There’s no disputing the cost savings home health and hospice organizations see when they outsource billing services, coding and OASIS review, or full revenue cycle management -- but selecting the right provider is key to a successful partnership.
The right choice offers agencies peace of mind as well as bottom line impact, according to SimiTree Principal J’non Griffin, who serves as SVP of Coding and OASIS.
“The right outsourcing arrangement will inspire confidence based on the reliability and expertise of the provider,” she said. “And it will also benefit agencies by plugging them into best practices and industry standards for success.”
With inflation driving labor and supply costs, and a proposed 4.2 percent rate cut looming for next year, the revenue cycle experts at SimiTree say choosing the right outsourcing partner could well be one of the deciding factors in whether agencies have a successful 2023.
They’ve compiled a few important tips to guide agencies in making the right choice.
1. Price Isn’t What Matters Most
“Certainly, price is one of the important factors to consider, but it is by no means the only factor – and making a decision based solely on price can lead to issues in other areas,” Griffin said.
Sometimes the price tag is the low fruit dangling on what turns out to be a tree of problems for unsuspecting agencies. When a provider charges significantly less than the industry standard, you should be wary. Is the cost lower because coders, billers and other positions requiring specialized training are not receiving regular training?
Everyone loves a deal, and no one wants to feel overcharged for services, but in the case of outsourcing services that determine your agency’s reimbursement, the price tag tends to be a “now or later” proposition. If you’re not paying an industry standard rate now, it’s likely that you are setting yourself up for substantial costs later when shoddy work results in claims denials or costly payment-related audits. The latter can result in paybacks, penalties and even fraud charges.
2. Reputation Matters
What is the provider’s reputation in the industry for reliability and security? How long has the company been in business? You will be sharing Protected Health Information (PHI), and a trusted name is important.
Generally, the most trustworthy providers will have been in business longer, offer recognizable names and serve the industry in highly visible roles as frequent educators at conferences and events.
Browse the web sites of major industry advocacy organizations to see whether recent conferences featured the names of the outsourcing firm’s leaders in prominent education roles.
3. Look at Full Spectrum of Services
Does the provider offer a full spectrum of services in addition to billing, coding, and revenue cycle management? Is the company positioned to easily step in when you have consulting needs as well – if your agency is elected for a Targeted Probe and Educate Review (TPE), for example, or if you receive unexpected Additional Documentation Requests (ADRs)?
You may have no need for anything other than coding now, but doesn’t it make sense to choose a provider with a full range of other services? Should the need arise in the future, you’ll save time and headaches by being able to ask a trusted partner for additional services.
“The right outsourcing partner will function as a network of additional resources for the agency, modeling best practices and industry standards and providing a degree of expertise that the agency would most likely not be able to achieve on its own,” Griffin said.
“In the right partnership, the agency will benefit from exposure to a higher level of expertise as well as from the work being outsourced. It’s an ongoing learning proposition.”
4. Find the Right Fit
One of the most important factors to weigh when considering an outsourcing partner is its level of experience in handling agencies like yours. In a successful partnership, the outsourcing provider becomes a seamless extension of your agency’s back office and existing employees, fitting into the existing framework to complete the necessary work.
“Does the provider have a track record of serving other agencies as small or as large as yours?” Griffin said. “If you are a small to mid-sized agency, for example, and the coding company typically serves large organizations with multiple agencies, will you be a good fit? It’s important to determine whether the provider has a track record of serving agencies similar to yours.”
A good fit will also inspire trust based on the friendliness and knowledgeability of the outsourcing team.
“Personalities matter,” Griffin said. “We consider likeability one of our strongest assets, and we hope you will, too.”
SimiTree’s Outsourced Services
SimiTree’s outsourcing team gives healthcare organizations access to a robust array of crucial services, from coding and OASIS review to full revenue cycle management. Our experts handle billing, collections, insurance verification, cash posting and all aspects of the revenue cycle.
We offer full QAPI outsourcing and Review Choice Demonstration outsourcing as well.
If you’d like to discuss the benefits of outsourcing with us, we’d love to answer additional questions specific to your agency. Use the form below to reach out today.