What if your billing team went away tomorrow?

What if your medical billing team went away tomorrow?

It’s happened to more than one practice.

Like many specialty medical practices, you probably have an in-house team that handles your revenue cycle management; From billing to coding, to auditing, collections, payment posting, claims re-submissions and dealing with payors. For some practices, this in-house arrangement works just fine, but have you ever thought about what would happen if your in-house team happened to fall apart, either because of employees finding other jobs or even retiring?

It’s every physician’s nightmare, but it doesn’t have to be. In fact, it might be time to explore another solution. A solution that would keep your revenue cycle management intact, no matter the circumstances of your practice.

Here are 2 significant advantages your practice would have if you considered outsourcing critical revenue cycle processes and leaving your team to focus on patient care and follow-up:

1. Many in-house medical billing and coding teams fail to keep up with changing regulations

Merem Healthcare Solutions Director of Billing Operations, Jennifer Smith, knows about this challenge intimately. She explains, “Carriers will change their policies and guidelines frequently. Without the proper knowledge and resources to stay up to date on these changes, this could be an extremely risky situation that could lead to lower reimbursement and an increase in denials.” Lower reimbursements and increases in denials obviously impact your practice’s bottom line in a big way.

When considering outsourced solutions, you will want to look for a strategic partner staffed with healthcare executives who have spent years in the physician practice space. These types of leaders have experienced these problems first-hand, and have developed proven solutions that have a mission of meeting or beating industry benchmarks, which are:

% of outstanding A/R = less than 120 days or -15% or less
30 days or less in A/R
97% or above net collection rate
Coding accuracy above 98%

You should examine whether your existing office staff is currently meeting or exceeding these goals, and if they are not, you should consider outsourcing.

2. Many in-house medical billing and coding teams occasionally miss charges

Let’s face it, your in-house teams do a lot more than just billing and coding. In busy physician practices, they might also be asked to answer phones, do patient intake, and handle other tasks that interrupt their regular day-to-day jobs. It’s not their fault; it’s the nature of a busy, profitable physician practice. And when this multi-tasking is taking place, it stands to reason that employees are occasionally missing charges, among other things.

If this is the case at YOUR practice, you might consider an off-site outsourcing solution as a resolution to these issues that will invariably come up with an in-house staff. Jennifer Smith points out, “This is our team’s job every day, and they do it well. They have the resources available to locate and stop denial trends and/or carrier changes. They are not interrupted by other duties and responsibilities, as is what often happens within physician practices.”

As you probably already knew, there are several “gotcha” moments in the lifecycle of in-house revenue cycle management, which adds up over time in terms of revenue lost, inefficient productivity, and lack of ongoing training. Simplify your practice and your life by considering the advantages that outsourcing brings, and spend more time focusing on the things that are really important to you and your practice.

Merem Healthcare Solutions offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. We offer a wide range of solutions which include auditing, billing, coding, consulting, credentialing, payment posting, practice management, and pre-collections training. Check us out on our website or feel free to call us to see how we can help run your practice like a well-oiled machine – (205) 329-7519.