Managers of specialty medical groups often have difficulty categorizing their RCM teams. However, this problem, especially for outpatient RCM processes, can sometimes lead to incompetents in the RCM operations for outpatient services. Understanding why specialty medical group practice managers outsource RCM services can help a practice avoid financial ruin.

Practice managers may find it challenging to manage administrative tasks, which can make them more stressed than outpatient RCM processes. According to a survey by the Healthcare Financial Management Association (HFMA), one in five practice managers can handle their ongoing RCM tasks but have outsourced for additional jobs, like catching up on pending charges a month or two weeks ago.

The report “Outpatient RCM outsourcing data” reflects the feedback of 157 practice managers. It states that a collaborative effort between practice managers and RCM outsourcing firms can lead to improved RCM processes, increasing overall revenue and making it more profitable for them.

Why limit your outsourcing to RCM services for outpatients?

As outpatient services increase and it becomes challenging to bill all charges on the same date, medical group managers and individual practice managers gradually outsource RCM tasks to meet their RCM obligations. This can be done for a few years or when there is more attrition and absence.

Any practice manager or RCM director should be able to rely on an outsourcing partner who can create a custom workflow and adapt it immediately.

Outsourcing RCM services to select outpatients has many benefits:

1. You can save time by outsourcing the most time-consuming tasks of our outpatient RCM processes. This will ensure that 100% of your submissions to insurance companies are timely.
2. Quality Assurance – Quality has always been important when a practice manager faces increased patient volumes. External experts will perform quality audits to ensure industry-standard quality in RCM.
3. Preparation for external audits – Incomplete charts and medical documentation can result in severe repercussions. These can lead to lawsuits and heavy fines. Internal audits can be avoided by outsourcing certain services offered by your practice.
4. You will be appropriately reimbursed – It is possible to keep cash flowing by having a contract negotiating vendor with selective credentialing and contract negotiation. This vendor can periodically review provider credentials and rates and change reimbursement guidelines.
5. Reduce cost – Outsourcing selective outpatient RCM services can help you save money. Because dedicated RCM outsourcing vendors are experts in their field and have experienced real-life situations with other clients, the cost of outsourcing is often greater than what insurance companies reimburse.

These are some of the reasons why specialists medical group managers choose to outsource RCM services for outpatients.

Nearly 22% of practice managers who oversee inpatient RCM processes have already announced that they would outsource a portion of their RCM processes. Only 12% of them will need to do this later. Nearly 10% of practice managers indicated that they might want to outsource all or part of their outpatient and auxiliary RCM processes while maintaining their inpatient RCM processes.

According to the survey, practice managers indicated that the most challenging parts of RCM were not being addressed by technology or experts. This is why medical practice managers and individuals always seek alternative outsourcing when they experience a crisis in RCM operations.

OBGYN and urology were the most popular specialty outpatient medical group practices that OBGYN, anesthesiology and gastroenterology managers outsourced. Other practice managers may have considered outsourcing RCM services to other complex outpatient practices, such as internal medicine, radiology, imaging and other diagnostic or screening specialties.

According to HFMA’s study, individual practice managers and medical groups that outsource RCM services were generally satisfied with the results. The survey by HFMA also found that practice managers who have outsourced a particular RCM process are more likely to outsource others because of the benefits.

For individual practice managers and medical groups more interested in openly allowing RCM processes for selected specialties or having questions about remote outsourcing, Novita Management and our team of RCM and RPA specialists are available for a complimentary consultation. We can answer your questions and help you make an informed decision based on your budget. Managers of practices! You have the opportunity to reap the benefits of specialist medical group practice managers outsourcing outpatient RCM services.