Should You Outsource Medical Billing Services?

While many practices trust the talent and experience of in-house employees over those 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.

This means that by outsourcing these responsibilities, practices 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 practice, and how to make the transition go as smooth as it should.

What Does It Mean To Outsource Billing?

Practices of all structures and sizes employ in-house staff to handle billing, meaning the responsibility for timely, accurate, and well-organized billing lies with the practice. As many practice managers understand, this process is fraught with challenges and is one of the major non-medical stressor to the financial and organizational health of the practice.
By outsourcing billing, you remove the pressure and responsibility of billing to 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 staff has more time for other tasks that can help improve the practice.

Difference Between In-House and Outsourced Medical Billing

The most obvious difference between in-house and outsourced billing 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 billing, outsourcing can provide several advantages compared to having your own team handle the payment process.

Billing Expertise

Perhaps the biggest benefit of hiring an outsourced team to handle your practices 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 billing specifically.

In addition, there are people 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.

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 in-house, these denied claims often go untouched, even if there’s reimbursement waiting to be claimed. With a dedicated team of experts at your side, billing can be given the time and attention it deserves, so you can be sure you get the money your practice deserves.

Trusting Your Healthcare Advocate

It can feel risky to hand over all your billing needs to people who don’t work in your 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 the key 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 in your practice: taking care of patients.

Benefits of Outsourcing Billing

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.

Faster Payments

In-house administrators simply don’t have the same capacity as a dedicated team. By expanding your team with outsourced billing services, you speed up the claim submission process, leading to quicker payments and more reliable revenue stream. And even when claims are denied, an outsourced team will jump right on them to ensure 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, in-house billing employees often need training, specific software or hardware, and office space 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 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 revenue cycle management and how to improve it. Plus, because your practice’s success defines their success, an external medical billing company is incentivized to make you as successful as possible.

Integrated Data

By integrating directly into your EHR system, practices are able to see the billing data they care about in real-time. In addition, this allows the billing company to tailor 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 billing team is dedicated to the world of medical billing. This means they’re constantly thinking about the changing landscape of regulations, payor habits and idiosyncrasies, and up-to-date best practices.

What to Look For in a Medical Billing Company

Not all medical billing companies are the same. It’s important to get familiar with a company’s services and working style before signing a contract so you don’t end up with a service that doesn’t work for your unique practice.

Comprehensive Revenue Cycle Management

A medical billing company should provide specific details on how they handle the billing process from start to finish. The 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 services so the practice doesn’t end up still being responsible for billing.

Transparent Communication

When evaluating an outsourced billing company, clear communication is vital. A company should not have any trouble revealing certain data points—especially unflattering ones—and respond to practices in a timely manner. 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 a medical billing company. Explaining your unique circumstances and goals to the billing company can help them tailor their services to best serve your and your patients’ interests.

Outsource Billing to Maximize Revenue

As hard-working as your in-house 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 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. Contact us today to learn more about our customizable services and how we can help your practice grow.