2021 HME Business Handbook: Strategy
How Outsourcing Has Dominated the HME Billing Market In 2021
What economic factors related to billing are eating up your revenue, and how do you act to take back control of your bottom line?
- By Ronnie Hastings
- Jun 01, 2021
billing is exploding.
Today the global medical billing
outsourcing market is expected
to grow to $9.528 billion from
$8.415 billion at a compound
annual growth rate (CAGR) of
13.2 percent in 2021. And the
pandemic has only furthered
In fact, about ninety percent of
healthcare leaders are considering
outsourcing in both clinical and
non-clinical functions to achieve
cost-efficiencies and succeed in
value-based care models due to the
challenges healthcare practices and
their CFOs face in budgeting.
Moreover, the rising labor cost
with each year typically ends up
with more than half of a healthcare
practice’s operating revenue,
leaving them to rethink the role of
in-house billers and coding staff.
Furthermore, in 2020, the
healthcare segment has been held
as the highest revenue share of
47.2 percent in the medical billing
outsourcing market for being
the prime users of outsourcing
services due to high claim volume.
Reprocessing claims drives up costs
as billing staff must dedicate more
time to unpaid claims.
However, given that economic
reality, providers should explore
opportunities to simplify and
streamline a complex organization,
and outsourcing is the best cost-effective
solution so far.
Outsourcing your HME billing operation
or any other medical billing specialties to
a third-party RCM solution can not only
help you determine the right balance of
automation and technology but also help
your practice focus more on patient care.
Also, the right operational extension
can help your provider business overcome
the challenges of disparate EHR
and systems to optimize revenue cycle
management without costly technology
fixes and integrations. The question is
how to choose the perfect RCM?
CHOOSING THE IDEAL RCM SOLUTION
- HIPAA compliance — A complete
HIPAA compliance should be on your
top priority list while choosing the operation
extension for your billing management.
As in the exchange of data during
the billing operation process, it is quite
essential to safeguard the privacy of
people and their information. Also, the
data needs to secure in order to avoid
fraud and laundering of unnecessary
information and money.
- A strong front and back end support
team — A seamless and efficient billing
operation is the key to better reimbursement.
An HME business should always
look for an experienced team handling
their billing operation who are also
experts that completely understand
insurance, payers requirements, changing
billing mandates, new codes, etc.
- An RCM that ensures the highest
productivity metrics — An RCM solution
that helps you eliminate all the
unnecessary costs while decreasing the
overall operational expense is a must,
as it not only helps the practice earn
more but assists them to invest further
to make the patient life and treatment
process adequate. Furthermore, an
RCM solution with the highest productivity
metrics also ensures lesser backlogs
or lost revenue which is also key
towards a thriving billing operation.
- Excellent standard of communication
and reporting — In order to decrease
the gaps in between your HME billing
and coding process, excellent communication
and customized based reporting
is essential as it plays the key ingredient
that aids in reducing your DOS, billing
errors, denial, and claims rejection.
- Helps you with better patient care
management — Improving your key
performance indicators (KPIs) such as
data and coding accuracy, reduced
denial rates and improvement in DSO
along with timely appeals, etc., RCM that
helps to focus on the patient care/clinical
side of the business is equally important.
- Excellent industry references — An
industry reference not only helps you
get the feedback of the work that
you will receive when you opt for the
services from the RCM operational
extension but also gives you the idea if
the operational extension is worth the
try and you are not wasting your money.
Today, there are numerous outsourcing
RCM solutions that are cost-effective and
better than in-house billing. This can save
your business from wasting time on technology
investments, software, and staff.
At Sunknowledge Services Inc., we have
reduced 80 percent of clients’ operational
costs and helped them with seamless
billing operations and a better cash flow.
POINTS TO REMEMBER
- Medical billing trends for 2021
stated that the medical billing
outsourcing industry will touch
nearly $16.9 billion.
- Outsourcing RCM helps healthcare
organizations improve KPIs in this
era of rising healthcare costs and
- Many companies have adopted
offshore business strategies directly
or indirectly as it has been better
- Key players in the outsourcing
market who are ruling can save
you considerable overhead while
driving increased revenues.
To read more about management and
operations strategies, visit hme-business.com/management. To learn more
on improving your billing operations
and productivity metrics, check out
Sunknowledge Services Inc.’s RCM
solutions at sunknowledge.com.
This article originally appeared in the May/Jun 2021 issue of HME Business.
Ronnie Hastings ( Assistant General Manager) brings to the table more than 15 years of professional experience. He has handled major initiatives in contact center operations, relationship management and sales. At Sunknowledge, he started working with Part C and Part D and effective coordination with the private healthcare. Over the last 10 years, he has been a successful mentor and evolved as a promising resource for the company. At present, Ronnie is a pioneer member of Sunknowledge’s strategic think tank and is heading responsibilities in marketing, business development, and account management. He is also a seasoned expert in telemedicine services. He can be reached at Ronnie.Hastings@sunknowledge.com.