Outsourcing Medical Billing

Surveys taken at the end of 2011 reveal that one of the most important issues that doctors face today is payment collection for services rendered on medical billing.  Because of complex rules and regulations that are required, medical practices are overwhelmed with paperwork related to billing procedures.  Whether it is contacting patients regarding payment or following up on unpaid claims from insurance companies, this time-consuming aspect is taking a toll on practices throughout the country.

There are some choices to consider when it applies to medical billing.  A doctor can build his internal staff to handle the load or he can outsource to a third party medical billing company.

Many practices opt for an in-house system.  On the surface this may appear to be an attractive way to keep control of your practice.  The main problem is the cost to provide salaries and benefits to the employees coupled with a lack of incentive for performance.  These employees receive their regular paychecks regardless of payment received or timely payment from date of service.

Alternatively, outsourced billing can be more attractive given the direct incentive to perform as they are compensated as a percentage of collections.  This model motivates the vender who is completely dedicated to the billing process to maximize reimbursement for the practice.  The savings add up quickly when the cost of hiring/training staff and buying newer technology is added to the total.

Areas to Consider

Operational Control.  Outsourcing billing responsibilities can feel like giving up control.  An outsourced billing service should be able to provide the practice with less administrative obligations.  The practice will have to be comfortable with trusting others to capture the money they are due.  The decision hinges on where or not loss of control is offset by less aggravation, more time for patient care and increased revenue.

Expense.  Hiring and training employees as well as the related technology platforms needed presents the dilemma of managing this with control of expenses.  The benefit of this approach is that you will have direct control of what is billed.  Practice managers and doctors must supervise this process daily to make sure everything is accounted for.  Losing key personnel will present difficulties.  When using a billing company, the issue of having to find and keep trusted and experienced billers is mute.

Compliance. Time allocated by you and your staff to keep up to date with ever-changing rules pertaining to medical billing is even more apparent today than ever.  In this regulatory environment, staying compliant is a full time job and needs to be taken seriously.

Coding.  Medical coding is a very specialized business and your income is hanging in the balance.  The change to ICD-10 coding will expose those practices that are not up-to-date with the new regulations.  Coders need to be experienced in your specialty, certified and receive continuing education and training.

Technology.  To properly handle medical billing, the technology platform needs to be state-of-the-art.  An overlooked benefit of outsourced billing is the use of electronic-billing systems that speed up the claims process.  Investing in the right technology can provide excellent long term benefits and savings.  If you are unable to afford a good system it might be better to farm out your billing.  This will eliminate the need to purchase and maintain a billing platform, saving a significant and reoccurring expense.

With the advent of ANSI 5010 and ICD10, practices must stay abreast of government and insurance carrier rules and requirements.  Medical billing firms dedicate considerable resources to monitoring these changes and training their staff on how these changes will affect the doctor’s collections.

Third party billing companies typically provide practices a lower number of days in accounts receivable (the number of days required to convert billing into payment) in comparison to in-house billing staff.   They will normally apply scrubbing technology that reviews claims for known errors.  Because they are working for multiple practices, errors that are discovered can be applied the entire client base as a whole.

Consider outsourcing your medical billing to a respected professional firm. With claim submission and payment collection in the hands of a well qualified vendor, practices will have more time and resources to focus on patient care and business growth.

Iron Comet Consulting is a Mckesson Platinum certified reseller, medical IT firm and medical billing service based in Stockbridge, Georgia. Our products combine the clinical with the financial to improve workflow and revenue capture. Mckesson’s Medisoft Clinical is a complete physician practice optimization solution. For more information, please visit http://www.ironcomet.com/



Share this post:

Leave a Reply

Your email address will not be published. Required fields are marked *