The healthcare industry is presenting physicians with serious challenges from staffing shortages and rising costs, to complex regulations and declining reimbursements. Managing a business devoted to patient care while maintaining a thriving practice can sometimes feel overwhelming.
A recent study sponsored by Synchrony found that over 60% of physician practices are looking to outsource their front-end business and financial management of the organization. This solution is gaining traction to alleviate administrative burdens and empower physicians to focus on what matters most – providing exceptional patient care.
Why Outsourcing Revenue Cycle Management (RCM) Makes Financial Sense
Outsourcing healthcare revenue cycle management (RCM) is a strategic move that many physicians are embracing.. By partnering with a reputable RCM service provider, physicians can unlock a wealth of benefits that directly impact their practice’s success.
In this article, we’re focusing on the six top reasons physicians are choosing to outsource their RCM.
1. Staffing Shortages Impact Healthcare Practices with Lack of Specialized Talent
The healthcare industry faces a well-documented staffing crisis. MGMA reports that 58% of medical practices say that staffing is their number one challenge. Finding and retaining qualified medical billing and coding professionals can be a significant hurdle for small to mid-sized practices.
Outsourcing RCM services benefits clinics from a dedicated team of experts with specialized medical billing and knowledge of coding regulations. These teams stay current with evolving standards and have the experience to optimize claim submissions and maximize reimbursements. Partnering with an RCM company allows physicians to tap into this specialized talent pool without the burden of recruiting, training, and managing in-house staff.
2. Increasing Operating Costs is Challenging all Healthcare Practices
High overhead costs significantly contribute to a practice’s cash flow challenges, and 60% of overhead costs are not attributable to patient care. Salaries, benefits, office space, technology, and administrative expenses contribute to the bottom line.
Outsourcing RCM services helps a practice dramatically streamline operations and reduce costs. RCM companies operate with economies of scale, leveraging technology and expertise to achieve greater efficiency. This translates to cost savings for any practice, freeing up resources that can be invested in patient care, staff development, or new equipment.
3. Complexities in Healthcare Payment Collections are Hurting Cash Flow
Collecting fair payments for medical services through insurance reimbursement is a constant challenge for physicians. Insurance plans, with their always-changing rules and regulations, make it difficult to accurately predict and maximize reimbursements. Furthermore, managing patient co-pays, deductibles, and out-of-pocket expenses adds another layer of complexity.
Over 15 years ago, a patient’s responsibility for healthcare payments represented about 12% of total revenue for a healthcare clinic. Today, it’s over 30% and will soon be closer to 40%-50% of contracted rates. High deductible health plans and increasing co-pays are requiring physicians to collect balances at most every visit. According to MGMA, practices will send an average of 3.3 billing statements before a patient’s outstanding balance is paid in full.
RCM service companies possess in-depth knowledge of payer rules and reimbursement policies and have advanced technology that streamlines insurance claims processing and patient collections.
RCM service companies will leverage this expertise to ensure insurance claims are submitted accurately, efficiently, and on time, minimizing denials and delays in payments. Additionally, they can handle patient communication and collections, reducing the administrative burden on your practice staff and fostering positive patient relationships.
4. Physician Insurance Reimbursements are Declining
Unfortunately, physician reimbursements have steadily declined in recent years. When adjusted for inflation, Medicare physician payments have decreased by 26%–29% in the last 20 years. This decrease in income directly impacts a practice’s financial stability and its ability to provide quality care.
RCM services companies can increase the rate of claim accuracy and reduce denials, playing a vital role in mitigating the negative impact of declining reimbursements. Additionally, it’s more important than ever to streamline operations and reduce overhead costs. That’s where your RCM service company will help your practice operate more efficiently, ultimately boosting your bottom line.
5. Healthcare Industry Regulations and Compliance is too Complex
The healthcare industry is heavily regulated, with a complex web of compliance requirements to navigate. The business of healthcare is tied up with the inefficiencies of government regulations and insurance bureaucracy. Failing to adhere to these regulations can result in hefty fines, penalties, and even jeopardize a practice’s ability to operate. Staying updated on changing regulations can be a full-time job in itself.
RCM service companies employ compliance specialists who stay up-to-date with the latest regulations to ensure your practice adheres to all coding, billing, and documentation standards. This comprehensive expertise provides financial peace of mind, allowing you to focus on patient care without the worry of compliance violations.
6. Physicians Want to Focus More on Higher Value Investments of Time
As a physician, your primary focus is likely your patients’ well-being. However, the administrative burden of managing the revenue cycle takes time away from patient care, adding to the business-side frustrations of managing a healthcare practice.
Outsourcing RCM allows you and your staff to free up valuable resources, dedicating them to higher-value activities. This may include spending more time with patients, offering preventive care services, investing in professional development, or pursuing research opportunities.
Unislink Can Help Your Practice Boost Its Bottom Line
Unislink is a leading provider of comprehensive RCM services dedicated to alleviating the administrative burdens faced by physicians nationwide. Our team of dedicated professionals possess a wealth of experience and leverage cutting-edge technology to ensure accurate coding, efficient claim submission, timely reimbursements, and improved patient collections.
At Unislink, we understand the unique challenges facing physicians. Our RCM services are tailored to meet the specific needs of your practice, ensuring a seamless transition with your EHR/EMR system and resulting in optimal financial payments.
Our comprehensive suite of services include:
- Revenue Cycle Analysis: We conduct a complimentary, thorough evaluation of your current RCM processes to identify areas for improvement and develop a unique and tailored strategy to enhance revenue and efficiency.
- Medical Credentialing: We navigate the complex credentialing process to ensure providers submit accurate billing claims on day one.
- Patient Demographics and Insurance Verification: We accurately collect and verify patient information and insurance eligibility to minimize claim denials and delays.
- Coding and Charge Entry: Our experienced medical coders ensure accurate and complete coding of medical services, maximizing reimbursement opportunities.
- Claim Submission and Follow-Up: We handle the entire claims submission process, including electronic and paper claims, and diligently follow up on outstanding claims to expedite payment.
- Denial Management: Our dedicated team investigates and appeals denied claims, working to recover lost revenue and improve claim acceptance rates.
- Patient Billing and Collections: We manage patient billing, collections, and payment plans, improving patient satisfaction and reducing outstanding balances.
- Reporting and Analytics: We provide comprehensive reporting and RCM data analytics to give you insights into your practice’s financial performance and identify areas for improvement.
Outsourcing your RCM to Unislink is an investment in the success of your practice with a proven return for your company. By improving efficiency and maximizing revenue, we not only immediately help your bottom line, we also empower you to deliver exceptional patient care while achieving your long-term financial goals.
Take the next step toward financial freedom. Contact us today and learn more about how our RCM services can transform your practice for the long term.