How RCM Consulting Services Can Improve Your Practice


Like all businesses, a healthcare clinic can fail just as quickly as it can succeed. As a clinic manager, you may have firsthand experience of an office evolving into a disorganized, inefficient business for one reason or another. Maybe your clientele is growing faster than you can expand, or a nurse quits without a qualified replacement to take their place. Or perhaps, the office’s finances are heading south, and you’re not sure how to reign it in.

Thankfully, you don’t have to have all the answers. Consulting companies are available to assist clinics looking to improve operations. Consultants can provide valuable insights regarding the office’s overall management— like revenue cycle optimization—helping you improve your bottom line so that you can get back to providing the best service to your patients.

Challenges in Revenue Cycle Management

Revenue cycle management (RCM) is a crucial financial process that allows medical practices to keep their doors open. As with most things regarding finance, it gets very complicated keeping track of claims processing and payments, and ensuring it is all done properly and follows regulations.

Everyone who has a personal insurance policy knows how difficult it can be to interact with their insurance provider, and it is no different for healthcare professionals. If a claim is not filled out perfectly, it can be denied by the insurance company, delaying payment. Even a patient account that is only partially incomplete can lead to a denial. Not to mention, health insurance claims can take weeks to process and mailed bills can get lost en route.

The insurance claim is just the first step. If the insurance company doesn’t pay for the entire visit’s bill, the rest is left for the patient to pay. You may have some patients who pay right away, but others may forget or have to pay in increments, meaning you’re still losing money. When a third party gets involved, such as an insurance company, things can get complicated.

Solutions for Improvement

  • Investing in Better RCM Software– This can improve operations in multiple ways but is usually a one-size-fits-all solution. RCM software will automate many duties, taking the risk of human error out of the equation. It can also provide quick answers to any questions because the information is at your fingertips.
  • Outsourcing Billing– This takes the responsibility of medical billing out of you and your employees’ hands entirely. If your practice cycles through many temporary hirers to handle administrative tasks, you cannot operate as efficiently as you could be. Plus, you are leaving yourself open to costly mistakes. Outsourcing these duties does not eradicate the risk of errors, but it does ensure they can be found and remedied quickly.
  • Hiring CRM Consulting Services– Consulting services can be used in conjunction with introducing new software. For example, consulting firms may help clinics use their electronic health record (EHR), practice management (EPM), and CRM software in tandem and more efficiently.

An experienced consultant can help you find software for each of these uses that is compatible with one another. Using both RCM software and outsourced help is an excellent solution as many human errors are eliminated, and you still receive answers from professionals that software cannot give you. RCM consulting services for NextGen users are an excellent example of how these solutions can work in tandem.

Advantages of CRM Consulting

  • Creating Useful Dashboards– Consultants will listen to your needs and provide tailored solutions, like dashboards that make features easily accessible and information freely available. They can set up financial dashboards to feature your office’s key performance indicators, such as payment posting and accounts receivable, to help you optimize your revenue cycle.
  • Actionable KPI Reports– Pouring through data that you are unfamiliar with can feel like looking at a different language. Similar to creating dashboards, a consultant can also build financial reports for you to easily pull on a regular basis. They act as your interpreter, making that information into something you can act upon to improve performance.   
  • Establishing a Streamlined Workflow– If you are lost in the woods, it can be challenging to get your bearing. Having guidance from someone who resides outside the chaos can provide you with quick and practical steps towards reorganizing processes for better outcomes. Again, your consultant will have seen how the best offices have operated and can apply those insights to yours.
  • Easing Employee Workloads– Your office likely doesn’t have an expert on staff to train your employees on how to use a new RCM software. Even if you did, their primary responsibilities wouldn’t allow much time for them to train others. A consultant can take over that role and quickly train your staff.
  • Fewer Mistakes Means Happier Patients– By relying on experienced advice and not learning from mistakes, your office will be able to provide top-quality levels of care to your patients. They will not receive inaccurate bills or experience long wait times, leading to a great customer experience.

Work Smarter

Working hard is not a vice but working ignorantly is. Make life easier on yourself and your employees by implementing the advantages of an RCM with a consultant’s advice. They can provide you with solutions you may not even know you needed as they have already seen what other medical practices like yours need, and they know what is available.