Reading Time: 4 minutes By Jerry Dennany, Chief Technology Officer at Brightree As an HME or pharmacy home infusion provider, your patients place their trust in you to get
During the past two years, HME providers have experienced a drastic change in the labor market. To start, there was a mad scramble for organizations to figure out how to operate on a daily basis as their billers and entire staff were moving to a model of working from home. There was also a shuffle of workers: some leaving to pursue other opportunities within the industry, some jumping to other areas of healthcare, and others to different industries all together. And then there was also a large group of folks who opted for early retirement, and these were generally employees with the highest level of expertise and institutional knowledge within your organization.
As a result of this massive disruption to regular operations, providers started to see an impact to cash flow. Think about it: when you hire new resources to manage all this attrition, the new employees might not be able to immediately produce the same throughput and quality that you’ve come to expect, and training can take three to six months. This can lead to issues like a backlog of tasks, an increase in denials, a reduction in cashflow and an increase in expenses and added burden on other colleagues and management.
At the same time as all this change in labor for providers, payers were experiencing labor shortages that resulted in much longer processing times for claims and call hold times when billers within your organization tried to contact them. Of course, this increase in the volume of outreach to payers leads to the need for additional resources on the provider side, which, depending on your geography, may have very limited access to good talent for the extremely specialized DME billing with ever changing rules and regulations on how payers get paid on claims. And the fact that payers cannot process claims in a timely manner further impacts your cashflow.
Co-sourcing becoming popular choice
So where does that leave providers like you? One choice is to keep the status quo, which means you’re leaving money on the table. Instead, some providers have made a bigger push towards automation by introducing more technology to overcome the labor shortage. For providers in the position to quickly adopt technology, that approach has helped them weather the storm. For other providers, they’ve started looking for an alternate solution so that they don’t have to worry about finding talent themselves. And the absolute best way to solve for that is co-sourcing because of the expertise and stability it brings an organization, including:
- Access to resources well versed in billing and collections
- Tap into scale as business expands
- Benefit from process improvements through best practices
- Access to consistent informational reporting
We’ve actually seen an outpouring of requests for co-sourcing in the past two years with the number of customers we’re serving through our Brightree Revenue Cycle Management Services exploding by 50%. And we’re processing over $700 million annually in claims on behalf of our customers.
No matter which billing entity you choose to team with for co-sourcing your revenue cycle management functions, there are five gains you should get with your move to this model.
- Focus on your core competency. With the right co-sourcing partner, you can zero in on taking care of your patients and growing your business because you’re no longer worrying about issues like: “Do I have the right number of employees? or “Do I have the right level of expertise?” And as you grow, your co-sourcing partner provides the new talent you need rather than you having to go find it yourself.
- Variable cost. As your volume fluctuates on a month-to-month basis, your co-sourcing service will scale up or down to meet that, which becomes an advantage in terms of savings because you’re no longer having to hire and fire people to mimic this model. And a good co-sourcing partner is deploying the right number of resources for the volume of work, so you don’t have to worry about your tasks or backlog increasing.
- Reduction in overhead. When you’re co-sourcing, you don’t have to take on additional overhead — like more employees, floor space, computers, phone lines, furniture — as you grow your business. All those expenses should be absorbed by the co-sourcing service that is managing your revenue cycle.
- Access to expertise across product lines. As providers like you look to enter new product lines, your co-sourcing partner should be able to provide the billing expertise to support it. That includes understanding how to bill those product lines based on the payer requirements and payer mix. The ability to tap into that expertise is a massive advantage because you don’t have to worry about billing and can instead focus on expanding in this new product line you’re entering.
- Business insight. Beyond resources, a good co-sourcing partner will bring you access to excellent reporting and analytics that can interpret data to help you monitor your business and establish goals as well as minimize any gaps to achieving them. I would say that this is one of the most important gains for providers because you’re basically getting access to an analyst on your team who is looking out for your best interest and giving you operational and financial insights into your business on what needs to improve, where the challenges are, what might be the bottlenecks and so on.
Tap into the talent
The challenges to finding expertise in today’s labor market for HME billing have never been greater –whether it’s “the great resignation” economy making it hard to find talent, the difficulty of staying on top of all the rules and regulations for specialized DME billing, or the need to absorb the growing cost of labor while reimbursement from payers is down.
So, it shouldn’t be surprising that the co-sourcing approach is attracting more and more HME providers by providing access to the talent and expertise you need for effective revenue cycle management. As a result, you no longer need to deal with attrition, training or managing billing employees or reductions in your cash flow and can instead focus on patients and growing your business.
With Brightree Revenue Cycle Management, our co-sourcing customers see an average 15% improvement in their collections* and 7% improvement in 90-day roll. And you can, too.
(*results may vary)
Sunil Krishnan, Vice President, Revenue Cycle Management
As Vice President for the Revenue Cycle Management service business for Brightree, Sunil leads global operations with a distinct focus on driving value for clients by maximizing their quality and ROI. In addition, Sunil’s expertise in managing operations and his keen focus on analytics helps customers achieve optimization and workflow efficiency, as well as help to provide actionable insights into businesses. Sunil has a diverse background with strong business and deep technical skills. Prior to joining Brightree, Sunil worked at Intel Corporation as a Senior Design Engineer. Sunil has a Masters in Electrical Engineering from Arizona State University and an MBA from the Goizueta Business School at Emory University.
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