By Casey Packer, OD
July 12, 2017
Practice ownership comes with a lot of responsibilities, and sometimes it can be hard to let go and delegate, or outsource, specific tasks to someone who is more knowledgeable and experienced. It’s common to want that feeling of control over everything, but in most cases, this is only going to slow down practice growth, and probably increase stress and worry over every little detail.
One of the first things I decided I needed to let go of was our insurance billing process. It was the most time consuming, and also crucial, part of my practice. It determines how much revenue I earn, and is greatly impacted by the knowledge of the person in charge of this task. I had an in-house employee managing the billing processes, but it wasn’t their specialty, and a lack of knowledge on the ins and outs of the insurance world was causing my practice to miss out on a significant amount of revenue from reimbursements.
Think about it. In many offices, there is an employee wearing many hats in the office, and managing the insurance process is just one of them. It’s crazy to have something so complicated given to an employee who just finds time to process claims when they aren’t busy performing other tasks. People are able to be much more efficient in their jobs when they can focus on one particular skill. Google is a perfect example of this.
Google was released to the market as a simple, clean search engine. At that time, Yahoo! was dominating the market with a busy homepage that easily distracted visitors from its ultimate function as a search engine. Google honed in on being the best search engine, and nothing else – and we all know how that story played out. So, why wouldn’t I want someone whose only job is to process my claims and payments efficiently, accurately, and with more expertise than anyone in my office could?
Why I Decided it was Time to Outsource
I knew I wasn’t maximizing my reimbursements the way I should have been, so when I looked into outsourcing our claims and billing, I knew that what I needed from a service was someone who could reduce my number of denials so that I could bring in more money faster from insurance claims. I was also looking for someone who understood, and could work with, my current EHR software without disrupting my normal office flow.
And, of course, I wanted someone who could show me they had the training and knowledge above and beyond any one in my practice when it comes insurance and billing, and ultimately, that’s what I found.
I went with the revenue cycle management service I did, because they checked all the boxes off the list of what I needed and expected from an expert in claims and billing. The transition to using the service was absolutely seamless. Within an hour, we were up and running, and our denial rate dropped before my eyes.
Why I’d Never Go Back to In-House Claim Management
Not only did our denial rates drop significantly, but outsourcing this service also opened up a workstation in my office for another employee, and was less expensive than having a full-time, or even part-time, employee dedicated to processing claims in my office. It’s a service that pays for itself in savings on employee expenses. It gave my team more time to work on other tasks in the office that needed their attention, and I could rest assured that claims were being filed correctly, and in a timely manner. I wasn’t spending extra time at the end of the day, or between patients, worrying about reimbursements or how we could make the billing process more efficient and profitable. Overall, things just ran smoother in my office.
One big benefit I wasn’t necessarily expecting from a revenue cycle service provider was the in-depth reporting and analytics features that I get access to. On top of being able to see high-level metrics, like overall claim acceptance and denial rates, I can drill down and see denials and payments by each specific procedure or payer. Plus, I can view how my practice has improved in these areas over time, and compare my practice to state and national averages. Access to these insights help me make better business decisions that result in more revenue for my practice.
I can’t imagine going back to managing our insurance revenue cycle in-house. The effects of stronger reimbursements have directly affected my bottom line, and significantly changed my work-life balance with less time spent worrying about claims and reimbursements and more money in my pocket to spend on vacations.
To find out if outsourcing revenue cycle management is right for your practice, like it was for mine, schedule some time to talk with my RCM service provider.
Casey Packer, OD, is a certified optometric glaucoma specialist and therapeutic optometrist, and owner of Lone Star Eye, in Austin, Texas.