Eyeworld

OCTOBER 2020 | EYEWORLD | 73 I revenue through improved collections and reduce internal costs (salaries, benefits, office space and supplies, and training). The reason many think outsourcing is too expensive is that hiring an RCM firm can in some cases cost more than what you may pay your internal staff. However, that does not take into account what it "costs" you when issues occur, such as employee leaves of absence or staff errors. You are also responsible for the ongoing costs of computer hardware, work- space, health insurance/benefit increases, etc., for internal staff. In the end, if outsourced RCM can demonstrate improved results with solid data, paying more to hire an outsourcing firm may yield better financial results for your business. Myth #3: By outsourcing, I will lose visibili- ty and control of my RCM operations. Outsourcing does not mean losing visibility but rather gaining an additional resource to help manage your revenue cycle processes and resulting cash flow. RCM firms should serve as another set of eyes and controls for your practice or ASC, helping free up time for the client management team by actively monitor- ing revenue cycle billing and addressing issues immediately. Outsourcing also does not mean your prac- tice or ASC loses control. In fact, a good RCM firm should work with their clients to imple- ment the client's desired policies and controls. While an outsourced firm may offer perspective as to what they often see, the client should ulti- mately approve and expect implementation of their policies by the firm. Additionally, while some RCM firms use their own software, which can affect visibility, others will use your existing software so that all activity, transactions, and reporting is transpar- ent and always accessible by the client. Myth #4: Keeping all RCM operations inside our organization will keep data more secure. A trustworthy outsourced RCM firm should be able to show and be willing to agree to secure data transfers between the client and itself. Many RCM firms will log into the client's system remotely to ensure no data is stored at the firm. Myth #5: Billing patients is the most im- portant part of RCM; a full-service RCM vendor is not necessary. While billing a patient is important, it is ac- tually one of the easiest aspects. Many errors occur during other areas of the RCM process. Full-service RCM firms employ an experienced staff with built-in redundancies to handle all RCM components. Full-service RCM firms should: • Be trained to perform patient phone calls for billing questions and payments • Have certified coders on hand to review the ever-changing billing codes, ensuring the practice or ASC is capturing all possible revenue while avoiding potential delays due to billing errors • Have routine processes and people to work insurance denials and "zero pays" • Have people in place to routinely work aged accounts receivable • Be able to provide monthly reporting on results • Be able to verify insurance benefits or interact with all insurance companies as needed • Be available to troubleshoot issues with the client at all times via phone/email/fax By never cutting corners, whether in RCM execution or in staff experience, full-service firms may offer significant value to your prac- tice or ASC. Conclusion In the world of medical billing, there is no "one-size-fits-all" solution. Some RCM firms address certain parts of the revenue cycle, while others provide a more comprehensive solution. An experienced RCM consultant can help you determine which outsourcing opportunity, if any, makes the most sense and will offer the greatest benefit to your medical business. Contact McCarville: rmcarville@medcgroup.com Malloy: emalloy@medcgroup.com LaRue: tlarue@medcgroup.com

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