In the current health care system, it has become very important for the physician practices to ensure smooth and timely returns for the services they provide. Due to increased expenses and falling collections, providers are now more concerned about billing and revenue targets. According to a survey, a large percentage of physicians (91%) prefer outsourcing billing to a less expensive partner.
Approximately 80% of all medical bills contain errors and doctors in the U.S. leave approximately $125 billion on the table each year due to poor billing practices. Medical billing companies can help providers in maximizing their collections by eliminating billing errors and optimizing the collection process.
Outsourcing billing to a professional medical billing company is beneficial in various ways.
1. Outsourcing is less expensive
A large number of providers want to keep billing in-house as they want to manage it themselves. It is assumed that keeping billing in-house is efficient and makes all the resources in easy access. Providers are also hesitant of sharing private information with third parties and want to keep the records in-house. However, hiring coding and billing professionals can be expensive especially for small and medium-size practices.
Billing is a task that requires consistent upgrades of the resources, training, hardware maintenance, taxes, and salaries of the billing staff. It can be a lot more expensive than outsourcing to a medical billing company. Medical billing companies charge a certain percentage of the collections and there is usually no extra cost involved. Providers are only required to share a certain percentage with the billing company and which can be as low as 4% of the collections which is cheaper than managing it in-house.
2. Billing Automation
Most of the billing companies use advanced billing applications and automation tools. A computer-assisted coding and billing system is one simple but most effective way to optimize revenues of medical practice. It expedites the billing process through increased efficiency in entering the billing codes, compiling billing documents and sending for payments. It is better to use a billing system that is electronic and automated. Billing data becomes accessible and available at one centralized location. By outsourcing, providers can completely automate their billing cycle.
3. Accurate Billing Documents
The majority of the physician payments are denied because of incomplete billing documents. An error in the basic demographic information (i.e. age, date of birth, sex, address) of the patient can cause payment rejection. A mismatch between diagnosis and procedural codes would provide a valid reason for payment denial.
It is vital to complete billing documents with comprehensive details and accurate diagnoses and procedural codes. Medical billing companies fill in every bit of patient health information and prepare accurate billing documents. This accuracy in claim preparation reduces the chance of rejections.
4. Certified Billing System and Compliance to Standards
Medical billing companies regularly check on the latest updates and keep their system compliant to standards. They hire certified medical billing staff and keep their processes HIPAA compliant. Outsourcing billing to a certified and HIPAA compliant company can make your data more secure and protected.
5. Efficient Payment Follow-Ups
Continuous two-way communication between the payer and payment claimant is a must to close the loop of a proper payment follow-up. Sometimes insurance carriers delay the payments with minor objections, just to maximize their profits. After a certain time, the provider needs to inquire with the insurer about status, remove their objections and resubmit the bills, and if need be, submit an appeal for nonpayment or underpayment.
A payment denied should not send the claim in limbo rather denial management should follow-up. Medical billing companies consistently monitor claims that are denied, underpaid or getting no responses. Their staff flags them and communicates with the payer for a fix to the problem.
6. Maximum Collections
Outsourced medical billing partners can help to maximize collections. They can also help to integrate online payment solutions which are quite helpful in collections. Sending bills, reminders, managing copays and payment follow-ups are of the features that medical billing companies offer. Most of the billing companies have a review system and every 30/90 days assess the ratio of bills being rejected.
They can provide valid causes and list down reasons for payment denials. Medical billing companies follow a plan to avoid ejections and implement a denial management strategy. This is why; outsourcing medical billing maximizes the collections of providers. Outsourcing medical billing to a professional medical billing company can reduce the administrative burden of the medical practices, maximize their collections and set them free to focus on improving the quality of care. By outsourcing, providers can get paid faster, reduce operational costs and meet their revenue targets