Starting Your Private Practice: A Guide to RCM
If you’re a physician dreaming of running your own private practice, you are not alone. Among the million physicians in the US, 51.8% are in practices with 10 or fewer physicians, according to the American Medical Association. It’s an exciting endeavor, but also a significant undertaking.
In fact, 28.8% of solo practitioners are experiencing high emotional exhaustion. While launching a medical business can be daunting, you can still set yourself up for success. But how? The answers may not be in your medical books, but in preparing your revenue cycle management.
In this blog, let’s take a closer look at the advantages of going solo, the fundamentals of healthcare RCM, and what thriving businesses do for financial success.
Why go solo? The perks of owning your own clinic
Back in med school, all you have to do is study and take the necessary steps to be a physician. No one teaches you about formal business training, and yet many venture into owning their own clinics.
The reasons may be deeper than you think. Apart from the economic impact, a private practice can help physicians shape their clinical setting and schedules, prioritize patient well-being without feeling rushed to see lots of patients, and feel purposefully fulfilled.
Dr. Choi, an AMA member, shared in an article, “Independent practice puts medicine back into the hands of physicians. It gives us control over all aspects of decision-making of the patient’s care.”
Interestingly, the Journal of the American Board of Family Medicine reported that independent primary care practices have dramatically lower levels of burnout (13.5%) than the national average (54.4%). The study revealed that independence and autonomy helped ease the burnout.
Ultimately, more physicians are seeing the positive impact of going solo and taking that bold leap, so what’s next? Careful planning, developing your business skills, and having the willingness to evolve. Let’s begin with learning about healthcare revenue cycle management.
What is healthcare revenue cycle management?
Without revenues, you can’t sustain your business. If you can’t maintain your business, you risk losing your professional freedom.
Keep in mind these fundamentals of RCM:
Defining healthcare RCM: It is the full spectrum of administrative and financial processes involved in managing the entire lifecycle of revenue generation related to patient services.
What the flow looks like: The process spans from the moment an appointment is scheduled through registration, insurance verification, coding, billing, claims submission, payment collection, and final account resolution.
The main goal of RCM: Secure accurate and timely reimbursement by reducing billing errors, minimizing claim denials, and improving cash flow.
The key tasks include:
- Verifying patient eligibility
- Coding services correctly
- Submitting clean claims
- Managing denials and appeals
- Following up on outstanding balances
When executed accurately and efficiently, RCM not only promotes financial stability but also contributes to a better patient experience by streamlining billing and payment processes.
That’s why a well-managed revenue cycle supports both your clinical mission and your business viability.
Best RCM practices for building a successful healthcare practice
At Synapse Reveue Cycle Management, we believe in running your business with your best foot forward. It’s like growing your own tree. As a seedling, give your practice the best nutrients and nourish the soil by strengthening your RCM knowledge. You will surely reap the benefits of owning a healthcare practice.
Here’s what you can do for a solid RCM:
1. Clean claims require accurate patient data collection. Mistakes happen, but it can be detrimental for a small healthcare practice. On day one, you already need to leverage on the right technology to reduce denials and improve accuracy.
- You can implement customizable patient check-in forms with automated reminders, secure messaging, and strong integration with EHR systems.
- You can also have a comprehensive patient intake platform including online scheduling, digital check-in, pre-registration, payment processing, and patient communication tools.
- You can explore a cloud-based patient intake solution enabling remote pre-registration, virtual check-ins, electronic signatures, and flexible forms.
2. Be ready for changes in payer requirements, compliance rules, and coding updates. The healthcare industry is dynamic as we know it. With the One Big Beautiful Bill Act (OBBBA) passed into law, many healthcare practice owners are worried about its implications for patient billing and care. Stay ahead of the curve by doing these steps:
- Monitor updates through CMS and HHS on Medicaid and ACA changes.
- Audit coding regularly to reduce errors and denials.
- Update billing formats to follow the new, clear, itemized, and patient-friendly structure.
- Coordinate documents carefully, especially for out-of-network emergency services.
- Give accurate cost estimates before treatment to avoid confusion.
Train staff to explain bills clearly and handle more patient questions.
3. Partner with RCM experts like Synapse. New practice owners have a lot on their plates. Studies consistently show that reducing administrative overload improves physician satisfaction and patient outcomes, making outsourcing a strategic move if you’re aiming to balance clinical and business demands.
- Our RCM professionals can handle intricate details of medical billing codes, payer rules, and ever-evolving healthcare regulations including HIPAA compliance and insurance mandates.
- We enhance your financial performance by improving your collection rate up to 98%, increasing your average revenue by 15%.
A Start-Up’s Smart Choice Reaped Results
The partnership resulted in consistent growth in average collections. Most notably, their average monthly collection doubled from $26,348.64 average monthly collection to $50,759.84 during the 3rd year. Average monthly collection continued to grow at 24.54% and 29% on year 4 and year 5 respectively.
The partnership resulted in consistent growth in average collections. Most notably, their average monthly collection doubled from $26,348.64 average monthly collection to $50,759.84 during the 3rd year. Average monthly collection continued to grow at 24.54% and 29% on year 4 and year 5 respectively.
Want to see our Synapse solutions in action?
Start your practice the right way – by committing to RCM education and seeking expertise. Grow your private practice through Synapse’s full suite of revenue cycle services:
- Fully integrated electronic health record systems.
- Extensive coding services that don’t miss.
- Manage and track all of your enrollments for you so you can concentrate on providing excellent patient care.
- Claim submission and tracking to resolving denials and delayed payments.
- Prior authorizations to get immediate approval on your first submission.
- Attract more patients with a user-friendly, visually appealing, and efficient online presence.
Source
Blechter, B., Jiang, N., Cleland, C., Berry, C., Ogedegbe, O., & Shelley, D. (2018). Correlates of Burnout in Small Independent Primary Care Practices in an Urban Setting. The Journal of the American Board of Family Medicine, 31(4), 529–536.
https://doi.org/10.3122/jabfm.2018.04.170360
Dreher, A., Theune, M., Kersting, C., Geiser, F., & Weltermann, B. (2019). Prevalence of burnout among German general practitioners: Comparison of physicians working in solo and group practices. PLOS ONE, 14(2), e0211223.
https://doi.org/10.1371/journal.pone.0211223
Kane, C. (n.d.). Policy Research Perspectives Recent Changes in Physician Practice Arrangements: Shifts Away from Private Practice and Towards Larger Practice Size Continue Through 2022.
https://www.ama-assn.org/system/files/2022-prp-practice-arrangement.pdf
What it takes to start your physician private practice. (2023, July 3). American Medical Association.
https://www.ama-assn.org/practice-management/private-practices/what-it-takes-start-your-physician-private-practice