The medical or healthcare services might seem quite simple and easy. There is a visible interaction between patients and their healthcare providers (nurses, doctors, etc.). However, there do exist some working hands behind the scenes. We are talking about the medical billing and coding staff, the people who ensure that physicians are being reimbursed in time & properly. These people ensure that the hospital or the medical practice is running smoothly. And for any practice to run smoothly, revenues and reimbursements are pretty important. Not just this, the medical billing and coding team also ensures that the whole billing process is carried out accurately & properly.
Medical billing and coding can be quite challenging, demanding, and time-consuming. And for small medical practices, the challenges can go even higher as there’s a small number of people working on medical billing. Not only this, in-house medical billing comes with several other challenges. This is one of the reasons why physicians and healthcare providers prefer outsourcing. The benefits of outsourcing medical billing will be discussed in detail below, but some of the major benefits include:
- Lesser risk of errors
- Maximized revenues and reimbursements
- More focus on providing safe and quality patient care
- A team of highly experienced professionals in medical billing
However, yes, physicians often do worry about outsourcing, i.e., things like losing control over the billing process. We will get to that in this article, but first, let’s discuss in-house medical billing and its pros and cons.
In-House Medical Billing
Medical billing for any healthcare practice is essential, which is why making the right decision is essential. In-house medical billing comes with some benefits as well as some cons.
1. Maintain control:
Healthcare providers have total control over the processes with an in-house billing team. And with their existing billing team and their capacity to execute the medical billing properly, the administrators might prefer to maintain the control.
2. Close proximity & accessibility:
With an in-house medical billing team, close proximity is one of the major advantages. For instance, if there is an issue with the billing process, the team can be reached out by just walking in across the hall/floor.
3. Patient confidentiality:
Patient confidentiality is an important issue for hospitals or healthcare practices like STD clinics. And an in-house medical billing team has complete control over the patient records.
1. Higher expenses:
In-house medical billing can be pretty expensive and costly. It involves fixed costs like salaries, computer equipment purchases, and maintenance. Some other expenses include:
- Medical billing software (purchase and maintenance)
- Employee benefits
- Technology costs
- Training costs, etc.
2. Training sessions:
For an in-house medical billing team, continuous training sessions are required. As if they aren’t updated regarding the changes in billing & coding, it can lead to the insurance claims being denied or rejected. Moreover, it can lead to lesser revenues and a lower reimbursement rate.
Liabilities include ignored encounter forms, claim denials that aren’t appealed to, and discarded superbills. The employees can generally neglect tasks like these due to the lack of proper supervision.
4. Billing capacity:
For in-house, billing capacity of a higher level is required. There are various tasks in medical billing that are time-consuming, for instance:
- Determining expected revenues
- Managing partial payment
- Claim denials or rejections
- Collecting deductibles
- Collecting co-pays
And many more.
5. Support team members:
If your billing team consists of one or two members, the billing processes can be affected as they are highly dependent on these members. For instance, if one member goes on leave, resigns, or is on vacation, the entire billing is affected, as it might result in late submissions. Along with that, your cash flows and operations can also be disrupted.
Outsourcing medical billing
There are several benefits when it comes to outsourcing medical billing services to a well-reputed company. One of the major benefits of outsourcing medical billing is the fact that you have an entire team dedicated to managing your billing process. Moreover, the outsourced medical billing team comprises professionals and experienced billers who are up to date regarding the healthcare industry. And with billing processes being outsourced, your in-house team and physicians can focus more on improving the practice and providing quality patient care.
Benefits of outsourcing medical billing
Some of the major benefits of outsourcing medical billing include the following:
Highly experienced team of billing professionals
One of the biggest benefits of outsourcing your billing processes is that you partner with an entire team of professional billers. This team of professionals oversees your complete medical billing process, submits clean claims, and manages claim denials (in case any occur). They are up-to-date with all the changes in the medical coding and insurance payer’s guidelines as well as can adapt to any new changes.
The risk of errors in medical billing is lower
Errors in medical billing lead to claim denials that can directly affect the reimbursement rate as well as the revenues. Managing the claim denials and rejections can be very time-consuming and confusing and can go unnoticed with an in-house team. However, the outsourced billing team of experts ensures that the healthcare practice doesn’t lose revenues, submits clean claims, and manages claim denials. This team of experts is up-to-date regarding the coding guidelines, payer requirements, and any changes, leading to a lesser risk of errors.
