Is your healthcare organization striving to become more financially stable this year? Are you concerned that your current staff can’t manage revenue-related tasks while keeping the focus on patient care? If so, it’s time to evaluate two main revenue cycle solutions: staff augmentation or hiring an all-in-one revenue management partner. Either could be the right solution, but it’s important to review the qualities of each before moving forward.
This article explains the benefits of using staff augmentation vs. an all-in-one revenue cycle management solution. Use the information below to evaluate your next move while addressing revenue cycle management staffing challenges.
Healthcare organizations in the U.S. are under constant pressure to meet community needs, stay financially strong, meet strict health and safety regulations, and much more. This is particularly true of federally qualified health centers (FQHCs), which are held to high standards to qualify for government reimbursements.
This is where revenue cycle management (RCM) comes in. By using innovative RCM solutions, a healthcare company can optimize its billing practices and capture as much revenue as possible while meeting the daily challenges of serving the community.
In the next sections, we’ll look at options for proactively improving your approach to RCM.
Staff augmentation is a type of revenue cycle management staffing that rounds out your workforce by adding resources precisely where they’re most needed. In the healthcare industry, staff augmentation often refers to working with a staffing company to find front desk attendants or hiring traveling nurses.
The Journal of Emergency Management reports that at the height of the COVID-19 pandemic, staff augmentation provided life-saving resources at a crucial point in history. Even the standard levels of disaster staffing couldn’t handle the crisis, so increased augmentation filled gaps that put lives at risk.
In the context of RCM, staff augmentation involves supplementing specific aspects of the healthcare billing, coding, and collections workforce to strengthen financial capabilities. Your existing healthcare associates may not have the training and experience to implement RCM improvement strategies, so your RCM partner steps in to help.
Augmentation is a highly targeted approach. Altruis provides staff augmentation services tailored to suit each healthcare organization. Choose your level of service, including seeking help temporarily with staff augmentation only in the key areas you select.
An all-in-one RCM partner is capable of handling all key steps in the medical billing and revenue management process. They can take care of anything from new provider enrollment to resolving complex challenges that are limiting your revenue generation.
Below are some of the main tasks an all-in-one RCM partner should be able to handle on your behalf. Evaluate whether improving any of these aspects could benefit your healthcare organization.
Ensuring that you can be reimbursed for services rendered by your organization requires that your providers are properly credentialed and contracted with the insurance plans. This process should begin as soon as a provider has accepted an offer to work at your facility to ensure that their services are reimbursable by the insurance plans. Keeping up with expiring credentials is also key to preventing any gaps in revenue.
Excellent RCM starts long before a patient sets foot in your clinic. Patient eligibility verification ensures that your patients' insurance is active and your providers can provide reimbursable care. This also involves patient pre-verification of insurance coverage, Medicare/Medicaid eligibility, and other details.
Medical coding includes converting properly coded claims into charges. This complex step requires everything to be tracked, addressing issues like miscodes immediately to prevent a negative impact on patients or revenue.
The claims submission process moves reimbursement requests to Medicare, Medicaid, private insurance, and other payment sources. Better accuracy yields higher first-time reimbursement rates and, ultimately, higher revenue. Prompt follow-up is an essential part of addressing denials, appeals, or resubmissions that still fall within the window of potential reimbursement.
If your staff doesn’t have the time or expertise to tackle collections, leave it to your RCM partner. They’ll use their most diligent techniques to turn the challenge of collections into an opportunity for greater revenue.
What do you need from your partner in RCM optimization? Whether you need staff augmentation or a full-scale RCM solution, here’s a list of the most important qualities to seek in the right partner.
Your partner should be able to work quickly while adjusting the course as necessary. If you’re worried about launching a new RCM plan immediately, ask about having a short kick-off meeting to speed things along and get the process moving.
Discuss your desire for collaboration with a potential RCM partner and learn more about their communication style. You’ll need regular updates, plus reassurance that they’re addressing access challenges, documentation, and revenue flow as quickly and smoothly as possible.
Work with your RCM partner strategically to determine whether staff augmentation or all-in-one services would be the best fit. Review your budget, goals, and plans for the future to reveal knowledge and skill gaps. Ensure they can meet the full range of your needs without wasting time or resources.
Hiring Altruis doesn’t mean you need to eliminate your billing team or completely revolutionize the way you do business. Our goal is to meld with your team seamlessly to smooth out your workflow and facilitate revenue generation.
Whether you need all-in-one revenue cycle solutions or just temporary partial staff augmentation, Altruis can help. We’re here to become your partner in healthcare success.
Schedule a call with us to learn more.