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The Upsides to Outsourcing Your Clinic’s RCM

It’s no secret that the key to improving overall profitability is increasing reimbursements. Yet, finding and retaining qualified staff to handle medical billing and collections can be difficult and expensive.

More often than not, clinics who report the fastest collection speeds and the least denials have Revenue Cycle Management (RCM) partners to alleviate the administrative burden of the billing process. Clinics that outsource their billing can see a 10% increase in net collections, as they often collect more claims faster. If that isn’t reason enough to outsource your RCM here are four other upsides to consider:

1. Control costs

Clinics that outsource their billing generally have less overhead. Yes, it’s true. Remember, the true costs of an internal billing team include more than just hourly wages, but also the employers share of taxes, employee benefits, software subscriptions, and clearinghouse fees. When comparing an outsourced RCM partner vs. an in-house team, be sure to consider all these costs, plus a higher risk of rejections, denials, decreased net collections, and bad patient debt.

You’ll also want to consider how low-volume seasons and events impact your revenue. While an in-house billing team’s costs will always remain the same, outsourced RCM costs can adapt to fluctuating patient volumes.

2. Reduce risk

If your claims are not settled within 40 days and your first-pass payment rates aren’t at least 90%, it may be time to outsource.

Payer rules are complex and without dedicated billing specialists, claims can take longer to clear, and there may be an increased risk of denials that require time-intensive claim re-submission and negotiation. Outsourced billing teams are not only experts in claim processing they are required to stay on top of fluctuating payer rules — including ever-changing Medicare and CMS updates.

3. Save time

Payer negotiations are time-consuming. They require countless hours on the phone clearing up denials and chasing down payments. From submitting claims to following up with payers, RCM teams handle everything, so you don’t have to. They also have the time and software needed to quickly mitigate and identify issues. It doesn’t take long to see your investment in an RCM service pay off. With an RCM team that is laser-focused on increasing reimbursements, your team can spend more time delivering great care.  

4. Increase cash flow

When you let experts handle the billing, accepted claims will come in faster. Typically, across the industry, clinics should expect a net collections rate of 96%, and RCM teams can help you get there. Plus, with more first-pass payments and less time spent on denials, your bottom line will go up, too.

More money in and less money out means you can invest elsewhere in your organization. Instead of hiring an entire billing team, you can invest in better equipment or new patient engagement tools. And as your clinic amenities improve, so will your reputation that will drive new referrals, all of which comes back to your bottom line.

Don’t stress billing messes

Running a practice isn’t easy, billing and claims collections can be complicated, but outsourcing to an RCM service can help. Avoid the stress and leave it to the experts.

At Clinicient, our Total Insight platform combines clinical documentation, RCM, care planning, outcomes management, scheduling, advanced analytics, and patient engagement tools. Request a free, no obligation demo today or call 1.877.252.4774 to learn more about Total Insight.

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