The in-house billing team has several administrative tasks to execute, meaning lesser capacity compared to an entire dedicated team of billers. An outsourced team of medical billers specifically oversees your whole medical billing. It means:
- Speeding up the claim processing and submission
- Lesser risk of errors
- Lesser claim denials
- Timely submissions
- Faster payments
- Higher revenues and reimbursement rate
As mentioned earlier, in-house billing consists of several expenses. They may include employee salaries & benefits, equipment costs, medical billing software purchase, and maintenance, etc. Moreover, employee training and in case any team member goes on leave or resigns; hiring a new employee and their training. All of this, alongside managing the other in-house medical billing employees. With outsourced billing, some of the benefits in relation to expenses include:
- Processing lesser payroll data
- Lesser office space and technology are required
- Lesser people to be managed
- Office management becomes comparatively easier
Moreover, with outsourced medical billing services companies like UControl Billing, your billing costs will depend on your monthly receipts. This means we only get paid when you get paid.
Decreased liability & increased transparency
Outsourcing billing services to an external team of billers might seem like you are losing control over the process and increased liability. However, in reality, the team of outsourced medical billers keeps you updated regarding revenue cycle management. They manage the claim denials and rejections timely, resulting in faster payments and higher revenues. Moreover, provide you with daily/weekly/monthly reports upon your request or automatically.
Outsourced medical billing companies are active in the industry of healthcare billing. Meaning they are up to date regarding all changes, and they keep up with the regulations and insurance payer requirements. These experts have processed a lot of claims so they can easily identify errors, denial trends, and any other issues regarding the billing process. And with that, they can submit clean claims and ensure timely submissions leading to a higher reimbursement rate.
Data is integrated into the EHR
Integrating with and managing various electronic health record (EHR) systems can be highly time-consuming for an in-house team. However, with an outsourced billing team, healthcare providers don’t have to worry about any technical issues regarding the billing of the EHR systems. Integrating data with an EHR system comes with a couple of benefits, including:
- Data can be seen in real-time.
- Billing companies can align the claims based on the practice agreement and policies.
- Trends of the approved and denied claims can be gathered over time, making it easier to make better future decisions and the RCM.
Another major benefit of outsourcing is that record-keeping and documentation are easier. And with the easily accessible required information, audits are significantly easier.
More focus on providing quality patient care
Revenue cycle management is one of the crucial tasks for any healthcare practice, as well as taking care of the patients as the core competency. Medical billing is a time-consuming and demanding process. And with you not overseeing the entire billing team and managing the billing tasks, would it be less stressful? With medical billing being handled by the outsourced medical billing team, you can focus more on providing your patients with quality and safe care. The third-party organization ensures that your practice runs smoothly, giving physicians more time to spend with their patients. Therefore, more patient satisfaction.
What’s the right time to outsource billing services?
If your practice is suffering from claim denials and revenue cycle leaks, outsourcing might be the best solution. By doing so, your healthcare practice can save time spent on managing the billing process as well as money. You can leave the medical billing, revenue cycle management, and a higher reimbursement rate to the experts and put your focus on patient care.
Why outsource medical billing?
Medical billing outsourcing services include handling everything from data entry to managing the claim denials. It includes following up on the claims and multiple insurance payers as well as submitting the claims in the first place.
Why choose UControl Billing ?
UControl Billing is a results-oriented and well-reputed medical billing outsoured services company. With UControl Billing, you get:
- Competitive Pricing
- Reduced overall expenses
- Maximized reimbursements
- Uninterrupted service & stability
- Faster turnarounds
- Streamlined workflow
- Increased cash flows
Our Medical Billing Services include:
- Fee schedule review and analysis
- Eligibility verification.
- Referrals, Authorization alert, Claim tracking, reduced rejections, and denials
- Patient statement processing, Mailing, Customized Monthly financial reports
- Rules-based claim review, scrubbing, Insurance follow-up.
- Helping with a collection agency to recover patient balances & Always remain HIPAA Compliant
Frequently Asked Questions (FAQs)
1. What is outsourcing medical billing?
Outsourcing medical billing to a well-reputed medical billing company comes with several benefits for the healthcare practice. Medical billing and coding can be quite challenging, demanding, and time-consuming. One of the major benefits of outsourcing medical billing is the fact that you have an entire team dedicated to managing your billing process.
2. What are common outsourcing medical billing errors?
Errors in medical billing result in claim denials, late payments, lower revenues, and a lower reimbursement rate. Some of the common medical billing errors include incorrect code, inaccurate modifier, incomplete documentation, unbundling, etc.
3. How do you prevent outsourcing medical billing errors?
Outsourcing medical billing services comes with several benefits. With billing processes being outsourced, your in-house team and physicians can focus more on improving the practice and providing quality patient care.
A couple of years ago, I executed the effective plan of creating a Medical billing and Coding company named U Control Billing. The company aims to bring revolutionary advancements to foster medical billing and coding revenues. As an official member of HIA-LI and MGMA, I feel honored in providing networking opportunities, problem-solving, and improving the revenue management cycle.