5 Reasons to Outsource Your PT Clinic's RCM

If you’re at a place where your clinic’s billing is the bane of your (or your staff’s) existence, it may be time to get some help. Not every practice needs to outsource its billing—let’s make that perfectly clear. If you have an expert biller (or a few) on staff—and you’re not experiencing any major billing frustrations—then outsourcing is probably not the right move for your clinic. But, for the clinics that are overloaded, overwhelmed, or completely burnt out on billing, it may be time to consider some revenue cycle management (RCM) outsourcing options. Who knows? Offloading your RCM process could be the perfect move for your clinic. Here are a few benefits to outsourcing: 

1. You’ll free up loads of time. 

“Billing takes barely any time at all!” said no one, ever. Real talk: RCM is complicated, and it takes a lot of time and/or manpower to successfully pull off. So, if you outsource your RCM needs, then whoever handles the billing in your clinic will suddenly find themselves with oodles of extra time. They could then devote that rediscovered time to other pressing initiatives (e.g., deploying marketing campaigns or improving the patient experience), or to improving the quality of their other work. Reducing work responsibilities could also boost employee morale, which could improve your company culture—which could lead to all sorts of cascading positive effects. You get the idea!

2. You won’t have to track—or worry about adhering to—tumultuous payer policy changes. 

Every year, Medicare publishes a myriad of updates to its billing policies that billers must follow to the letter. Additionally, commercial payers sometimes update their billing policies in response to Medicare’s updates—and that’s on top of the other updates that they periodically roll out. The Department of Health and Human Services (HHS) frequently changes HIPAA guidelines. Even individual states occasionally create new billing laws. It’s a lot to keep track of, but the good news is that a good RCM team will track—and adhere to—these changes for you. Talk about a relief!  

3. You’ll likely receive fewer claim denials and improve your clinic’s claim processing time. 

Speaking of good RCM teams: they’re comprised of billing experts. In addition to staying up to date with payer changes, these experts are less likely to make common billing mistakes, thereby reducing your office’s denial rate. Take for instance: our team has a clean claim submission rate of 98.5%. It’s hard to beat a number like that! In addition to helping you achieve a lower denial rate, a good RCM team can help you reduce days in A/R, improving your cash flow and preventing money from getting stuck in limbo before it runs through the whole pipeline. 

4. You might increase your collection rate.

Becker’s reports that some clinics may actually see a slight increase to their collection rate if they trade their in-house billing efforts for an outsourced RCM team. That’s because RCM teams can typically reduce rejections and denials, which improves claim turnaround time. That, in turn, increases the likelihood that you’ll collect patient payment because—according to a study conducted by McKesson—your chances of successfully collecting payment drop from 90% or better to 29% over the course of seven months. (Of course, the best way to boost your practice’s patient payment collection rate is to collect at the time of service whenever possible.) A global market report found similar trends: “Practices and hospitals that have outsourced their revenue cycle management function to third-party experts have experienced significant improvement in their collection rates, denial resolution efficiency, patient satisfaction rates, and revenue.”

5. You could save some dough. 

Hiring staff is expensive. You’re not just paying the amount on an employee’s paycheck: you’re also paying for things like health insurance, 401k-matching, and holidays. In some cases (especially if you’re working in a smaller clinic), it’s cheaper to pay for an RCM service than it is to hire in-house help. Another thing to consider: In-house billers need a good billing software to maximize their performance, and while you shouldn’t overpay for software, it’s an additional expense that you’ll have to absorb. Finally, don’t forget about the higher collection rate and steadier cash flow that an RCM team can provide; that’ll pad your RCM ROI even more!

 Outsourcing your billing may not be the best move for your practice—or it might be the move that steers you out of troubled waters. You really have to decide what’s best for your staff and your budget-related needs. (If you need help making that decision, take this quiz.) In the meantime, if you have any RCM-related questions, feel free to leave them in the comment section below!