Healthcare Revenue Cycle Management is the end to end spectrum of administrative and clinical functions that lead to the capturing, management and collection of patient service revenue. This covers the patient account from its initiation to payment.
As you may already know, medical coding is the very important process of going about converting diagnosis codes to ICD-9 codes and procedure codes to CPT codes. Medical Coding also involves HCPC (pronounced “hick-pick”) codes that identified supplies and drugs for correct billing. The Code Certification credential is a way that distinguishes coders on the basis of their exhibiting commitment and demonstrating coding competencies. This is across all settings, including both hospitals and physician practices.
Considering the massive overhaul the health industry is currently undergoing, the decision over whether, or not, to outsource your clinic’s medical billing may be something you have no choice but to consider. You may be discovering that your staff is now having difficulty keeping up with day-to-day routines, while also trying to keep current with an avalanche of complicated legislation, and expansive updates to medical billing codes.
For the longest time physicians were advised to keep billing “in-house” no matter what. But times they are a changing.
You may be faced with multiple fee options if you are considering seeking help with your old A/R cleanup and denial management. Many medical billing companies will charge a very high percentage of what they collect (over 35%). Others may offer a fixed fee approach. Which is best for your practice?
As is so often the case, the best answer lies between these two options. One of the weaknesses of a high percentage of collections with no fixed fee is that the doing the old AR clean-up has no incentive to pursue smaller claims. It will cost well over $20 for each old claim worked by the medical billing company. This means that any claim under $100 will not provide much profit for the company and will likely be ignored. This is an issue because many of the older AR claims are these smaller claims.
On top of the difficult transition to ICD-10, healthcare providers are being pressured to adjust to a multitude of changes alongside the industry. This includes optimizing their Revenue Cycle Management, or RCM.
Implementing cost-effective strategy solutions in conjunction with doctor-patient relationships is equally imperative. In fact, both must work in tandem with one another in order to run a practice that is successful and lucrative.
Parents sending a child off to college for the first time deal with a mixed set of emotions. Worries about sending their child away without supervision arise, but they also realize the potential benefits a college education provides. Deciding whether to keep your billing in-house or have it outsourced is a similar ordeal.
Most physicians and managers have, at some point, wondered whether they should outsource medical billing operations or allow the processes to remain in-house. While there are benefits and drawbacks no matter which you choose, this article will point out several of the reasons you should consider outsourcing your medical billing.
- Affordable Care Act
- Benefits of Outsourcing
- Claims Processing
- Health Plan Patients
- ICD 9/ ICD 10
- Insurance Benefits
- Medical Billing
- Medical Billing Careers
- medical claims
- Medical Coding
- Physician Practice Management
- Practice Management
- Psychology Billing
- Revenue Cycle Management
- Sleep Apnea