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While many healthcare providers trust the talent and experience of their in-house team over that of an external stakeholder, the overwhelming and ever-changing landscape of the healthcare industry makes it difficult for a small in-office team to truly stay on top of all the best practices for medical billing and coding.
This means that by outsourcing these responsibilities, private practices and healthcare organizations can increase revenue and practically expand their teams to include experts who stay completely up-to-date on the changes and the future of medical billing. If this process seems complicated and intimidating, don’t worry. Here’s a look into what outsourced billing is, how it can help your medical practice, how it can bring about increased revenue and cash flow, and how to make the transition go as smoothly as it should.
What Exactly is Medical Billing Outsourcing?
Practices of all structures and sizes employ in-house staff to handle medical coding and billing, meaning the responsibility for timely, accurate, and well-organized billing lies with the practice. As many private practice managers understand, this in-house billing process is fraught with challenges and is one of the major non-medical stressors to the financial and organizational health of the practice.
With medical billing outsourcing services, healthcare facilities can remove the pressure and responsibility to a third-party company of people who do it full-time and have the awareness and experience to adapt to changes in the healthcare industry that affect how payments are processed. This way, your medical billing staff has more time for other tasks that can help improve the practice.
Benefits of Outsourcing Medical Billing Services
The most obvious difference between in-house and medical billing outsourcing companies is that your team no longer handles any part of the process. However, while this can seem like taking a risk by releasing control of patient data, outsourcing can provide several advantages compared to having your own billing department handle the payment process and various billing tasks.
Outsourcing medical billing isn’t the right decision for every practice, but for many, outsourced revenue cycle management can help practices thrive and scale by increasing revenue and decreasing expenses.
Professional Expertise
Perhaps the biggest benefit of hiring an outsourced team to handle your practice’s medical billing is that you’re essentially partnering with an entire billing department with the resources and dedication to all things medical billing. Yes, your team is talented and capable, but with the many responsibilities they have, they simply cannot devote as much time to becoming an expert in the medical billing process specifically.
In addition, there are medical billing specialists whose job is to watch for regulatory changes and inform others in the company to stay proactive in how billing is done, rather than being rocked by the waves of an ever-changing industry. You may also get perks like a statement call center for questions your team might have about any given medical billing service.
Lower Risk of Errors
An error in billing is a big deal, as improper filing or recording can affect reimbursement and can result in claim denials that shouldn’t have happened. When billing is done internally, these denied claims often go untouched, even if there’s reimbursement waiting to be claimed. With a dedicated team of experts at your side, unpaid claims can be given the time and attention they need, so you can be sure you get the money your practice deserves.
Increased Capacity
It can feel risky to hand over all your billing needs to third-party companies who don’t work in your medical practice, which is why trust is key when deciding to outsource. Choosing the right company that takes the time to build a relationship with all stakeholders is key for this to work the way it should. Ultimately, this decision should be to free up your team to focus more on what’s essential: patient satisfaction.
Faster Payments
In-house administrators simply don’t have the same capacity as a dedicated team, especially when trying to process claims, review billing errors, and more. By expanding your team with outsourced billing services, you speed up the claim submission process, leading to quicker payments and more cash flow. And even when claims are denied, outsourcing medical billing ensures a team will jump right on them so no errors got in the way of approval.
Reduced Costs
Handling billing in-house can have many hidden expenses that practice leaders may not be aware of. In addition to salary and benefits, an in-house billing department often needs training, specific software or hardware, and office resources to do their job. Plus, if a team member who helped with billing leaves, not every practice has the time to search diligently for a replacement (who will then, in turn, need training, etc.) and manage the team of people responsible for coding and billing.
Decreased Liability
Although it can seem that giving the responsibility of billing to a group of strangers is a loss of control, the reality is that it’s a reduction in liability for the practice. With increased transparency of data like denial rates and collection ratios, an outsourced billing team gives you full awareness of your entire revenue cycle and how to improve it. Plus, because your practice’s success defines their success, medical billing companies are incentivized to make you as successful as possible.
Integrated Data
This is a unique billing service that might not be available to you if you have a small billing department. By integrating directly into our electronic health records (EHR) system, medical practices can see the billing data and practice revenue they care about in real-time. In addition, this allows the billing company to tailor billing claims to align with your unique policies and agreements. Over time, collecting data about claims both approved and denied can establish trends that lead to better decisions in the future and higher collections.
Proactive Compliance
As mentioned earlier, an outsourced medical billing team is dedicated to the world of medical billing services. This means they’re constantly thinking about the changing landscape of regulations, payor habits and idiosyncrasies, and up-to-date best practices for your medical facility.
What to Look For in a Good Medical Billing Company
Not all medical billing companies are the same. It’s important to get familiar with a company’s outsourced billing services and working style before signing a contract so you don’t end up with billing services that don’t work for your unique practice. Here are our top three things to look for in a medical billing partner when outsourcing medical billing services.
Comprehensive Revenue Cycle Management
The right medical billing company will provide specific details on how they handle the billing process from start to finish. Your practice should set expectations of how involved or hands-off they want to be in the billing process, but the billing company should offer comprehensive billing services so the practice doesn’t end up still being responsible for billing processes and other administrative tasks.
Transparent Communication
When evaluating an outsourced billing services company, clear communication is vital. A company should not have any trouble revealing certain data points—especially unflattering ones—and should respond to your practice promptly. Communication helps ensure compliance and builds trust.
A Contract That Meets Your Practice Goals
Not every practice has the same goals, which means not every practice should get exactly the same services from an outsourced medical billing services company. Explaining your unique circumstances and goals to the outsourced billing company can help them tailor their services to best serve your and your patients’ interests.
Outsourced Medical Billing Services with PayrHealth
As hard-working as your in-house medical billing team is, there are only so many hours in their day that they can spend focused on denied claims, detailed forms, and regulatory changes on the horizon. By outsourcing these responsibilities to a team of devoted medical billing experts, you free up their time to better serve your practice and, most importantly, your patients.
PayrHealth is here to be your advocate in revenue cycle management, tracking down every denial and reporting key metrics in real time to provide you with the information you need to increase financial performance and grow your practice. Contact us today to learn more about our customizable services and how we can help.
