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Why it’s Best to Outsource Your RCM

Revenue cycle management (RCM) is one of the most important parts of your clinical practice. It’s also one of the most challenging, especially for small practices with a limited number of staff who are asked to take on a lot during a typical day. Keeping your practice profitable means collecting as much of your billed charges as possible, so for many small and independent practices a better option is to outsource revenue cycle management (RCM) to a third-party vendor. Here are just a few reasons it might make sense for your practice.

1: Manage Growth

As a small practice you may have been able to manage billing on your own, even with limited staff, when your practice was small. As you grow to add new providers, new services, new clinic locations, or more patient volume, that billing can get more complicated. Third-party RCM vendors have expertise in medical billing services for a wide variety of medical specialties and clinic sizes. They also have a dedicated staff of medical billing professionals that they can expand as you grow. You won’t need to hire more staff or provide more training as your needs change.

2: Control Costs

The largest expense for almost any organization—medical practices included—is staffing costs. Hiring a staff member means paying a salary, taxes, benefits, and other costs, and those can add up quickly. If you are struggling with clinic profitability, one of the best ways to cut operational costs is to reduce your staff. Most clinics don’t want to do that on the medical staff side because you want to maintain a high level of service for your patients. Outsourcing your RCM makes a lot of sense to keep staff costs low.

3: Maximize Collections

Healthcare payment models are very unique; you provide a service today, but often don’t get paid for an average of 40-50 days after the service is rendered and you may get paid from multiple sources (one or more payers and patients). The more time that goes by between date of service and payment, the less likely you are to collect the full amount. Practices that have small or inexperienced RCM staff may not be able to focus enough attention on collection efforts to maximize it. If you notice are collecting less than 80% of your billed charges, outsourcing can not only cut costs, it could also improve collections so the overall benefit to your bottom line is significant.

4: Streamline Billing

Medical billing can be complicated, and even small errors can result in denied insurance claims, which shifts the burden of payment to your patients and is frustrating for everyone. An experienced RCM outsourcing company with a good track record for submitting clean claims and getting paid immediately, that also knows how to follow up on denied claims properly, can streamline your services.

Onpoint Medical Solutions is a trusted partner of AdvancedMD, with solutions that integrate medical billing into your EHR for increased productivity and savings. Find out more today.

How to Save Money on Prescription Drugs with GoodRX and RXSaver

Did you know that different pharmacies charge different amounts for the same medication?  What if there was a way to not only find the best price for prescriptions and medications but also get a discount?

It doesn’t matter if you are taking one medication or several, everyone wants to know what the out-of-pocket expense is going to be.  Whether you have insurance or not every dollar counts in medical expenses and the cost of medicine can add up quickly.  And don’t assume because you have insurance that you’re getting the best price for your prescription drugs.

Today, I am sharing two tools that can not only save you money but allows you to compare prices at nearby pharmacies to ensure you are getting the best price.  I have no vested interest in either of these tools.  They are both free; they work, and I just wanted to share.

The first tool is called RXSaver by RetailMeNot.  RXSaver works by giving you access to prescription pricing information.  It can save you up to 80% on your prescriptions, whether you have insurance or not.  RXSaver is an online tool that can help anyone save on prescription medications.  And for those of you who rely on your phone to help manage your life there is even an RXSaver app.  You will want to check out RXSaver for more details.

The second tool is called GoodRX.  GoodRx reports that the country spends more than $500 billion on prescription drugs each year.  Americans pay on average more than $1,200 for their medications per year, which is far higher than in any other developed nation.

They are similar to RXSaver in that they compare prescription prices; show the lowest price and provide discount coupons.  They have both an online presence and a mobile app

GoodRx offers competitive pricing by looking across the various retailers, including Walmart, Costco and CVS.  That price is often cheaper for the consumer than the cash price offered at the register, which is typically highly inflated. 

Check out both RXSaver and GoodRX.  Download the apps and use whichever one offers the best price.

MGMA COVID-19 Medical Practice Reopening Checklist

Do you know what it will take to open your medical practice?  Recently, the Medical Group Management Association (MGMA) provided a COVID-19 MEDICAL PRACTICE REOPENING CHECKLIST that is a great tool to help you navigate this next phase.  Many providers may think that as soon as you announce the re-opening that the patients will come but that may not be true.  So, it is best to plan ahead.  This is a great resource to help you determine your reopening readiness. 

The MGMA has been a leading association for medical practices, administrators and executives since 1926.  They are a national organization representing more than 40,000 medical practices of all sizes, types, structures and specialties.

Billing and Collections is a Team Effort!

Rub employees the right wayIf you want your billing and collections to be as smooth and effective as possible, it must be a team effort.  It can’t be up to just a couple of people and it definitely can’t be a blame game.

Practices are overwhelmed with phone calls, paperwork, pre-authorizations, and patient care.  Sometimes the ‘paper’ things can fall through the cracks.  It is these things that end up snowballing and result in more work, frantic calls and denied claims.

Here are some tips that will help smooth out the process.  They may seem insignificant or deemed to be more trouble than they are worth.  But, in the long run, if everyone on the team does their part, it means less clean-up work, less stress, and faster payments.

The collection process starts BEFORE the patient shows up for their appointment.

  1. If the patient is new to the practice send a welcome packet with all of the paperwork that they need to complete.  Sending it before the appointment helps to ensure they will have all of the correct information.
  2. If they are established patients then remind them to bring their current insurance card.
  3. On the day of the visit, ask to see a copy of the patient’s insurance card.  Too many times this step is either omitted or the staff will just ask if anything has changed.  Most patients will automatically say no simply because they don’t remember.  Insurance plans change more frequently these days, so it is best to verify and update all information at every visit.
  4. Make sure that the name on the insurance card matches exactly to what is entered in your practice management system.  Mis-spellings, missing middle initials, and typographical errors will all result in denied claims.
  5. Collect all outstanding patient balances before the patient goes into the exam room.
  6. Make it as easy as possible for patients to pay their deductibles, copay or self-pay payments.  Allow payments via credit cards, patient portals, mobile devices, and paper checks.
  7. Train select employees to set up payment plans for those patients that can’t pay their portion of the bill in full.  Make sure your back office or billing company knows of these payment plans so they can track compliance.
  8. The billing staff or company can’t bill and collect if charges aren’t submitted.  Make sure that charges are submitted daily.  There should be a check and balance to ensure that a charge was submitted for every patient that had an appointment that day.
  9. Make sure that coding is accurate.  Do you have the correct modifier?  Are the number of units correct?
  10. Make sure the pre-authorization/referral matches the service and the date of service exactly.  Make sure the information is noted on the claim.

When everyone on the team takes their part of the billing and collection process seriously things will go much smoother.  The practice will see an increase in revenue and the staff won’t struggle with clean-up work.  That is a win for everyone.

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