In-house Medical Billing and Revenue Cycle Management Services New Jersey can prove to be pretty pricey as well as hazardous. It needs a set of devoted staffs with sufficient training and vision regarding RCM. It also requires capital for infrastructure, technology, etc.
Especially in this year, 2020, when the whole world is facing a Global Pandemic, the sector which is under peer pressure is the medical sector. Outsourcing RCM services has thus become extremely essential in order to maintain a steady medical administration. You must search for efficient Medical Billing and Outsourcing Companies in New Jersey.
RCM services when outsourced is performed by highly efficient staff and best-updated technologies. It includes flawless medical billing and coding. An error-free work mechanism will increase the weightage and goodwill of your esteemed organization.
We will lay down certain factors that you should always keep in mind while choosing a third party partner for outsourcing revenue management services.
First, PERFORMANCE IS THE KEY!
If your partner can ensure that the KPI’s are successfully met, only then you should issue the payment. The Third Partys’ have a performance-based fee structure. So, performance on time must be the first thing that you should look for in the Third Party. The Key Performance Indicators (KPI) always tell the truth. It will clearly show you whether your organization is meeting its goals or not. Keep an eye on the KPI, and accordingly invite the Third Party Partner.
A good partner will always serve you with quality Return of Investment. (ROI) Moreover, the better a performer, the lesser is the Turn around time (TAT). An efficient performer will also work on patient engagement to ensure smooth cash flow, as well as boost the overall profitability of your organization.
Second, DENIAL MANAGEMENT STRATEGIES – A MUST HAVE!
The goal of Denial Management is to look into every unpaid claim. The Denial Management team makes a linkage between individual payers’ code and common denial reason codes. This in return helps expose vulnerabilities in sections like Billing, registration, documentation, medical coding, etc. These vulnerabilities are then taken care of by the RCM team in order to avoid further denials in the future and to ensure swift approval of claims. Therefore, a partner who cannot handle denials efficiency can never fully contribute to the profitability of your organization.
Third, CREDENTIALS & CERTIFICATIONS.
You need to check whether the coders and billers of your outsourced partner hold valid certificates or not. You should look for the coder’s certificates from places like Office of the National Coordinator for Health Information Technology Authorized Testing and Certification Bodies (ONC-ATCB), Electronic Healthcare Network Accreditation Commission (EHNAC), etc. The person must be a Masters or Bachelors in Healthcare Administration and Management. No doubt there is much software that ensures flawless coding, yet you need to make sure you have a skilled coder with whom the software compliments. The same goes for billers. Moreover, you should discourage manual medical billing, and always opt for the e-billing mechanism to minimize errors.
Fourth, DETAILED REPORTING
The devil is in the details. When you have planned to Outsource RCM services, you must find the partner who can ensure you comprehensive and meticulous reporting, which is a must at every stage of a successful RCM. It is extremely important that the KPIs must be precise.
The report should at least have an A/R analysis, categorical account divisions of providers and payers, outstanding A/R payee list, list of causes of claim denials, etc. In short, the report must be capable of highlighting the vulnerabilities of the organization, so that they can be mended, ensuring maximized profits. The Outsourced Partner must have a competent reporting system that can provide real-time financial whereabouts.
Fifth, RISK PREDICTABILITY
Risk predictability is such a skill that comes only with experience and expertise. It is thus a solid factor by which you can accurately judge a third party before outsourcing. The one with a competent security mechanism should be entrusted.
Sixth, TRUSTWORTHY SERVICES AT A REASONABLE PRICE
Always compare the price of the RCM services and then only make a deal. These third-party partners should ideally charge around 5-9% of your total collection. You must always have a transparent understanding of the services you are being offered and at what cost. You can negotiate with practicality. Always keep in mind that initially, you chose to Outsource RCM primarily to save money and hazards. Therefore spending solely within your budget is extremely necessary.
In a nutshell, Outsourcing Medical Billing and Revenue Cycle Management Services to the most efficient Third-party Partner can boost up your profits, increase the efficiency of your firm, and reduce unnecessary expenses in salaries, capitals, or other costs.
Do you need a Medical Billing Company in NJ? Aurus is considered as one of the best Medical Billing Consultants in New Jersey. They are best at providing Medical Billing and Revenue Cycle Management Services New Jersey. Prioritize the partner based on the above-mentioned factors. Take the Top 10 Medical Billing Companies in the USA to choose from. Choose wisely.