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Improve Practice Outcomes by Outsourcing your Revenue Cycle

Revenue Cycle Management

Disclaimer: This blog article was written by an AdvancedMD partner. The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of AdvancedMD.

A successful private practice is not easy to run. It requires an array of staff members, including but not limited to healthcare providers, administrative staff, financial staff, and business-forward staff members to all work together to improve patient engagement and retention while also improving profit and revenue. That’s not all, there are quite a few outsourced members that need to be involved as well. This creates room for automation of several processes and generally facilitates the revenue cycle and payments at your practice.

When you decide to outsource certain processes and tasks at your practice to a vendor outside of your practice, you not only ensure that those tasks are now undertaken and completed by professionals, but you are also providing yourself and your staff additional time to practice healthcare. You also reduce the total costs of running your practice successfully all the while reducing the amount of stress you and your staff are under. Outsourcing the RCM process and medical billing is often recommended to practices, and here are a few ideas you may want to consider.

What does a billing partner bring to your practice?

Outsourcing to a billing partner allows you to not only benefit from the services provided by them but your practice will also receive an array of benefits in terms of saving time and providing better patient care. It is often difficult to find the right combination of a billing partner, an EHR for all the medical record documentation, and a practice management system, all at one place and working in sync. The next set of questions that you need answered is the cost in partnering with a billing vendor and what kind of technological benefits they can bring to you. Your billing partner should help you improve patient relationships by automating a wide variety of clinical and administrative tasks. Some of the key areas that need to be covered are listed below:

Dashboards
Your practice needs to have highly customizable dashboards that provide you an overview of key performance indicators, claims efficiency, overview of financial health of the practice on the practice management side. On the EHR front, they need to provide you with the details of the notes, lab and radiology results, prescriptions, messages, and other important information pertaining to patient care.

Patient Information At-a-glance
The EHR system that you choose should be able to provide you an overview of the patient’s past medical history, allergies, problem list, medications, orders, immunization status, etc. at the click of a mouse or all on a single window module which helps providers tremendously while reviewing medical records and treating patients simultaneously.

Customizable Templates
Documentation plays a vital role in today’s healthcare environment and is mandated in every part of patient care. Every provider would love to work on an EHR that provides a vast library of templates that are highly customizable to match the provider’s style of documentation. This eases off the administrative burden on the providers, enabling them to save time and focus on patient care.

Technology & Interoperability
When it comes to exchanging healthcare data, interoperability plays a key role. There are countless systems and tools that handle healthcare data, and this data needs to be transferred between each other seamlessly. Unfortunately, most of the EHRs lack this functionality in some or the other area and add up to the administrative burden for practices. Choose an EHR or a practice management system that allows you to connect with any other software in an efficient manner. Sending electronic prescriptions, faxing medical records from within the system, exchanging patient data and medical records; all these need to be part of the EHR and PMS bundle that you choose.

Patient Centric Modules
Since technology takes the driver’s seat, your EHR should enable patients to connect with your practice online and provide all necessary information with ease, avoiding loads of paperwork when they visit the practice. Having online patient portals becomes essential to reduce such burden for the practice and patients. Modules such as patient portal, appointment reminders, telemedicine, patient messaging, and signing consent forms are all part of this process and make it an easy task for both the patient to complete them and for the provider to review at the time of the visit. Online appointment scheduling is one of the key features which helps practices handle patient inflow with ease at any point in time.

Apart from this, practices need a robust EHR system which helps you carry out all the documentation related activities. Documentation and record keeping needs to comply and adhere to industry standards and make the most important part of the process. Easy to document yet being compliant is the need of the hour for physicians to save time and focus on patient care. If you are using an existing legacy system for record keeping, it becomes difficult to seamlessly transfer to newer EHR systems since most of the updated versions are mostly cloud based and it becomes difficult during the transition. Moreover, finding an EHR system that is cost effect yet compliant and easy to use is a bigger challenge that practices face when choosing one.

Reducing administrative burden on your practice, making sure to reduce computational and administrative errors to improve revenue flow is a much-needed aspect when it comes to practice management systems and EHRs, and finding one that is cost effective yet robust is a tougher task than you can think of.

