Debunk the Myth: Outsourcing Doesn't Mean Losing Control

The Landscape of Today's Medical Practice

Today’s Medical practice is not for the faint of heart. As a practice leader, there seems to be no boundaries to the hats I wear and the jobs I perform, but I love it. As a practice leader, I am responsible for;

1.   People and HR

2.   Office operations.

3.   Scheduling.

4.   Check in/ Check out

5.   Supply orders

6.   System maintenance and IT

7.   Leasing and vendor management

8.   Patient satisfaction

9.   Physician satisfaction

10. Growth

11. Retention

And this is just the morning for me. It never ends and is never boring, not for one minute. These days a practice manager is the glue that holds the practice together. The job titles may change, but the responsibilities remain the same. Practice leaders will all agree, WE NEED HELP.

The Real Challenge

You may think the smaller the practice, the easier the challenge. In some areas or instances, that may be correct, but normally the smaller the practice, the less resources the practice employees and the more diverse everyone’s job responsibilities become. The core responsibility and function of a medical practice is to care for patients. Therefore, all practices outsource back office functions, such as accounting or IT. The one function that most practice leaders are hesitant to outsource, is their Revenue Cycle functions.  

For any medical practice, Revenue Cycle Management is a time-consuming, often confusing process with ample room for error and rules that change regularly. Most practice leaders believe they have a handle on the data and bottom line, only to find out they are losing substantial amounts of money from coding errors, lack of resources to handle the work, and a insufficient level of urgency to resolve the problems. Many practice leaders feel that outsourcing such a vital function equals a loss of control. When in reality it is the opposite.

The Top Revenue Cycle challenges

Challenge #1: Ever-Changing Rules

One of the main frustrations of medical billing is that the rules always seem to be changing. New coding systems and updated compliance regulations come out every so often, and if your practice doesn’t keep up with the latest development, you’ll suffer a deluge of problems, setbacks, and rejected claims – all of which can result in major payment delays.

Challenge #2: Insufficient Staff

Keeping a dedicated billing specialist on your staff is great – if you can afford to do it. If you can’t afford it, then your regular staff will have to handle the billing on top of all their other duties, which will likely result in poor morale and a higher turnover rate. And if you can’t keep your staff on board, that means you’ll spend a lot of extra time training new employees, only to watch them walk out the door six months later because the workload is completely unmanageable.

Challenge #3: Too Much Problem-Solving

Rejected claims, Late payments, No payments, Improper coding, the list of potential problems your practice will spend time solving includes all these things, plus other issues like software malfunctions. When your already overworked staff is having to figure out billing problems and pursue past-due accounts, then a bad situation has just become much, much worse – and this kind of heavy, scattered workflow just isn’t sustainable.

Gain control

There is one thing that all practice leaders will agree on, managing the revenue cycle is a full time job. No matter if you are a solo practice or 10 provider firm, if you want to maximize your revenue; you have to dedicate 100% all the time.

With a lack of resources, time and expertize, it makes it virtually impossible to stay in control. Partnering with a reputable RCM, provides you the breathing room to review monthly reports and see at a glance the health of the practice. Things like charge entry errors or payer reimbursement issues can be identified early before they spiral out of control. Transparency and the ability to run any report 24 hours a day gives a sense of control that you never had before. Adding an expert billing team to the mix utilizes a team approach to progress toward mutual goals.