Page 45 - HME Business, May/June 2021

2021 HME BUSINESS HANDBOOK
Outsourcing your HME billing operation or any other medical billing specialties to a third-party RCM solution can not only help you determine the right balance of automation and technology but also help your practice focus more on patient care.
Also, the right operational extension can help your provider business over- come the challenges of disparate EHR and systems to optimize revenue cycle management without costly technology fixes and integrations. The question is how to choose the perfect RCM?
PRO-TIPS:
CHOOSING THE IDEAL RCM SOLUTION • HIPAA compliance — A complete
HIPAA compliance should be on your top priority list while choosing the oper- ation extension for your billing manage- ment. As in the exchange of data during the billing operation process, it is quite essential to safeguard the privacy of people and their information. Also, the data needs to secure in order to avoid fraud and laundering of unnecessary information and money.
• A strong front and back end support team — A seamless and efficient billing operation is the key to better reimburse- ment. An HME business should always look for an experienced team handling their billing operation who are also experts that completely understand insurance, payers requirements, changing billing mandates, new codes, etc.
• An RCM that ensures the highest productivity metrics — An RCM solu- tion that helps you eliminate all the unnecessary costs while decreasing the overall operational expense is a must, as it not only helps the practice earn more but assists them to invest further to make the patient life and treatment
POINTS TO REMEMBER
• Medical billing trends for 2021 stated that the medical billing outsourcing industry will touch nearly $ 16.9 billion.
• Outsourcing RCM helps healthcare organizations improve KPIs in this era of rising healthcare costs and administrative burden.
• Many companies have adopted offshore business strategies directly or indirectly as it has been better and cost-effective.
process adequate. Furthermore, an RCM solution with the highest produc- tivity metrics also ensures lesser back- logs or lost revenue which is also key towards a thriving billing operation.
• Excellent standard of communication and reporting — In order to decrease the gaps in between your HME billing and coding process, excellent communi- cation and customized based reporting is essential as it plays the key ingredient that aids in reducing your DOS, billing errors, denial, and claims rejection.
• Helps you with better patient care management — Improving your key performance indicators (KPIs) such as data and coding accuracy, reduced denial rates and improvement in DSO along with timely appeals, etc., RCM that helps to focus on the patient care/clinical side of the business is equally important.
• Excellent industry references — An industry reference not only helps you get the feedback of the work that
you will receive when you opt for the services from the RCM operational extension but also gives you the idea if the operational extension is worth the try and you are not wasting your money.
Today, there are numerous outsourcing RCM solutions that are cost-effective and better than in-house billing. This can save your business from wasting time on tech- nology investments, software, and staff.
At Sunknowledge Services Inc., we have reduced 80 percent of clients’ operational costs and helped them with seamless billing operations and a better cash flow. ■
Ronnie Hastings (Ronnie.Hastings@ sunknowledge.com) leverages his 15-plus year’s experience to work with Part C
and Part D coordination with the private healthcare at Sunknowledge.
• Key players in the outsourcing market who are ruling can save you considerable overhead while driving increased revenues.
LEARN MORE
To read more about management and operations strategies, visit hme-busi- ness.com/management. To learn more on improving your billing operations and productivity metrics, check out Sunknowledge Services Inc.’s RCM solutions at sunknowledge.com.
STRATEGY
HOW OUTSOURCING HAS DOMINATED THE HME BILLING MARKET IN 2021
O
UTSOURCED medical
billing is exploding. Today the global medical billing
outsourcing market is expected to grow to $ 9.528 billion from $ 8.415 billion at a compound annual growth rate (CAGR) of 13.2 percent in 2021. And the pandemic has only furthered outsourcing’s growth.
In fact, about ninety percent of healthcare leaders are considering outsourcing in both clinical and non-clinical functions to achieve cost-efficiencies and succeed in value-based care models due to the challenges healthcare practices and their CFOs face in budgeting.
Moreover, the rising labor cost with each year typically ends up with more than half of a health- care practice’s operating revenue, leaving them to rethink the role of in-house billers and coding staff.
Furthermore, in 2020, the healthcare segment has been held as the highest revenue share of 47.2 percent in the medical billing outsourcing market for being
the prime users of outsourcing services due to high claim volume. Reprocessing claims drives up costs as billing staff must dedicate more time to unpaid claims.
However, given that economic reality, providers should explore opportunities to simplify and streamline a complex organization, and outsourcing is the best cost- effective solution so far.
By Ronnie Hastings
Management Solutions | Technology | Products hme-business.com | May/June 2021 | HMEBusiness 43