; make sure the partner provides clear contracts and invoices, as well as data and metrics showing their performance results.

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Seth Turnoff

SEARCHLESS Patient Acquisition | Healthcare DTC | Mustache Owner
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Make sure they can communicate effectively and when you need them. If they have a ticket-portal or something that is not real-time and when you need them, it might not be a good fit. Don't focus solely on their fee. Do you really want a budget RCM provider? Focus on their competency and value-add to your practice. A good RCM partner will pay for itself 6X with the amount they are saving you by doing things correctly the first time.

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5 Best practices for outsourcing RCM

Outsourcing RCM services can be a rewarding and beneficial decision for your practice, but it also requires some planning and preparation to make it work. To ensure success, it’s important to do your research and compare different RCM providers, set expectations and define goals before signing a contract, maintain regular communication with your partner, and monitor and evaluate the results. Specifically, you should inquire about services, fees, reputation, reviews, credentials, and references; define budget, timeline, scope of work, key performance indicators, and service level agreements; provide information, feedback, and support; review reports and data; discuss any issues or opportunities for improvement; compare results with baseline and expectations; and celebrate successes.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Seth Turnoff

SEARCHLESS Patient Acquisition | Healthcare DTC | Mustache Owner
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Keep a close eye on things once you onboard a partner. The first 120 days will be very telling in your future together.If things begin to slip, you will have time to catch them before it gets too late. The thing with Revenue Cycle - if things are bad enough for you to notice - its REALLY bad.

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How do you know if outsourcing RCM services is right for your practice?

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6

1 Benefits of outsourcing RCM

2 Drawbacks of outsourcing RCM

3 Questions to ask before outsourcing RCM

4 Tips for choosing an RCM partner

5 Best practices for outsourcing RCM

6 Here’s what else to consider

Practice Management

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How do you know if outsourcing RCM services is right for your practice?

1

2

3

4

5

6

1 Benefits of outsourcing RCM

2 Drawbacks of outsourcing RCM

3 Questions to ask before outsourcing RCM

4 Tips for choosing an RCM partner

5 Best practices for outsourcing RCM

6 Here’s what else to consider

Practice Management

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