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

March 1, 2023

Your goal as a physician is to provide superior healthcare for your patients, but running a successful medical group takes a lot more than clinical excellence. The day-to-day demands of operating a busy physician practice require you to have superior business management skills.  

The larger your practice, the more skilled you and your team need to be in non-clinical roles such as accounting, human resources, vendor negotiations and contracting, managing insurance claims, bill collection and IT.  Many medical groups that choose to take on these business functions internally find they’re in a never-ending uphill battle. 

Here are four tell-tale signs that it’s time to consider outsourcing some or all your practice management and revenue cycle operations: 

1.  Employee staffing consumes far too much of your time.

A  poll from the Medical Group Management Association (MGMA) found that 73% of medical practices ranked staffing as their biggest challenge for 2022.1    Finding high-quality candidates in today’s tight healthcare labor market is a time-consuming battle that many practices aren’t winning.   

Staff shortages impact the level of care and service you can provide to your patients.  If staffing is a significant issue for your medical group, then it’s time to do something about it.  A practice management expert can help with employee recruitment and onboarding while also finding operational efficiencies that help you run a successful practice with less staff. 

2.  The costs of running your physician practice are climbing while revenues are flat or shrinking.

In today’s tight labor market, your staffing costs are likely rising in every corner of your practice. Other costs, from building and occupancy to medical supplies2  and equipment to administrative costs are on the rise, too.  

Are your revenues keeping pace with your growing costs? If you find the gap between costs and revenue is getting smaller, it’s time to seek new solutions before it’s too late.  

When you are not achieving the financial return you want, one of the smartest moves you can take is consulting with an expert who will review your current revenue cycle operations and practice management processes.  It’s possible that you’re leaking revenue and don’t even know it; an expert will know how to spot both problems and opportunities for revenue improvement. 

3.  Coding errors and claims denials are on the rise.

Healthcare coding complexities present a perennial challenge for many physician practices. There can be as many as 1,000 unique code changes across all specialties in a single year. It’s extremely difficult for staff in a single medical group to keep up, and that’s when mistakes happen. 

Over 50% of providers use modifiers incorrectly3 and 80% of bills contain errors.4  Errors and omissions in coding can cost practices thousands of dollars each month and lead to potential abuse or fraud cases. 

Coding and documentation errors also result in unnecessarily high rates of claim denials. If your practice isn’t achieving a clean claims rate of 95% or better (some R1 clients achieve 99%), then there’s a good chance your bottom-line revenues should be higher than they are.  That means you’re not capturing all the money you’re due.

You can minimize risk and maximize accuracy by having an expert come in and audit your coding processes and claim denial patterns. Better yet, hire an expert to handle these functions for you.  

4. You’re experiencing friction in processes and cross-departmental exchanges.

If you look close enough at any medical group, it’s not unusual to find “band-aid” fixes to solutions to what first seemed like small issues but expanded in frequency and intensity as the practice grew. Pretty soon, systems aren’t talking to each other, no one knows why processes are convoluted and staff is mired in multi-step manual tasks that should have been automated years ago. We call this healthcare “friction” and it’s a sure sign that your practice needs some serious attention. 

How working with an expert like R1 works:

R1 works closely with you and your team to perfect practice workflows and strategies. Our solutions ease administrative burdens and financial worries. We stay on top of critical issues affecting your practice and continually innovate new ways to help you address root-cause challenges, accurately and profitability. 

Some medical groups are hesitant to reach out to a physician practice management company because they’re worried about outsourcing costs; R1 clients regularly report a stronger bottom-line thanks to the services we provide. Outsourcing the smart way doesn’t cost; it pays.

“The comprehensive nature of R1’s services allows us to do what we love to do and not get burned out by administrative work. They essentially take that off our plate and support us every step of the way with practice management support—including billing services, coding education, quality, compliance, and much more.” -Jeff Rutledge, MD, FAAP, Physician Owner, RDMG 

What can we help you with today? 

R1 will handle the business issues you’re struggling with, so you have more time to do what you do best: care for your patients. Below is a list of our most popular practice management services.  

Practice entity services

Guidance for entity structure, governance, and strategic planning for your organization.

Finance and accounting services

Track, analyze, and report expenses as well as manage your accounts payable, tax preparation, and banking relationships.

Practice operations management

Management of your day-to-day operations to allow better focus on patient care.

Human resources

Ongoing compliance for insurance and workers’ compensation as well as assistance with federal compliance.

Payroll services

Processing of payroll, related payroll, and tax statements, year-end taxes, and more.

Third-party billing and collection vendor partnering

Assist in the selection and negotiations of billing company and collection agency.

Risk and litigation management

Deploy strategies to mitigate risks and manage malpractice liability coverage.

Provider recruiting services

Develop staffing needs assessment and candidate management during the recruiting process.

Tools for optimizing provider scheduling

Increase cost efficiencies and appropriately manage resources by ensuring provider coverage aligns with patient demand.

Provider scheduling services

Ensure full provider coverage via tailored schedule management with 24/7 on-demand scheduling back-up.

Credentialing and privileging

Verify the qualifications of practitioners and enable the proper authorization to provide care.

IT infrastructure and applications

Support for telecommunications, A/V, website, network and server administration, desktop support, and technology procurement to ensure continuous operations.

Practice analytics

Customizable and interactive dashboards support interactivity for ad hoc data analysis and exploration.

Stakeholder satisfaction

Monitor and report on patient and staff satisfaction and engagement via ongoing surveys.

Reach out to us today at contact@r1rcm.com to learn more about how we can help your practice.

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Author Bio: Scott Maul is the VP of Client Services for R1

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