Are you struggling between revenue cycle management and core practice? If yes, then to your great relief, you are not alone. Submitting claims to the payers efficiently with minimal denials and collecting dues in a timely manner is a dream run for any provider’s office - a far-fetched dream, however.
According to the Black Book survey, practices of all sizes are contemplating to outsource their revenue cycle management. The constantly changing medical regulatory environment along with ICD-10 transition are continuously causing profit margins to shrink, making even bare survival difficult. In fact, many a providers are facing worries to streamline their revenue cycle management process so much that in the process losing on the quality in their practice.
Revenue Cycle Management (RCM) is certainly vital for running a successful practice. The revenue cycle process that starts with patient’s appointment and ends with collections also includes appointment scheduling and insurance eligibility verification. Coding and charge capture, claims submission, payment posting, statement processing and the management of denied claims - all form part of RCM. The extent of efficiency with which these steps are performed directly impacts your ability to get paid the full amount as quickly as possible. However, keeping your RCM sprightly at the expense of quality of practice is hands down a poor bargain.
ICD-10 transition has literally shaken the medical billing world with its repurcussions, soliciting substantial investment toward staff recruitment, training and updating technology. To top it, updating the technology poses an imminent risk of obsolescence along with a very heavy expenditure each time. In simpler words, it is no longer profitable for a provider’s office to manage its revenue cycle mangement in-house
A medical billing services, on the other hand, has a team of qualified, experienced and trained billing coders and technicians who are both prepared and well equipped to deal with the changing rules, regulations and coding requirements of the medical insurance arena. They are better informed about important industry changes (e.g. – HIPAA updates, changes from the ICD-9 to ICD-10 disease classification series, etc.), with their vast knowledge and learning on the job, providing vital services to a host of other practices. A billing service provider also operates at lower rates as it distributes its running expenses across its entire client base. Medical billing being its core business, the service provider can afford to acquire the best of staff possible. The highly trained team focuses on increasing your profitability. Not to mention, a professional medical billing service also provides you with detailed monthly reports and accessibility to the reports 24X7, giving you a sense of control over your revenue management process like never before. The staff of the medical billing service submits claims faster and with least error, enabling provider’s office to receive payment from payers in the shortest turnaround time. Payments are posted by professionals, resulting in denials being detected up front. The denials are re-worked upon and re-submitted for timely payment. The service provider further transmits claims electronically to all possible carriers. This also cuts the reimbursement cycle to the shortest possible.