Outsourcing billing management for hospital physician practices
Today’s hospital-based practices are facing an increasing number of complex challenges – from ever more complicated coding and compliance issues to managed care pressures that impact cash flow.
In the current economy, most practices are seeing less margin for error and a greater need for consistency. As new economic policies are developed that will greatly impact the healthcare industry, it’s even more crucial for practices to be aware of outside business management services that can offer efficient, affordable return on investment.
Before selecting a billing and practice management services provider, certain guidelines should be followed when engaging prospects.
Prepare a list of goals and objectives.
Is the billing side in good shape or does it need to be reorganized? Is there a need to update the billing management software and information technology in place, or is there a need to convert current systems? And, based on current software and technology status, should current billing personnel be retained?
Analyze the budget and make comparisons.
While it may sound like a no-brainer, it’s often surprising to learn that the right practice management firm isn’t cost-prohibitive. If in-house billing and practice management procedures are currently being managed in-house, it’s crucial to analyze the cost comparisons and benefits an outside source can offer vs. what is currently being invested in-house.
Make sure the firm is experienced in your area.
All medical billing professionals are not the same. Some firms may put their focus under one large umbrella or may be better suited to one specialty area. Other firms offer specialty areas, whereby billing operations management professionals and coding and compliance management teams are put into place to assist certain customers based on their individual practice needs.
Avoid “cookie cutter” contract models and objectives.
Defining each practice’s needs varies from practice to practice, per the competitive landscape of the industry. It’s important that the prospective billing and management firm in question has an ability to benchmark your needs to that of your competitors. For real-world analysis, ask the firm if they are able to provide blinded data from other practices they manage.
How and where will processes be put in place?
While having discussions with a national firm, it’s crucial to understand how your practice will be managed. Billing and practice management isn’t ideally directed remotely or over the telephone. If the firm in consideration can’t bring its experienced teams to your local office or in-house, you may want to consider one that is able to service your practice’s needs locally with accountable, dependable management teams.
Ask the firm how it will gauge and present ROI.
Simply doing the work and getting the results isn’t enough for today’s healthcare executives and practice managers. As planning objectives are defined each year, ROI benchmarking and reporting is needed from the previous year to not only monitor the practice, but to also maintain accounting records and documentation of annual financials. Make sure monthly financial statements and comparative reports are part of the deliverables.
G. Darrell Hulsey is president and CEO of Medical Management Professionals, an accounts receivable management services firm. He has more than 17 years of experience in healthcare administration.
