When practices are experiencing time-consuming regulatory hurdles, increasing technical operating costs, insurance denials and declining reimbursement what can an administrator do? Administrators need to stay focused on performance of the overall practice and consider shifting the strain on your practice’s revenue cycle management operations to an outsourcing solution.

When you review your options consider outsourcing your business office. A question administrators need to ask is whether their clinic has the culture to outsource the business office. There is always resistance to change in every clinic, whether it is a new doctor or manager or a new EHR or practice management system. Some clinic staff will deal with change effectively and others will resist.

An administrator needs to review staffing issues and address the culture issues before taking on big initiatives. Financial viability depends on administrator leadership and the health of the practice must override the wishes of individual employees or providers. Meeting one-on-one with informal leaders or practice “Champions” to get their buy in is a wise use of time. Cultural resistance to change is a serious detriment to a successful business. Resistant staff must be given an ultimatum or removed when they consistently drag down change initiatives, no matter how valuable they are (or it appears they are).

ORI works with practices to influence a comprehensive culture change towards a business oriented model. This begins with an assessment which provides projections on cost savings and change initiatives that focus on quality front end data entry, increased productivity, and efficient billing workflows. The goal is to increase reimbursement, decrease aging and increase recovery rates with more robust technology and fewer staff. While administrators see the bottom line improving with outsourcing, staff may feel threatened by the change. Administrators can strategically shift billing operations to outsourcing while reduce internal staff and then re-purpose office space and equipment to drive production and quality.

The Medical Group Management Association (MGMA) provides accepted bench marking for staffing ratios. Outsourcing will reduce the support staff and technology  costs significantly. ORI assesses these savings with practices and provides projected savings reports prior to establishing contractual relationship (MGMA Executive Summary Report).

Communicating with patients and health insurance companies is a big area of savings with medical billing outsourcing. Outsource Receivables operates as a first party service so patients and insurance companies experience a seamless transition and a clear separation of responsibilities with the outsourcing company and clinic staff is required for success. For example, if a front desk staff person questions a patients bill or calls for a review of insurance coverage it can create conflict with patients and the clinic. The billing office staff will follow the explanation of benefits and work any denials directly with the insurance company. Once the insurance has paid, the billing office will hold the patient accountable for their balances and establish qualified payment plans when necessary. Ensuring that there is clear and consistent communication and a culture of patient responsibility may be a big change for some clinic staff. ORI assists with the transition by providing front desk staff training on consistent patient policy and trains staff on new technology. Once staff understand that the outsourced billing office is a valuable resource they stop trying to research balance inquiries and rely on their billing partner’s expertise.

With the challenges of bringing about change it can be easy to put decisions off. Some clinics wait until they are far behind and have a huge backlog of aging. ORI recommends that you take the first step and get a free outsourcing assessment of your practice. We will provide a review of processes, technology and financials to give you a clear picture of how much can be saved by outsourcing. Typically, the savings are significant when you consider that your entire billing office will be offsite with the most advanced technology. The savings are even greater when ORI helps clients on-board a new practice management and EMR/EHR system. With advanced systems in place, clinics can automate many of the duties handled by staff, and implement new processes and workflows that drive down costs.

The end result is that you will maximize revenue collected from both patients and payers, increase cash flow by reducing days in A/R, improve patient satisfaction and staff productivity and improve your decision making with access to specialized expertise and reporting.

To get your Practice Assessment and learn more about the benefits of outsourcing with ORI, contact Dan Smits today.

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