• linkedin
  • Increase Font
  • Sharebar

    The revenue cycle decision

    Should your practice handle billing in-house or contract with a revenue cycle management vendor? Here's how to decide.

    In these challenging times for physician practices, the business side of medicine requires navigating reimbursement declines and rising costs while conforming to the Affordable Care Act and transitioning to the International Classification of Diseases-10th revision (ICD-10) code set. And while delivering high-quality care remains physicians’ top priority, sound revenue cycle management nonetheless dovetails closely with the success of their practices.

    About 35% of respondents—mainly acute care hospitals and clinics/physician practices—to a 2014 survey by the American Health Information Management Association/eHealth Initiative believe ICD-10 will have a negative effect on their revenue; 18% are uncertain of its impact; and 27% haven’t conducted financial impact assessments.

    Related: ICD-10 in 2015: What physicians need to know about testing, costs and preparedness

    Many physicians ponder whether to seek outside expertise for revenue cycle management. An estimated 95% of independent physicians perceive outsourcing these services and technology processes as the most sensible solution, according to the Black Book Report 2015, a healthcare market research entity. Of those practices, 64% are contemplating a combination of new software and outsourcing help to improve their revenue cycle management systems.

    Making the decision

    Before making these decisions, a practice must weigh the pros and cons carefully. There are multiple aspects to consider, such as the size of the practice and the capabilities of its staff.

    “Physicians really need to approach the question of insourcing or outsourcing collections from a scale and internal capability perspective,” says Jim Lazarus, managing director of strategy and innovation in revenue cycle solutions at The Advisory Board Company, a healthcare consulting firm in Washington, D.C.

    For a practice with 15 or fewer physicians, internal billing is usually a more cost-effective approach. It may be prudent to hire a capable person to focus on billing, but to serve also as a “jack of all trades,” overseeing medical records and providing other office support, Lazarus says.

    NEXT: Making the decision to outsource or not

    3 Comments

    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • JUSTINDJENKINS
      Revenue decision is much important than anything else.. make great strategy make your better life. SamishLeather Mad Max Fury Road Tom Hardy Jacket
    • JohnPeter
      Susan, great article.I love reading articles on RCM and medical billing on this site. And inspired by the articles on this site I have created an awesome piece of content which has some unique information http://bit.ly/1KZzdtz I thought you might like to check this
    • ElliotBarry
      I think practices should go for outsource instead of handling billing in house. On Oct 1 2015 ICD-10 is going to be implement so the small practices consist of 15 to 30 physicians will prefer to outsource their billing instead of in-house billing. And RCM is not limited to billing; it’s a wider process which includes processing of claims and management of denials, patient payments and generation of revenue. Overall your blog is really good and it’s going to be guide map in the decision making for those who want to contract with RCM vendors http://goo.gl/JM2YS8

    Latest Tweets Follow