Medical Billing is an important process for all health practices. Every health care professional must receive appropriate payment for their services, but medical billing has become more complicated. Codes and regulations are always changing. It can be overwhelming. Subsequently, outsourced medical billing comes in.
What is outsourced medical billing?
Outsourced medical invoicing is the process of hiring an outside third-party company to handle the medical invoicing process for health practices. (As opposed to hiring an internal invoicing department.) The practice only needs to collect the necessary patient information, and the third-party billing company will handle the rest, from the requirements for submission of claims, submission requirements, processing payments and dealing with refusals.
How does outsourced medical invoicing work?
- Patient Information Collection: The practice collects, then provides the patient information needed to the billing company.
- Requirement submission: The billing company prepares and submits requirements for the insurance providers (and follows up).
- Payment feature: When payments are received, they are recorded correctly.
- Disposable management: The billing company handles any refusals or rejections and determines the appropriate bill.
Benefits of Outsourced Medical Billing
There can be many advantages to using outsourced medical invoicing that can improve the financial health and operating effectiveness of your health practices.
Cost savings
One of the biggest benefits of outsourcing medical invoicing we can identify is the cost saving. Your practice reduces the costs associated with employment, labour, salaries, benefits, training and buying of invoicing software or hardware.
Increased income
Specialized billing firms are more efficient when it comes to submitting accurate requirements, allowing for accelerated payments and fewer rejections. Their knowledge will provide more accurate requirements; therefore, there will be a higher percentage of requirements accepted which increases the practice’s practice flow.
Compliance
Medical billing has constant regulatory changes, from HIPAA regulations, ICD-10 changes and variation of codes. A billing firm will ensure the invoicing process is maintained as compatible without penalty risks or legal issues to the practice.
Scalable
Like practices will have complex billing requirements when they grow; therefore, the billing companies coming into practice can add services as the practice grows without having to hire or train more employees.
Focus on patient service
Health professionals can do their best to take care of patients. So, clipping away administrative burden in turn reduces any burden on them. This also frees up their time to concentrate better on their patients rather than a pile of needless work.
In-House vs. Outsourced Medical Billing: A Comparison
Cost
In-house billing requires a significant amount of investment in salary, benefits, training and billing software. For smaller practices, the expense can be daunting. Outsourced billing avoids additional expenses and utilizes a projected fee structure – typically one percent of collections. This fee structure works better from a budgetary perspective.
Control
Again, the in-house billing team has complete control over the billing process within the practice. The practice has the option to supervise their employees directly, set policy, and view day-to-day billing operations. With outsourced billing, while the practice is required to relinquish some of their control, provided that the provider is reputable, they will provide transparent reports and dashboards keeping you in the loop regarding oversight.
Expertise
An in-house billing team’s effectiveness depends on the experience level of each employee. Practices need to be dedicated to regularly training to keep up with changes in codes, entries and subsequent rules involving the billing process. Outsourced billing companies are dedicated to employing only experienced billing specialists who remain current for industry changes, compliance, and regulations.
Compliance
An in-house billing team remains in a constant state of training to keep abreast of the ever changing rules which directly affect every aspect of billing from HIPAA to ICD-10. Billing companies are dedicated to compliance as their primary means of reducing the regulatory risk of a practice.
Which Is Right for Your Practice?
At the end of the day, the decision to choose human over computer is absolutely yours! However, it does depend on a number of factors like the size of the ideal practice, budget and level of control. You have to understand that small practices are likely to consider outsourced medical billing becase
benefit with outsourcing and potentially reduced overhead costs, whereas larger organizations with complex collection needs have the opportunity for potentially more control by managing an internal team.