Long-term post-acute care (LTPAC) CFO’s, business officer managers, and directors carry a lot of weight on their shoulders as the industry continues to transform at a rapid pace. Quality of care standards continue to rise, yet profit margins shrink smaller and smaller. Financial leadership must learn to evolve with the industry and strategically pursue initiatives focused on sustained growth. This becomes even more challenging when expected to simultaneously juggle day-to-day revenue cycle management (RCM) operations.
Providers can alleviate much of this burden by freeing up internal resources and gaining back valuable time to work towards your goals. Here are four signs that it may be time to outsource your RCM:
1. You Have Difficulty Hiring & Retaining Employees
One of the most common reasons a provider decides to outsource RCM is the realization that they do not have the internal staffing infrastructure to effectively manage the complexities of a claim’s life cycle. Turnover remains high, and when seats are left empty, others are expected to pick up the slack. When claim volumes become too large for in-house staff to work through, providers put themselves at risk of missed deadlines and reimbursements they will no longer be able to collect. Rather than imposing overtime (which runs its own risks of burnout), allow your staff to remain focused on their normal workload - and the care of your patients.
2. You Are Unable to Keep Up with Training
Even if you can maintain appropriate staffing ratios for your typical workload, you still need to tackle the never-ending duty of training. Experience plays a large factor in recovery performance, so employees must be knowledgeable within their areas of responsibility and up-to-date on the latest trends and regulatory compliance. This requires ongoing training directly through payers and other industry tools, and many providers are not in a position where they can easily dedicate this time “away from the desk.”
Outsourcing your RCM will eliminate this stress, but be sure to do your homework and consider companies with the right experience. Highly-skilled teams will be involved in the continued growth of payers, which means they will be in better positions to interpret new information as it rolls out, and relay how it may impact your organization’s processes and daily activities.
3. You Ignore the Analytics
To understand how well your revenue cycle is being managed, you need to keep a pulse on key performance indicators (KPI’s). Easier said than done, though, as this should extend beyond capturing periodic snapshots of your aging, DSO, denial rates, and the like. It requires an analytical eye to help recognize patterns and pinpoint delays. There may be internal processes that are broken, or other inefficiencies that are more difficult to detect from the inside. A non-biased third party can investigate deeper into your analytics to determine the root of any issues – and provide solutions to help prevent them from reoccurring.
4. You Have Exhausted Your Efforts
When you’ve tried your hardest to move the needle and it still won’t budge, it’s time to bring in the professionals. With so many moving parts to the revenue cycle, there are countless opportunities for files to get hung up, and it’s easy to become overwhelmed when you cannot locate the issue to properly address it. Time is always of the essence when there is risk of revenue leakage, so if you notice roadblocks that are preventing you from collecting your revenue in full, act swiftly by engaging a qualified RCM consultant before the problem intensifies.
Richter’s Outsourced Revenue Cycle Management
For more than 20 years, the RCM team at Richter has watched the LTPAC field grow and develop. We understand the challenges you are up against today, and will help you establish the right tools and processes to optimize business performance for the future.