5 Key Signs it's time to outsource your RCM

Like many other physician practices, you might be not sure whether or not to outsource your  Revenue Cycle Management functions. You may have already outsourced payroll and transcription, but when it comes to billing, you might think “Will that be worth it?”


You may rethink the idea because you feel the costs would be too much and you might be losing control of this very important aspect of your business.


In reality today, many medical practices and organizations are choosing to outsource billing and coding rather than manage them in-house. For most, it’s a difficult decision that affects all areas of the practice. But in the end, every dollar being collected are compelling enough reasons to make the switch.


Here are five key signs it might be time for your practice to outsource the  Revenue Cycle Management :


1. Revenues are diminishing
Coding and billing inefficiencies and reduced payment from insurance companies are the two main reasons why practices experience shrinking collections. Getting to the root cause of the problem calls for a detailed analysis of various procedures and requires investment of time and money. An outside resource with expertise in  Revenue Cycle Management can help to identify the issues and propose solutions.


2. Insight on your practice’s performance

Do you have immediate access to the financial performance of your practice? Or does it take a few days; or weeks to compile reports and assess the results? Having access to practice data on a real-time basis allows you to quickly identify AR issues, but if your internal billing system isn’t delivering this level of insight, you may be missing valuable information.


3. Staff management is time-consuming and expensive
Many practices experience reduced revenue collections when  the practice typically relies heavily on their staff to perform various roles and functions. When a staff member is absent, it can cause your revenue cycle to decrease in overall cash flow.  Finding substitute during absence has always been very difficult, but the increased complexity of billing and coding makes finding skilled resources for short-term engagements almost impossible. Unfortunately, there are few easy answers, as health care organizations look to optimize staffing models without sacrificing clinical quality and operating efficiency.


4. Regulatory issues are too complex to handle
Outsourcing RCM is a beneficial option for practices that are finding it difficult to handle compliance and regulatory challenges. With the implementation of ICD-10, these issues will become more complicated. Clearly, compliance and regulatory issues will continue to grow more complicated and will require a level of expertise that many practices don’t have in house.


5. Patient time and quality care getting affected
Managing the administration of your practice can become all-consuming, but in today’s competitive environment it has become necessary to build a successful doctor-patient relationship. If you find you have left with less time to spend with patients or manage relationships with your hospitals and partners, you should find ways to re-balance your workload.


If your practice is facing any of the above mentioned issues, it’s time for your practice to outsource your RCM functions to get your revenue cycle back on track. Outsourcing has long term benefits, which will be worthwhile. It will not only help optimize revenue but also improve the workflow of a medical practice.