4 Signs It’s Time to Work with a Physician Practice Management Company

Your aim as a doctor is to give your patients the best possible treatment, but managing a successful medical practice requires much more than just clinical brilliance. You must possess exceptional business management abilities to handle the daily responsibilities of running a big medical practice.   

More expertise in non-clinical jobs including accounting, human resources, contracting with vendors, managing insurance claims, bill collection, and IT is required as your firm grows.  Many medical groups that decide to handle these commercial responsibilities internally discover that they are fighting an uphill struggle all the time.

In the ever-changing landscape of healthcare, running a successful physician practice requires not only exceptional medical expertise but also effective management of administrative tasks, financial operations, and regulatory compliance. To alleviate the burden of managing these non-clinical aspects and to ensure the practice's growth and sustainability, healthcare providers often turn to physician practice management companies.

This essay explores the signs that indicate it's time for a physician practice to collaborate with a professional management company to optimize operations, improve patient care, and enhance financial performance.

Here are four warning indicators that it's time to think about outsourcing part or all of your revenue cycle and practice management tasks: 

Employee Staffing Consumes Far Too Much of Your Time

According to a recent survey by the Medical Group Management Association (MGMA), staffing will be the largest concern for medical practices in 2022, according to 73% of respondents.    In today's competitive healthcare labor market, finding qualified candidates can be a time-consuming struggle that many practices are failing to win.   

Lack of staff affects the degree of treatment and assistance you can give your patients.  It's time to take action if staffing is a big problem for your medical group.  A practice management specialist can assist with hiring and onboarding staff in addition to identifying operational efficiencies that enable you to run a profitable practice with fewer employees. 

The Costs of Running Your Physician Practice Are Climbing While Revenues Are Flat or Shrinking

Your practice's employment costs are probably going up everywhere because of the competitive labor market today. Other expenses, such as those related to construction and occupancy, medical supplies and equipment2, and administrative expenses, are also rising.  

Are your revenues growing as quickly as your costs? It's essential to look for fresh solutions before it's too late if you notice that the difference between costs and revenues is closing.  

One of the wisest decisions you can make when you are not getting the financial return you desire is to contact an expert who will examine your existing practice management and revenue cycle operations.  It's possible that you're losing money without even realizing it; a professional will know how to identify both issues and chances to boost revenue. 

Coding Errors and Claims Denials Are on the Rise

Complexities in healthcare coding are a recurring problem for many medical offices. In a single year, there may be up to 1,000 different code changes across all specializations. Staff in a single medical organization find it exceedingly challenging to keep up, which is when mistakes occur. 

80 percent of bills have errors, and more than 50 percent of providers employ modifiers incorrectly3.  Coding mistakes and omissions can cost businesses thousands of dollars every month and raise the risk of abuse or fraud cases. 

Additionally, unreasonably high rates of claim denials are brought on by coding and documentation problems. Your practice's bottom-line revenues should probably be greater than they are if it isn't attaining a clean claims rate of 95% or more (some R1 clients achieve 99%).  That implies that you are not collecting the full amount of your debt.

By having a professional examine your coding procedures and claim denial trends, you may reduce risk and increase accuracy. Hire a professional to perform these tasks for you instead.

Medical coding is a critical aspect of the healthcare revenue cycle, ensuring accurate and timely reimbursement for services provided by physicians. However, the complexities of coding guidelines, constant updates, and the need for precise documentation can make in-house coding a challenging and resource-intensive task for physicians and their staff. As a solution, many physicians opt to outsource medical coding services to specialized companies.  

You're Experiencing Friction in Processes & Cross-Departmental Exchanges

Any medical practice will likely include "Band-Aid" treatments for problems that at first seemed to be minor but rose in frequency and severity as the practice evolved if you look closely enough. Soon enough, systems will stop interacting with one another, processes will be complicated for no apparent reason, and staff members will be stuck performing lengthy manual activities that have long since been automated. This type of medical "friction" is a surefire indication that your practice requires substantial attention. 

Conclusion

Recognizing the signs that indicate the need for support from a physician practice management company can significantly benefit healthcare providers and their practices. By leveraging the expertise of these specialized companies, physician practices can alleviate administrative burdens, improve financial performance, enhance regulatory compliance, and elevate patient satisfaction.

As the healthcare landscape continues to evolve, partnering with a physician practice management company becomes a strategic choice for physicians seeking to thrive in an increasingly competitive and challenging industry.

Healthcare practice consulting plays a crucial role in empowering physicians for success in a dynamic and challenging healthcare environment. By offering strategic planning, financial management support, workflow optimization, compliance guidance, and a patient-centered approach, consultants enable physicians to focus on their core competency – providing exceptional patient care.

The collaboration between physicians and healthcare practice consulting firms fosters a culture of continuous improvement and innovation, ensuring that physicians can thrive, adapt, and excel in an ever-evolving healthcare landscape.