It all starts with the physician who sees the patient to determine the problem and diagnoses and puts together the treatment plan to treat the patient’s illness.

However, to be able to continue that treatment process the physicians need to be fairly reimbursed for their skill, knowledge and time so that they can afford to maintain their office, pay themselves and their staff, adhere to medical guidelines and regulations and sustain the practice into the future. That process is called Revenue Cycle Management or RCM for short.

RCM-STI has a unique program to assist your practice in this RCM process that we call Revenue Cycle Optimization (RCO). What sets us apart from other companies that bill and collect professional medical fees from insurance companies and patients is in our approach to your RCM financial requirements that we explain in our “first principles”:

Sharing of practice and patient information is needed by all to do their job correctly.

Our approach is not to replace your office staff but to augment them and to make your practice more efficient. No one person can do everything, and people do their best work when they work within their experience. To optimize your practice revenue each person needs to know their place in the practice and have the tools and information that they need to do their jobs. To pull an experienced patient liaison staff person from their primary job so they can sit on telephone hold waiting for the insurance company to answer a question doesn’t make sense. The office staff should work to keep patients comfortable and assist the physician in providing the information they need to treat the patient; including making appointments, checking insurance eligibility, recording the reason for the visit, and making sure that demographic and insurance information is entered accurately within the PMS. Once the physician determines the procedure and diagnosis, RCM-STI’s billing staff can deal with the insurance company by checking that the charges are scrubbed for accuracy, filing claims electronically and checking that they were received and accepted, and filing appeals if needed. Once payment is received our staff posts the payments, completes secondary insurance billing or bills the patient for the balance and the process is repeated. If anyone needs to sit on hold for 30 minutes to get an answer from an insurance company, it is the RCM-STI billing staff not yours.

Technology is critical to succeed but changing it is difficult and expensive.

You can’t operate a modern medical practice without information technology. Billing is processed through a commercial electronic clearinghouse
(an electronic data exchange) and payments are returned in the same manner. Portals are required to check patient eligibility and communicate with patients and even billing statements are now sent in an electronic format including the ability for patients to pay bills online with electronic reminders sent
to the patient’s cell phone for payments or recall information. If you are still working with paper, you are increasing your clerical costs and reducing your ability to get paid quickly or at all. Our staff uses these technology tools to optimize your revenue and collections so you can keep your patients happy.

A division of responsibilities is important for the best results.

The practice functions best when the physicians are spending most of their time treating patients. The office staff spends their time working with patients to ensure their wellbeing, answering their questions, making appointments, and scheduling recalls for follow-up visits as well as assisting the physicians as needed. RCM-STI’s experienced RCM staff takes care of your billing, collections, posting of payments and handling insurance appeals for payment issues. At RCM-STI, we conduct internal training sessions with our billing staff to keep them familiar with current billing rules and regulations, as well as reviewing practice reports and analytics to monitor your practice collection status. That is the best way to optimize your revenue, with everyone doing what they do best for maximum efficiency so you can treat patients in a comfortable environment and get paid for the work that you do. That is our concept of Revenue Cycle Optimization.

To share our knowledge of techniques and regulations to benefit the practice.

Medicine is a complicated business model that is highly regulated, and those rules and regulations can affect your income in a positive or negative manner. For Revenue Cycle Optimization to occur we share knowledge of these rules and regulations, as well as provide feedback and education on appropriate billing processes with your staff. Some RCM companies don’t want to share information with your staff because they want you to depend on them. We don’t have that concern because we understand to optimize revenue, we need everyone to work at a high level to maximize outcomes. So, our vision of Revenue Cycle Optimization is not just about billing and collecting your revenue. It includes adding workflow, structure, technology assistance, training and sharing essential knowledge for your physicians and staff. That is the kind of RCM service that is required in today’s healthcare environment to help you maintain a viable medical practice.

Experience, Efficiency, Excellence; the three E’s are required to be successful.

In his 2008 book “Outliers,” Malcolm Gladwell states that it requires someone to spend 10,000 hours to become great at something. Skill comes from practice, training and dedication to the function. Physicians understand better than anyone how long it takes to master medicine. Excellence requires experience, you just can’t expect a staff member to be good and efficient at something
if they don’t have the experience in doing and understanding it. Plus, experienced people are more efficient. Often, they can perform a function in a quarter of the time of someone who’s not experienced. STI is a United States based RCM company with multiple office locations dedicated to the independent physician market since 1979. We have many staff members that have been with us over 20 years and they understand medical billing and collection better than most people. We also understand medical billing rules and regulations. Billing rules and regulations are not as complex as medicine, but they are complicated, and we can apply them to help your practice grow.

Affordability is important for Medical Practice Viability

Everyone understands how difficult it is to find an experienced medical biller to work within a medial office, especially after COVID. No one wants to pay more than they must for a product or service, but medical billing is unique. If billing is improperly done it can result in a zero payment, so what seems to be a less expensive process can become the most expensive option. Missing a timely filing deadline, not checking patient eligibility, or not getting authorization for a procedure can result in write-offs that impacts your revenue. So, outsourcing your billing to an experienced billing staff at RCM-STI can be a viable alternative to adding more staff members. More importantly, RCM-STI only receives payment after we collect and post your fees. So, what really is better, an inexperienced biller, a less expensive billing company without the skills and staffing that you need, or an organized and experienced RCM company like RCM-STI?

If you agree with our first principles and our approach to Revenue Cycle Optimization, we would be like to speak with you to discuss your practice’s RCM plans. STI does credentialing, billing and collections for every medical specialty. We provide several options for RCM from full-service billing if you need to replace retiring billing staff members as well as our “Flex Option,” a boutique program that is personalized to augment your current staff needs for additional billing and collection staff support. For more information or to review our RCM Newsletters for medical practice education visit our web site RCM-STI.com

To schedule a consultation on your practice RCM needs, feel free to call me at 800-487-9135 extension 1188 or by email at sales@RCM-STI.com

We’ve heard many recurring reasons from new STI RCM clients on why they decided to select us. Below are some of the most typical.

“After many years our best biller is retiring, and I can’t find an affordable and capable replacement”.

“We are tired of being bounced around the organization between multiple people and no one seems to know us or is responsible for our billing. We want an organization that assigns a biller to our practice that is consistent and that we can call and speak to daily.”

“They are doing the billing, but no one seems to follow-up on our insurance claims to make sure they are being paid.”

“The number of rejections and write-offs seems excessive”

“Too many write-offs and timely filing issues”

“I’m not getting paid what I expect for the amount of work I’m doing”

“We have to call and ask for reports, they don’t send them to us consistently or on a monthly basis”

“When we check our insurance accounts receivable report, we keep seeing the same names”
“They didn’t seem to have enough people”

“When we call to discuss anything, we have a language issue”

“We need to call the billing company to answer a patient question or payment, we don’t have access to their system”

“My Accounts Receivable is too high”

“My account isn’t getting the attention it needs”

“My biller can’t keep up, but I don’t want to let her go.  What options do I have?”

“Communication with my billing company is poor and no one returns my telephone calls”

“My work isn’t processed in a timely fashion; they are always behind in posting payments”