August 10, 2015

How Can a Revenue Cycle Management Company Help You With ICD-10?

By Alex Tate

If you’re part of a small practice, you’ve no doubt found the past few years in the healthcare industry to be a little overwhelming at times, to say the least. With mounting regulatory challenges, escalating costs, and fewer reimbursements, providers are feeling real strain. And now, with the looming ICD-10 transition, many practices are scrambling to become compliant by the Oct. 1 implementation deadline.

You may have thought about outsourcing to a revenue cycle management (RCM) company but wondered if that would be a waste of your resources. While it’s true that you can take the necessary steps to train your staff and keep all of your coding and billing in-house, the bigger truth is that outsourcing your coding and billing to a revenue cycle management company can offer tremendous benefits:

They’re Already Up and Running

By now, most RCM companies have transitioned to ICD-10, so they are very comfortable with the new codes and have become highly efficient at using the new system. Your practice can leverage this efficiency to maximize revenue.

Proper Coding and Documentation

No provider wants to find itself in the middle of an audit, which is why it’s critical to maintain proper coding, billing patterns, and full and complete documentation. A quality revenue cycle management company is a true partner and can work with you to ensure that all of the i’s are dotted and t’s crossed with each claim submission.

A Whole Team at Your Disposal 

Besides dealing the new coding headaches, in-house billers have a plethora of other tasks and responsibilities that are necessary to help you get paid. When you only have one or two people on your team, it can be extremely difficult to follow up with all patients and payers in a timely manner. But when you outsource your billing needs, you have a whole team at your disposal that is working tirelessly to make sure you get paid on time, every time.

Avoiding Training Hassles

The ICD-10 transition calls for significant staff training to make sure everyone will be up to speed by the Oct. 1 deadline. The thing is, this training is not a one-time deal, but will require an ongoing commitment as more changes and updates emerge down the road.

Most small practices simply don’t have the time or resources to keep up with this training, but if it doesn’t happen, the odds of remaining compliant and getting paid become smaller and smaller. When you outsource your billing and coding needs, you can dedicate more time and resources toward providing the best patient care possible.

Avoiding Claims Denials

Even if you have a dedicated billing team that works diligently on each and every claim, there inevitably will be those times when some kind of data entry error or other mistake occurs. With an RCM company, your claims will be scrubbed and properly coded each and every time.

RCM Vendors

Revenue cycle vendors are detail-oriented and trained to find any errors that could cause a claim to be denied. In this way they can be an invaluable resource that helps you get paid faster and more often.

Tracking Unpaid Claims

Forget about the time it takes to submit clean claims; how much time does it take to constantly stay on top of all those unpaid claims? Plenty, and your practice simply doesn’t always have it. Your revenue cycle management team has the resource power to track all of your claims on your behalf.

Take Administrative Tasks off Your Plate

You went into medicine to care for patients, not to spend countless hours on paperwork and trying to stay up to date on the latest mandates and changes in medical billing. But sadly, administrative demands are on the rise for most small practices, and that trend isn’t changing anytime soon.

Outsourcing to a RCM company means you’ll have someone handling not only your coding and billing, but also all of those other tasks that are necessary for keeping your revenue cycle moving steadily along.

Industry Changes are More Manageable

We can hardly expect ICD-10 to be the last major change to happen in the healthcare industry. Partnering up with a reliable RCM company means you’ll have support and guidance navigating other transitions that could disrupt your workflow.

Stay Compliant

As we mentioned earlier, coding rules are constantly changing, and in order to stay 100 percent compliant your staff would need to be monitoring changes in rules constantly in order to ensure that they were using the right codes to get paid. But outsourcing ensures that your practice is consistently current with both insurance requirements and coding rules so you never have to worry.

Receive Payments on Time

The one thing that will make you and your entire staff happy is if you get paid on time, consistently. When you hire a company to handle your billing and coding, it will not only be dedicated, but also accurate and timely with getting your claims submitted and paid.

Lower Costs

Many physicians assume that outsourcing to a RCM company will cost an arm and a leg, but the opposite is true. Most vendors only get paid when you do, and even then it’s a small percentage of the original claim. When you think about the yearly salaries and health insurance packages for your in-house billers, it becomes clear that outsourcing is a small expense by comparison.

The bottom line is this: smaller providers want to direct their energies toward providing quality care for their patients, not toward spending hours every week struggling to remain compliant with new mandates that they don’t necessarily even fully understand. By working with a revenue cycle management company, you can rest assured that the right codes will always be used, your claims will be submitted accurately, and your practice can stay financially healthy.

About the Author

Alex Tate is a digital marketing specialist, content strategist, and a health IT consultant at CureMD who provides perceptive, engaging, and informative content on industry-wide topics, including EHR, EMR, practice management, and compliance.

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