Outsource Needed Services & Jump-Start Efficiency

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By Steven Faith, OD

July 22, 2015

Between seeing patients and managing your staff, a practice owner doesn’t have much time. You delegate to staff, but what happens when your staff also is too overloaded to efficiently handle all of your business operations? That’s where outsourcing some of your business needs makes sense. Services that your practice can potentially outsource include human resources/payroll services, IT services, electronic insurance billing, patient payment and e-bill processing services, web site and social media updates, electronic patient communication, web store maintenance and product rotation.

In addition to the return on investment that results from increased efficiency, our doctors and staff also experience RMI–or return on mental investment–through our outsourcing relationships. Just as we do with co-managing patient care with our co-managing surgeons and other health care professionals, we feel outsourcing is like co-managing with our many business professionals for the continued and future health of our business.

Here is how we use our practice management resource, Primary Eyecare Network (PEN), to find and use the best outsource partners, including what we gain by doing so.

Choose Services for Outsourcing

There’s not necessarily a monetary line you cross in determining when is the right time to outsource. How we look at outsourcing is, if the task is taking employee resources or doctor energy and focus away from patient care, then we outsource the task. Now, some doctors enjoy sitting at home at night calculating employee payroll tax withdrawals, or prefer overseeing the daily insurance billings, but our doctors enjoy being with and focusing on patients.

One of the services we outsource is our medical insurance billing. Before outsourcing these services to Compliance Specialists, Inc. (CSEye) we had three full-time employees working on our insurance billing of vision plans and medical insurance plans, including Medicare, Medicaid and all private insurance carriers. After our conversion to CSEye for these services, we cut the number of employee hours in half dedicated to this task, which freed those employees for direct patient services. We also found that our insurance payments began depositing directly into our bank account in 2-9 days, on average, instead of 30-60 days. In some instances, the payment was deposited before the EOB showed up in our office.

We didn’t save money on this outsourcing. However, we have received insurance income faster and more efficiently and reduced our accounts receivable aging at the same time. Essentially, we reallocated 50 percent of the designated employee resources away from non-patient tasks to direct patient care. Thus, making both our patients’ experience more positive with less distracted staff and our doctors and clinic more efficient and productive by seeing more patients.

Devote More Time to Patient Care

Along with added efficiency, outsourcing allows our staff to focus more fully on serving patients. We outsource our IT services to TeamLogicIT, a national IT resource company. Some practice owners think they are good at services like IT, or have someone on staff that can do those functions.

After we switched to a dedicated IT team of professionals, our clinic and administrative staff had more time for patient care and spent less time on the phone or computer corresponding with companies regarding our office server network, EHR or integration or diagnostic medical equipment issues. TeamLogicIT works on our behalf behind the scenes and sometimes recognizes and resolves problems before we even knew they existed.

TeamLogicIT monitors our entire network and computer systems 24 hours a day and resolves any problems before we know about them. They are responsible for any system upgrades, repairs, security and all things IT including EHR, diagnostic equipment, all installations, on-site and cloud-based backups, remote and onsite repairs, problem solving with all system network companies including phone and internet.

In our area, outside of San Francisco, you can pay by the hour ($125-$150/hour depending on the network and system) or a monthly service maintenance ranging from $500/month to $3,500/month. The cost of lost productivity and reinstalling lost data after a virus or malware attack is much more expensive than these outsourced services– believe me, we know.

Use Optometric Organization to Identify Outsource Partners

An optometric practice management organization can help ODs find dependable companies to outsource to. For example, PEN has a relationship with CSEye, that includes a discount for members. Our office would not have known about CSEye without PEN’s guidance.

Most of the collaborative partners we use for outsourcing have a lower cost structure through PEN than if we approached them on our own. But there are also many non-financial reasons why it is mutually beneficial. For instance, by billing these services through our single PEN statement, the partner vendor receives one payment for all PEN members utilizing their programs.

This saves the vendor and us considerable time and money. With traditional billing processes, we have estimated it takes between $10-$15 per vendor to pay each invoice we receive: including opening and reviewing the paper or electronic invoice; entering the invoice and payment into the accounting software; and then either physically mailing or electronically ePay’ing the vendor directly. We have over 50 vendors we deal with every month. With our single statement, we pay most of our vendors with one payment saving us tremendous time and money.

Research & Vet Before Outsourcing

We use TriNet for our current Professional Employer Organization (PEO). They help manage our HR, payroll, employee benefits and 401k services for our employees. Through a nominal monthly fee per employee, we were able to reduce our benefit costs, expand our benefit offerings and reduce the 401k administrative management time our doctors experienced in the past with these duties. TriNet is a national company with a diversity of client businesses.

Before contracting with TriNet, we were able to contact a few similar-sized companies under TriNet’s umbrella and inquire about the benefits of TriNet. We have utilized a PEO since 1994, and had some questions based on our prior experience. Talking with other businesses was wonderful in helping us make the final decision to choose TriNet.

We always have our staff interview potential outsource companies, too. For example, our billing team interviewed CSEye before we contracted with them, and our clinic and administrative teams were instrumental in our choice of TeamLogicIT as our IT professionals.

Coordinate In-House Staff with Outsource Resources

We made sure that all of our staff saw the benefit of outsourcing some of their tasks. They know that our number one priority is quality patient care. There was never a perceived threat of loss of work or job position by using an outside agency for many of our office administrative and non-patient tasks that we have outsourced. As a result, our in-house staff are instrumental in monitoring and coordinating most of the work of our outsource companies.Many of our in-house staff saw the potential of managing the outsource work rather than managing the in-house task. They all have seen the benefit of reallocating their prior workload.

Evaluate Outsource Needs Periodically

We are also in the process of outsourcing our accounts receivable through the assistance of our banking partner, Wells Fargo. They have some efficient methods of helping our patients pay us easier and faster, sometimes even immediately through automated clearing house (ACH) deposits. That will involve the outsourcing of some electronic patient billing services through their e-bill/bill pay department. As many of our patients pay more of their bills electronically, we want to make sure our office shows up on their own bank’s Bill Pay list of approved payees. This not only gives our own office more financial credibility with patients, but more securely insulates us from the many bank and credit card fraud activities all business owners face.

Steven Faith, OD, is the owner of Livermore Optometry Group in Livermore, Calif, and a member of the advisory board of Primary Eyecare Network (PEN). To contact: livopt@pacbell.net