In an effort to lower costs, some healthcare organizations are opting for offshore revenue cycle services — but they often underestimate the lost revenue of utilizing a low-cost service. In fact, a cheaper offshore provider can create significant revenue loss and data risks, and you may not realize the impact on your bottom line until it’s too late.
Working with a U.S.-based revenue cycle business may require a slightly higher fee, but the expertise of U.S.-based workers in understanding our healthcare system, working with payers, interfacing with stakeholders, creating continuity of team members, and most importantly, collecting every appropriate penny for clients is critical. Revenue cycle services require intense and consistent detail work that impacts your revenue. While offshoring may appear to be cheaper, the savings are often lost with just a couple of failed claims.
Revenue Cycle Services Require Transparency and Communication
You already know that revenue cycle services are key to maintaining growth, ensuring profitability, and preventing costly errors. They don’t just require high analytical skills, but transparency and communication, which may be more difficult if you’re working with an offshore company. Here’s what your organization needs to be able to do with a very narrow margin of error:
- Coding:
Coding services for reimbursement require staying current with any changes in the U.S. healthcare system and a focus on clarity and accuracy. - Claim QA & Submission:
Claims need to be carefully reviewed and checked prior to being submitted to payers; errors can cause denials or reimbursement delays. - Denial Management:
When claims do get denied, it’s important to discover the cause, appeal, and make adjustments so that revenue is recovered. - Self-Pay Management:
Patient communication is vital when it comes to managing and collecting their payments, which may involve implementing billing plans and conducting frequent follow-ups. - Coding Audits:
Ensuring that billing codes are correct can keep your organization from leaking significant revenue. - Reporting & Visibility:
You need transparent, data-driven reports that track performance to measure collections and determine where revenue is being gained or lost. - Insurance Plan & IPA Negotiations & Audits:
Getting the best possible reimbursement is a priority, which means you need audits and astute negotiation capability with providers. - Credentialing:
You need to maintain a pulse on physician credentialing, ensuring that providers are enrolled and approved with payers so that reimbursements can be submitted.
Onshore revenue cycle companies are far more likely to be well-versed in U.S. healthcare laws and compliance, which are complex, nuanced, and subject to change. Additionally, being in a similar time zone and speaking the same language can significantly reduce the likelihood of miscommunication and delays. A U.S.-based company can offer better patient support for the same reasons, which boosts self-pay and your organization’s reputation for care.
Get Services that Seamlessly Integrate into Your Process
You need an onshore revenue cycle service provider that can seamlessly integrate into your processes. They should make it easy for you to collect reimbursements, track revenue gains, identify areas for improvement, and attain the best possible arrangements with insurance providers. They should be able to reduce and prevent errors, increasing clean claims and boosting your organization’s profitability.
At MedHQ, we’re fully based in the U.S. and have the privilege of working tirelessly on behalf of our clients to improve profitability and eliminate friction. We have a wealth of experience in the American healthcare system that allows us to optimize your revenue cycle.
“Data drives our decisions, but people carry them out,” says Derrick Idbeis, Chief Commercial Officer. “Our average team member has a decade of healthcare experience which has helped us maintain a clean claim rate over 95 percent.”
Don’t settle for cheap offshore services when you can maximize your revenue with accurate, transparent, responsive revenue cycle management with an American company like MedHQ. Get in touch with us today to find out more about how we can help!
