For medical practices, the decision to outsource medical billing services allow them to avoid the hassle of in-house billing. By contrast, a practice that keeps billing in-house must stay on top of the latest changes in coding, legal regulations, technology and insurance industry trends. At Advanced Reimbursement Solutions in Wilmington, DE, we operate as a full cycle revenue management enterprise that provides medical billing services.
The Bottom Line: Outsourcing Results High Reimbursement With No Hassle
Practices that keep their billing in-house spend around 30-40% of their collections on the claim submission process. This is because handling claims accurately requires a high level of expertise that is expensive and time-consuming to maintain. Most medical practices would prefer to focus on providing care to their patients!
10 Reasons Why Practices Outsource Medical Billing Services
#1: They Save Money on Office Staff
When practices process claims in-house, they need to hire enough staff to handle the administrative aspects of doing so. Sometimes they need to hire temps when the volume is especially high. Larger practices need to create full-fledged billing departments. By outsourcing billing, a practice can save money on staff. Ultimately, this offsets the cost of the billing service.
#2: They Save Time
When a practice keeps its billing in-house, administrative staff must divert hours towards billing that could be used in other ways. This is especially true for practices that do not have a separate billing department. Employees that do not have medical billing in their job descriptions end up keying in information, preparing claims, and following up on reimbursements. This time can be saved by outsourcing.
#3: They Avoid Training and Re-Training Staff
The technological and legal landscape of medical billing is ever-changing. When a practice keeps its billing in-house, it must provide extensive training to staff and continuously make sure they are aware of changes to the rules. By contrast, professional billing services make awareness of regulatory changes a routine aspect of running their business. They stay current on all the rules on behalf of their clients.
#4: They Avoid Employee Turnover
Practices that keep their billing in-house often experience high employee turnover. This happens because the process of submitting claims correctly requires high competency and focus, yet it tends to be tedious. There are few people with the intelligence necessary to do medical billing who find long-term job satisfaction in claims submission. When a practice outsources its medical billing, it no longer has to make the investment of training new staff every time there is turnover.
#5: They Reduce the Number of In-Coming Phone Calls
When a practice maintains a billing department or staff dedicated to billing, a high percentage of the phone calls it receives pertain to claims. By cutting down on these calls, the practice can respond to other types of calls more quickly.
#6: Their Billing Is Done by Experts
A medical practice is responsible for many things. It needs to excel at providing patient care and taking care of administrative duties. Given its other responsibilities, it may not be able to focus on ensuring that its billing is top-notch.
On the other hand, medical billing services specialize in claims submission and reimbursement as their main area of focus. This means that, in most cases, the quality of the service they provide exceeds that which a typical practice could achieve on its own.
#7: They Save Office Space
By outsourcing its medical billing, a medical practice can save space because records pertaining to the claims do not need to be stored within the office. Companies that focus on medical billing have sophisticated mechanisms to keep the records organized externally. Their organizational systems have an added benefit. Within the context of appropriate legal compliance, data within these databases is easy to access for analytical purposes.
#8: They Do Not Need to Invest in Billing Software
When a practice does not outsource its billing, it must stay technologically equipped to handle the job internally. This means spending money on the latest billing software. Updates to this software are expensive and unavoidable given the frequency of changes within the billing process.
This expense is more efficiently handled by a medical billing company than by an individual practice. This is because the billing company can provide services to many practices after making just a few software purchases.
#9: They Benefit From Automatic Insurance Verification
When a practice outsources its billing, it gets access to immediate insurance verification. This includes information pertaining to whether or not a patient has had the maximum number of visits allowed for a condition, whether patients have met their deductibles, and whether some event has made them ineligible for the coverage.
#10: They Reduce Coding Errors
In addition to staying current on the ever-changing rules, medical billing companies invest in state-of-the-art software that can check claims for errors and predict when they might be problematic. As they process a claim, these companies thoroughly check to make sure it is clean and ready for submission. Any problems they find can be fixed before payment is delayed. This ensures that claims are submitted with greater accuracy.
#11: Reimbursement Goes Faster
In part because of the reduction in coding errors, practices that outsource their billing get reimbursed faster than those that do not. A paper-based claim submitted directly from a practice can take up to two months to be paid. By contrast, a properly coded claim submitted by a billing service can be paid in as little as one week. Therefore, practices that outsource their billing can look forward to an increase in their cash flow.