Having an EHR combined with practice management system, both under the same umbrella is now a possibility, thanks to the technological advances that have made it possible. On top of it, software that is completely cloud based is a plus, meaning no installations or advanced technical skills required by the practice staff. These fusion models make it easy to train your staff on how to navigate and use the software in an efficient way. Other billing and record keeping activities such as payment reconciliation and credit card processing are all done with such an ease with these software models.

While it is true that partnering with a revenue cycle management vendor would include a takeover of the processes at your practice, you will need to have complete transparency, meaning that you will be receiving detailed reports of the processes handled and you will have access to all the information, regarding any claim at any point that you wish. All this is possible only when you have a robust reporting mechanism in place.

HIPAA Compliance

One of the biggest concerns with outsourcing medical billing or utilizing a healthcare billing software service is confidentiality and security, especially since patient data is involved. It is important to keep in mind that the vendor you outsource to has to be HIPAA compliant or your practice could be at risk of violating the law. The legal consequences could be detrimental to the functioning of your practice, which is why it is important to choose HIPAA-compliant vendors.

Reduced Denials & Proper Denial Management

An outsourced billing vendor needs to develop a seamless process of setting up the claim submission process, perform insurance verification at the time of appointment scheduling, automate the coding process, and ensure timely submission of the billing. This not only facilitates the entire process to ensure a timely submission but also reduces the risk of an error being made. When you partner with a billing vendor, there is a significant reduction in denials by payers and when a claim is denied, there are proper denial management protocols in place, to eradicate that specific cause of denial going forward.

Accountability & Reduced Audit Risk

One thing your practice may be experiencing is claims denials. In fact, that may be the exact reason you are thinking of outsourcing the medical billing process in the first place. With the expansion of ICD-10-CM coding, mistakes in coding that result in frequent claim denials make your practice vulnerable to audits. These audits are not preferred as they disrupt the smooth running of your practice. Moreover, the denials can be quite costly to your practice, which is why it is crucial to avoid them.

When you partner with an outsourced vendor, the accountability for coding errors and denials falls on them, and not your practice, meaning that you are at a significantly lesser risk of being audited. Moreover, these errors can be reduced significantly.

Focus on Patient-centric Care

With all the financial and administrative tasks being performed by a billing vendor, you can spend all your time and energy on providing the best healthcare to your patients. Your administrative staff now can spend their time communicating with the patients, trying to understand ways in which their experience can be improved. Patient-centric care will become a reality at your practice.

Improved Patient Retention

When patients feel that their voices are heard and it is them that your practice is working for, they are more likely to pick your practice and stay for a longer duration. Not just that, they are also going to participate more in surveys and engage more, in an attempt to improve your practice. All this happens because they feel heard, as your staff can now dedicate time to listening to them.


About Practolytics

Practolytics partnered with AdvancedMD in 2013 to create a one-stop solution for all the medical billing, practice management, patient management, and revenue cycle management activities a healthcare practice need to carry out. A Platinum partner amongst 850+ billing companies, Practolytics is a 20+ year-old healthcare technology and revenue cycle management services company providing medical billing service solutions to 180+ practices of all sizes spreading across 31 states and serving more than 28 critical specialties.

Practolytics with support from AdvancedMD billing software processes more than 2.5M claims annually, collecting more than $500M for its clients. End-to-end services include medical billing, medical coding, chart audit, credentialing, eligibility, benefits verification, and preauthorization services. The company’s diverse background in every aspect of healthcare allows it to maximize revenue and consistently deliver optimum results. To learn more about customized billing solutions for your practice, please visit the Practolytics medical billing company website.



Manik Chawla
Innovative and trusted advisor, with experience driving profitability through astute management of medical group businesses, revenue cycle operations, transitions, and process improvements. Lead revenue cycle management, customer service and support, ensuring an outstanding customer experience. Record of successfully launching two startup billing companies in the complex and competitive healthcare industry and also skilled at developing strategic partnerships and leading teams to design and manage successful business solutions.

Topic: Revenue Cycle Management


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