Outsourcing Revenue Cycle Management

Multi-Tasking in front of a computer

When is it time to bring in reinforcements?

By Mike Connors, PT, DPT, PhD

Revenue cycle management is an integral part of the business life cycle of any organization.

In a system where we bill for the services we provide, an effective revenue cycle management effort is imperative to ensure the health and well-being of your practice.

However, even the most diligent owners may find themselves bogged down with billing or distracted by other business demands. Giving too much attention to one item leads to a lack of attention on the other. How do you find balance? And how do you know whether you need help to keep things on track?

In order to best assess the correct option to manage the revenue cycle of the organization, you must first explore whether you have the expertise to keep billing in house or to outsource this service to billing experts.

A favorite quote in business is “no one will go after your money like you will.” While this can be true, a business owner must also realize if they have the requisite expertise to have billing occur in house. In order to be successful in this endeavor, you need to ensure you have the staff knowledge and manpower to complete billing in a correct and timely manner. Solo practitioners may have difficulty handling billing along with a full schedule of appointments, while those managing moderately sized practices may find that they have the right providers and front desk staff, but all lack the ability to successfully manage billing. Hiring a dedicated billing expert may be the right solution.

Technology and systems are equally important in evaluating whether you’re able to effectively handle billing in-house. You will want to ensure that your documentation system and clearinghouse effectively communicate with each other and that the systems will appropriately help the clinician bill and code for the services they provide. The job of the billing expert is to ensure that claims that are submitted to be billed are scrubbed and clean when submitted to avoid delays in billing, and thus delays in payment. After all, time is money!

A second option is to outsource your revenue cycle management to an organization to perform this service on your behalf. While this is an expense that varies based on volume and typically is based on percentage of collections, there is a certainty to the practice owner on relying on a billing expert to undertake this effort on your behalf. A good billing company will have a high level of transparency and will partner with you to ensure an adequate level of collections is occurring for the services rendered by the practice. There should be an open level of communication to ensure that the practice owner is well aware of the health and well-being of the revenue cycle management.

Mike Connors

Mike Connors, PT, DPT, PhD, is a VPCO for Athletico and a PPS member.

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