#12: They Don’t Need to Communicate Directly With Insurance Carriers and Third-Party Payers
In-house claim submission is not always a straightforward or transparent process. Often, certain aspects need to be clarified by asking insurance carriers and third-party payers questions. Companies that provide medical billing usually have staff specifically dedicated to maintaining relationships with these entities. They handle the communication on behalf of the practices.
#13: They Gain Access to Expert Legal Resources
All legal aspects related to people’s health are complicated and at times controversial. Laws are always subject to repeal and revision. Regulations that govern medical billing are no exception, and the situation is especially complex given that there are different laws at the state and federal levels.
For a medical practice, keeping track of these laws and ensuring compliance is challenging. Fortunately, medical billing services specialize in having the most accurate legal information and often benefit from important connections within the field of law.
#14: They Gain Access to Experience
When a billing problem arises for a practice that keeps its billing in-house, it can only determine a solution based on its own past experience. By contrast, companies that specialize in medical billing services handle thousands of claims for many different procedures and a huge variety of practices. Chances are, when an issue does arise, they have seen it before and know what to do.
#15: They Are Prepared in the Event of a Payer Audit
Payer audits are common scenarios for billing services, and ones they are equipped to handle as a result of working with many different practices. To a billing service, this is a routine aspect of billing that they can handle easily. When they are called in to support a practice through an audit, billing services have valuable experience and documentation that can help make the process move smoothly.
#16: They Are Less Affected by Changes to Coding Procedures
In the case of in-house billing, the staff are not always aware of important changes before they result in rejected claims. This makes re-submission a frequent and costly process that takes employee time and delays cash flow. A company that provides medical billing services uses preemptive measures to keep on top of regulatory trends and to ensure that the maximum number of claims are paid the first time they are submitted.
#17: Their Patient Information Is Secure
A private medical record is one of the most valuable commodities on the black market. It can yield 10 to 20 times more profit than a credit card number. For a medical practice, maintaining the IT systems necessary to provide adequate security is expensive. Medical billing services have the resources to invest in the most advanced technology, keeping patient records secure. Their processes are HIPAA-compliant and check all the legal boxes related to keeping medical information safe.
#18: They Can Make Better Business-Related Decisions
The electronic databases used by medical billing companies can easily show which payers are more timely with their reimbursements and which procedures are most likely to yield rejected claims. This information can help a practice identify which procedures it should offer and which payers it should accept.
These databases can also show the percentage of claims that are paid on their first submission. Additionally, they can identify frequent issues in the submission process. With this information, practices can better train their providers and staff to submit claims correctly.
#19: They Can Stay Focused on Their Patients
A practice that does not have to devote time to billing can focus on the most important aspect of its work: caring for patients. Time previously spent keeping up to date on coding and billing regulations can be spent learning about advances in medical treatments. Staff that would otherwise have to keep on top of the reimbursement cycle can spend more time nurturing relationships with patients. When doctors don’t have to navigate the complicated billing process, they can direct more energy towards providing care.
#20: They See An Increase In Patient Satisfaction
For patients, a visit to the doctor’s office or hospital must be as straightforward as possible. Having a medical condition that needs attention is unpleasant enough without the added stress of dealing with complicated financial matters. When practices outsource their medical billing, patients benefit from an accurate, simplified billing process.
Why Outsource Medical Billing?
The main reason practices outsource their medical billing is that doing so increases revenue, improves accuracy, and reduces administrative expenses. When a practice does not have to worry about submitting its claims according to ever-changing requirements, it has more time to spend cultivating positive patient relationships.
Benefits of outsourcing include:
- Expedited cash flow
- Greater accuracy in claim submission
- Reduction in staff costs
- Overall reduction in resources devoted to medical billing
- Access to legal expertise
- Access to the most advanced medical billing technology
- Increased security
- Access to collective knowledge pertaining to many aspects of billing
- Increased organization of medical billing information
- More time to spend with patients
- Greater patient satisfaction
For additional information, contact Advanced Reimbursement Solutions in Wilmington, DE today. We are happy to let you know more about our services!
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