RCM and Why it is Important

In the most recent podcast episode, medical business consultant Juli Quinn discussed the challenges faced by healthcare providers in terms of medical billing and reimbursement. The rising costs of healthcare and decreasing reimbursement rates have created a toxic system in medicine, with insurance costs constantly going up and constant changes and loopholes in the reimbursement process.

One of the biggest challenges faced by medical practices is medical billing. According to Quinn, 30% of all claims are rejected or lost in some way, which requires a second touch. This can result in a loss of revenue for the practice, especially if the claim requires calling the insurance company, which can take up to 20 minutes on hold. The lack of education on billing and business in medical school and residency training is also highlighted as a contributing factor.

Another challenge faced by medical practices is staffing. The international pandemic has made it difficult to find and retain qualified staff, and turnover can have a significant impact on overhead costs. Quinn suggests that bridging the gaps in medical billing and reimbursement can help practices recover more cash flow and keep their doors open.

To address these challenges, Quinn recommends outsourcing insurance follow-up and medical billing to companies like CivxData. CivxData combines onshore and offshore labor to offer local knowledge and skilled labor at a better price. They have a large resource of medical billing professionals in India who work in a beautiful office and focus only on billing. CivxData can do any or all aspects of the RCM cycle, including prior authorizations, front office tasks, and coding. They aim to get claims out within a week for quick cash flow and have a massive resource of skilled labor behind them to get the job done.

In conclusion, medical billing and reimbursement are critical components of running a successful medical practice. Healthcare providers must keep their doors open and manage their overhead costs, and outsourcing medical billing and insurance follow-up can be a game-changer for a provider's bottom line. By partnering with companies like CivxData, medical practices can focus on providing quality care to their patients while leaving the business side to the experts.

Contact Juli:

juliq@civxdata.com