In the 2015 Black Book report, 85% of solo and small physician practices are considering switching to an outsourced revenue cycle.
This report suggests this is because many consider their processes to be out of date as result profitability is declining. Since more physicians are looking to counter the employment trend and stay independent, outsourcing medical billing is gaining appeal.
Outsourcing can reduce personnel headaches, and it can increase revenue through the use of best practices and trained billers. Outsourcing certain parts or your revenue cycle such as the billing will provide for better patient experience. Nearly 50 percent of patients have trouble understanding their medical bills. Medical bills are the number one source of frustration among patients.
Even so, practices can be hesitant to change their processes around patient collections for fear of upsetting patients or causing more problems in the collections process. The reality is that having clear policies, methods, and procedures often has a positive effect. When checking eligibility and completing prior authorizations, your practice can verify coverage and provide up-to-date information to patients about their medical bill. The process may be completed in-house, or you can outsource. Outsourcing is a more cost-effective solution then handling in-house. Often, eligibility verification and prior authorizations are done on a flat fee for a set number of transactions where a per transaction fee may be charged after.
According to the American Medical Association (AMA), prior authorizations are expensive at around $11 a piece when done in house.
The ability to verify coverage allows your front office staff to collect copays at the time of visit. Having coverage information at your fingertips can reduce overall patient A/R and post-visit collections, benefiting both the medical practice and the patient. When the visit is complete, the patient responsibility amounts can be handled by your billing service. Primarily, your front office staff is done with managing the patient collections after the copay. The billing service forwards patient due amounts upon receipt of the explanation of benefits and electronic remittance advice and sends out patient statements. The billing service can also handle patient billing calls, removing this from your workload.
Having fewer phone calls about billing issues will benefit not only your staff, but it will also benefit patients by reducing hold times and allowing you to focus your attention on the patients that are in for their appointments.
When patients call your office, they may wait as much as seven minutes or more on hold. Meanwhile, patients in the waiting area may become irritant. Reducing the number of billing calls can help with this issue. Having a patient portal is part of the solutions. Otherwise, some services will manage your incoming calls and deal with appointment setting, prescription refill requests, and other patient needs. Outsourcing phone calls leave your staff free to focus on patients who are in the office.
If your medical office is struggling with patient satisfaction because of phone wait time, patient collections, and in office wait times, outsourcing will help. Moreover, it may do so at a reduced cost compared to what you pay today, while also cutting staff management, which is often a time-consuming task. Overall outsourcing the main components of your revenue cycle is the most cost-effective solution available.