Is the 16-Day RPM Rule No Longer a Revenue Barrier for OBGYNs?

-
Image
The 16-day RPM rule is becoming less of a revenue barrier for OBGYNs due to regulatory clarifications, improved device compliance, and better billing workflows. Previously, the requirement that remote patient monitoring (RPM) devices collect data for at least 16 days per 30-day period limited reimbursement opportunities. For OBGYN practices managing pregnancy-related monitoring and chronic maternal conditions, this rule often restricted consistent RPM reimbursement . Recent operational adjustments and clearer CMS guidance are changing how practices approach RPM billing for OBGYNs . What Is the 16-Day RPM Rule? The 16-day RPM rule requires that patient monitoring devices record and transmit data for at least 16 days within 30 days to qualify for monthly RPM reimbursement. This rule was designed to ensure consistent patient engagement, but it created challenges in: Short-term pregnancy monitoring Intermittent blood pressure tracking Gestational diabetes management Post...
Post a Comment

How Outsourced Medical Billing Can Improve Your Practice’s Profitability

-

Banner image with a healthcare professional using a laptop and text highlighting how outsourced medical billing can improve practice profitability

Managing a medical practice comes with its fair share of challenges—from patient care to staffing and compliance. But one of the most overlooked factors impacting a practice’s financial health is inefficient billing. That’s where outsourced medical billing comes in—not just as a cost-cutting solution, but as a profitability booster.

Here’s how outsourcing your medical billing can significantly improve your bottom line.

1. Reduced Administrative Costs

Running an in-house billing department requires trained staff, billing software, continual updates, and compliance oversight. These overhead costs can add up quickly. Outsourcing eliminates the need for these expenses, allowing you to pay only for the services you use—often at a fraction of the cost.

2. Faster Claim Submission and Reimbursement

Professional billing companies are equipped with experienced teams and advanced tools that ensure quick and accurate claim submission. This minimizes delays and accelerates cash flow, giving your practice quicker access to revenue.

3. Fewer Errors, Fewer Denials

Billing and coding errors are among the top causes of claim denials. An outsourced billing partner performs rigorous claim scrubbing, coding audits, and payer rule checks—significantly reducing denials and improving the overall claim acceptance rate.

4. Improved Revenue Cycle Management

Outsourced billing isn’t just about sending claims—it’s about end-to-end revenue cycle management (RCM). From eligibility checks and coding to denial management and patient billing, these providers offer comprehensive support that enhances overall revenue capture.

5. More Time to Focus on Patient Care

Every minute your staff spends chasing down payments or correcting billing errors is time taken away from patient service. By outsourcing billing, your team is free to focus on what matters most—delivering exceptional care, which in turn helps grow your practice organically.

6. Increased Compliance and Reduced Risk

Medical billing companies stay current with evolving regulations (HIPAA, ICD, CPT changes, etc.) to ensure full compliance. This minimizes your legal exposure and the risk of audits or penalties due to outdated practices.

7. Access to Analytics and Reporting

Most outsourced billing providers offer detailed analytics dashboards and monthly reports. These insights help you track trends, monitor collections, identify revenue leaks, and make data-driven decisions to scale profitably.

Final Thoughts

Outsourcing medical billing isn’t just a convenience—it’s a strategic decision that can significantly impact your profitability. From cutting costs and reducing errors to improving reimbursement speed and compliance, the benefits are clear.

If your practice is struggling with high denial rates, delayed payments, or operational inefficiencies, it might be time to let the experts take over your billing—so you can focus on growing your business and caring for your patients. 

If you're looking to streamline your billing operations and boost your bottom line, partnering with a trusted medical billing service can make all the difference.
Explore our customized medical billing solutions for your specialty.

Location: 85CMV6H7+9G

Comments

Post a Comment

Popular posts from this blog

How to Reduce Days in A/R with Smart Denial Management Strategies

-
Image
 Timely reimbursement is the lifeblood of a financially healthy medical practice. Yet, increasing Days in Accounts Receivable (A/R) continues to be one of the most pressing revenue cycle issues for healthcare providers. One of the major culprits behind this issue? Denials. In this blog, we explore how strategic denial management not only reduces days in A/R but also improves cash flow and strengthens your bottom line. Understanding Days in A/R Days in A/R refers to the average number of days it takes for a practice to collect payments due after services have been provided. Industry benchmarks typically suggest keeping A/R days under 35. Anything higher signals inefficiencies - and likely unresolved denials. How Claim Denials Affect A/R Denied claims delay payments and increase administrative burden. Without an effective process to identify, appeal, and correct them, your A/R days will climb - and revenue will suffer. Top causes of denials include: Missing or incorrect ...
Read more

Understanding the Differences Between Claim Denials and Rejections in Medical Billing

-
Image
In the world of medical billing, two terms often cause confusion for healthcare providers and billing staff alike: claim rejections and claim denials . While both impact revenue and delay reimbursements, they are not the same —and understanding the difference is key to faster, cleaner claim processing. Let’s break it down. What Is a Claim Rejection? A claim rejection occurs when a claim is never accepted into the payer’s adjudication system . It is blocked due to errors or missing information , such as: Incorrect patient demographics Invalid insurance ID numbers Incomplete CPT or ICD-10 codes Formatting errors (especially in EDI files) These claims must be corrected and resubmitted —but the good news is they haven't been officially processed yet, so no appeal is needed . What Is a Claim Denial? A claim denial happens after the payer reviews and processes the claim , then decides not to pay it . Reasons may include: Lack of medical necessity Services n...
Read more