“With the ever constant changing landscape of insurance requirements, reimbursement policies, and federal regulation, it is comforting knowing that OHS helps us to run our practice in an optimal way. ”

Jason Brodsky, M.D., President
Inpatient Surgical Consultants, PA

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Benefits of Using a Medical Billing Service for Improved Revenue Cycle Management

Are you thinking about oursourcing your medical billing to a medical billing service? Below are some of the top reasons people look for a company to help with their revenue cycle management. Keep reading or click to download a PDF version of this whitepaper.

SAVES TIME/RESOURCES

It takes a great deal of time to hire, train, and maintain a revenue cycle management (“RCM”) staff. With the ever changing regulations and protocols in the healthcare industry, outsourcing relieves your business of these burdens and allows you to focus on the core of your medical practice.

ENHANCES REVENUE GENERATION

A RCM service will be able to generate a higher practice income through efficiencies of scale, broader experience with payors, resources dedicated to denial management, and self-pay follow-up, even after calculating the fees.

DECREASE DAYS IN A/R

Lack of follow up is a major contributor in lost revenue. Contributing factors such as timely filing issues, contractual allowances and write offs result in an increase in days in A/R.

MONTHLY REPORTING

A contemporary RCM service will provide customized monthly reports and analytics that offer a deeper look at key metrics, allowing the organization to make better strategic decisions. This should include provider productivity, coding methods, resource management, enhanced patient care and myriad other practice specific ones.

DETAILED INFORMATION (COST/UTILIZATION PATTERNS TO ASSIST IN CONTRACT NEGOTIATIONS)

Negotiating with payors in today’s environment is not only a tedious process, but puts a tremendous strain on providers and their management team. Having detailed, empirical historical information on an ongoing basis is a competitively enabling foundation when negotiating contracts.

DESIGNATED TEAM

A RCM should be your “Business Partner”, not your “Billing Company”. Clients should have dedicated personnel to handle your account almost as if they were your own employees..

SINGLE POINT OF ACCOUNTABILITY

When outsourcing, you have an accredited organization focused on the highest level of performance while providing checks and balances, making sure there are no inconsistencies. This allows for a more efficient billing process that offers a one stop solution.

COST OF BUILDING A CBO (TRAINING, TURNOVER, RECRUITMENT, CERTIFICATIONS, COMPLIANCE PLAN, ETC)

The costs and personnel complexities associated with implementing and running a CBO is very high. A CBO administrator is required to hire, train, certify and carry out a compliance plan. The average cost of recruiting, hiring and training a new employee is $3,500 (that does not include the decreased production caused by turnover). Technology (hardware/software) resources, salary, benefits and office space are just a few contributing factors to the overwhelming expense of in-house billing.

GOVERNMENT PROTOCOLS

With the complex regulatory environment in the healthcare industry, the demands for billing knowledge and experience have become overwhelming for healthcare providers. Full service billing services are in demand partly because of their efficient administrative processes, HIPAA compliance, and their ability to stay contemporary with regulations and requirements.

TECHNOLOGY

End to End Management of IT – Ability to meet the demand for skilled IT personnel, continuous assessment of your application (Industry Standards, HIPAA), hardware, network, heating, ventilation, HVAC, power, security, staffing, policies, procedures, upgrades, backups, monthly maintenance fees and the ability to integrate various systems and deploy new technologies.
*Offsite Backups – required by HIPAA
-“Data backup plan (Required). Establish and implement procedures to create and maintain retrievable exact copies of electronic protected health information.”
--From the Department of Health and Human Services

BILLING BUSINESS IS DIFFERENT FROM YOUR CORE BUSINESS

Medical Billing is complex and requires 100% of your staff members’ time. Practices are looking to full service billing partners to allow the practice to focus on quality patient care.

CONTINUOUS CHANGE IN HEALTHCARE REGULATIONS

With the constant change in health regulations, providers no longer have the time and resources to dedicate to reading material, checking websites, interacting with payers and attending industry

Download a PDF version of this whitepaper.

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