5 Reasons You Might Need a Third-Party RCM Partner

So far, 2020 is bringing unprecedented challenges to the healthcare industry and beyond. Ensuring a strong and stable bottom line will require fiscally sound oversight and management of the reimbursement function from the initial patient access point through the entire revenue cycle management (RCM) process.

If your organization was struggling with financial and operational issues before the COVID-19 Public Health Emergency, there is every indication that this will continue or increase as people return to work and patients return to the healthcare system. Now is the time assess the current state of your business and to examine how engaging a third-party partner might positively impact your bottom-line.

5 Areas That Benefit From Honest Review

Let’s look at the primary areas that show stress and the need for additional support. These five areas are often overlooked when stakeholders get too busy or are distracted:

  1. RCM Staffing— Finding and maintaining well-trained business staff seems to be an ongoing and overwhelming challenge. Maintaining exemplary RCM staff that meet and exceed revenue goals means a constant focus on recruiting, hiring, onboarding, and training, not to mention scalable coverage issues due to shortages from lost time or an influx of patients.
  2. Expanding Patient Collections As healthcare participants continue to feel the growing impact of High Deductible Health Plans (HDHPs), financial policies are more important than ever. Without accurate information, accountability, and oversight, can you be sure that responsible business staff are in fact collecting the right amount?
  3. Breaches in Intermediate Processing Once a patient leaves a treatment area, there are a series of functions that must all take place to ensure accurate reimbursement. This can be complicated by missing charges, documentation issues, coding errors, and timeliness concerns.
  4. Actual Performance is Not Meeting Set Goals—S tandard financial goals that are reviewed continually provide constant feedback, such as:
    1. Days Outstanding and Net Days in AR – an indicator of overall performance
    2. Cash Collections – operational performance and financial policy adherence
    3. Bad Debt – at risk of being a total loss of income
    4. Stagnant Denials Management – rejected claims not being processed, corrected and resubmitted
  5. One Time Events like Major Upgrades or Transitions in Technology— One-off situations come up and can be managed more easily with expert transition support.

What You Gain with a Third-Party Partner

When engaging support from a remote team, revenue integrity is gained through advanced automation and a highly specialized and experienced workforce. Accuracy rates improve with steady focus (and no distraction), and powerful analytics allow you to keep a finger on the pulse of the results. Expect improvements to the following:

  • Better Reimbursement— Pristine coding, timely billing, and well-managed denials all lend themselves to better overall revenue
  • Accelerate and Increase Cash Flow— Improved AR management leads to an increase in cash flow needed to fund operations and launch expansions
  • Improved Patient Satisfaction— Patients deserve the best experience available with accurate pay estimations and fully communicated financial policies
  • Scalable Productivity— Eliminate training and ongoing hiring issues by relying on an experienced third party partner to become a seamless extension of your staff
  • Cost Savings— Advanced technology virtually eliminates redundant, time-intensive labor for many manual processes

With the economies of scale, a third-party partner can support your financial goals by exceeding industry best practices. From coding and billing through the claims denial process, a third-party RCM partner may be the optimum solution to increase efficiencies and your bottom-line.

Learn more about partnering with a third-party group that can positively impact your bottom-line.

About the Author

Infinx
Infinx Healthcare provides innovative and scalable payment lifecycle solutions for healthcare practices. Combining an intelligent, cloud-based platform driven by AI with our trained and certified coding and billing specialists, we help clients realize revenue, enabling them to shift focus from administrative details to billable patient care.

Leave A Comment

×

SUBSCRIBE TO OUR NEWSLETTER

Subscribe to our monthly newsletter for industry updates on prior authorization and RCM.

Speed Up Prior Authorizations Using Automation and Artificial Intelligence

Accelerate your approvals, collect more revenue, and improve the patient experience

Schedule a Demo