It is no news that there is a growing shift
in RCM work being transitioned out from in-house billing teams to specialized
RCM companies. But this trend raised a daunting question – Why are healthcare
providers and business owners unable to achieve their goals despite having a
team under the same roof but can do so with a team off-site?
There are many noticeable scenarios where
we can see in-house healthcare RCM teams made up of well-paid and experienced
staff that end up doing only certain aspects of the RCM functions effectively.
The common concerns shared by business owners cannot be simply solved by an
in-house billing team: a fact that business owners are painfully realizing and
coming to terms with.
Healthcare providers are operating at a
time where reimbursements and margins have plummeted. Happy workers who punch
out claims and punch in payments day in and day out are not what business
owners are looking for. Business owners are looking for results that move the
needle, giving them a stronger footing today vs. yesterday and a road map that
ensures they are on the safe side of industry curveballs. After all, the year
2020 has opened our eyes to the uncertainties that surround us.
To be fair and unbiased, healthcare
providers must be warned about the risks that could come with partnering with
the wrong RCM company. Due diligence is critical before you chose the right
partner for you. Aurora-Consulting is designed to provide exactly that type of
expert consultancy that ensures healthcare providers are informed and guided
when making such necessary decisions.
Here are 4 key reasons why a “Specialized
RCM company” has an incredible advantage over “In-house Billing Teams”:
1. Focus and Alignment
The primary focus of a healthcare provider
is patient care. The primary focus of a specialized RCM company is cash flow.
Healthcare care providers are aligned with
providing great patient care, health results, and patient customer service. RCM
companies are aligned and compensated for maintaining healthy cash flow.
2. Structure
For a Healthcare provider, their billing
team is a cost center and is not always structured adequately or strategically
to follow the life cycle of a claim. Specialized RCM companies are structured
as SBUs (Strategic Business Units) that follow the life cycle of a claim and
intervene as required with knowledge and expertise.
3. Energy
Unfortunately, the cost center mindset of
in-house billing teams does not give them the attention or nurturing needed
from their leaders every time. Specialized RCM companies on the other hand find
excuses to celebrate the progression of a client’s cash flow ex: the
overturning of a denial, breaking a revenue record, or improving the days in
AR.
4. Knowledge Pool
In-house billing teams have insight and
knowledge of how the care given to patients converts into ICD codes, CPT codes,
and Charges but all their learning is limited to what happens within the
practice.
Specialized RCM companies learn from a vast
pool of comparable healthcare providers and bring forth only the best practices
and solutions that have proven results and advice against the ones that have
failed.
We believe in providing value before
providing a bill, which is why we provide a free comprehensive consultation to
anyone looking to improve their revenue. Contact us at info@aurorarcm.com and
start benefiting today.
