Should Your Medical Practice Outsource Its Billing? Five Things You Must Know


In far too many practices, physicians continue to be naive about the complexities of medical billing and neglect this area of their practice even if it is the life line of their practice. Practices continue to fail to invest in adequate resources when it comes to revenue cycle management and legal compliance.

Being proficient at medical billing requires constant attention and on-going education in order to stay current with regulations and guidelines. Turning this process over to unqualified staff is an irresponsible business practice. Practices think they can purchase expensive hardware and software to fix their medical billing problems, but unfortunately, even the best technology has limited potential in the hands of untrained people.

Outsourcing your practices billing is not just about saving money anymore. These days outsourcing in the health care industry has became a viable business option due to increasing operational costs, declining insurance reimbursements, and mandates for costly changes in technology and compliance requirements. Outsourcing can assist your practice with meeting these objectives and making sure your practice stays ahead of the constant changes in the health care industry.

Outsourcing can allow you to put your billing in the hands of experienced, certified professionals who focus exclusively on the financial performance of your practice. This may not always translate into cost savings, but it can enhance your billing performance and increase quality control. Outsourcing can also help:

  • Improve your practice’s efficiencies;
  • Introduce new or improved technologies;
  • Reduce and stabilize expenses associated with billing while improving results; and
  • Increase patient satisfaction.

As with any service there are good outsourcing firms and there are bad. As a practice considering outsourcing your billing, how do you distinguish between the good and the bad?

The first key is to beware of rock-bottom pricing: it can be an indicator of low-wage billers who have little experience and no certification.

The second issue is to make sure the service can provide you with meaningful and timely reporting. Many billing services “limit” the information that they give their clients in terms of reporting and claims data. If you are using a billing service that is limiting the reports that you have access too, this is definitely an indicator that they may not be doing as good a job as they should and don’t want you to see the results.

The vendor should provide the practice with access to the billing system and it should allow the practice to schedule office and surgery patients, enter patient demographic information and generate a patient encounter form that communicates outstanding patient balances. An integrated system that can be accessed by both parties is essential for the two entities to work as a single, operationally integrated unit.

Third is to choose a firm that is willing to train y our front-desk staff to ensure the flow of accurate information. When it comes to billing, if you put garbage in you are going to get garbage out. You need a firm that is willing to spend time with your staff and train them regarding the information that they need in order to accurately and timely file your claims and get them paid. To many “lazy” billing services just bill what they can out of the information they receive from the practice and don’t take the time to adequately train staff regarding exactly what they need. This is one of the most critical steps in the process.

Fourth is to identify a service that provides good customer service. Make sure that you choose a firm that sees its services as an extension of your care. You want to ask them what their office hours are and how quickly will they respond to your patient questions regarding their patient invoices.

The fifth key area is that you must choose a firm that is constantly not only educating their staff regarding the on-going changes that occur in the health care industry but also providing your practice with key education that is specific to your practice specialty. With the rules and regulations and compliance constantly changing in the healthcare industry, it is critical that you work with a firm that can keep you abreast of these changes so that your practice will be aware and can make any necessary changes in order to stay ahead of the requirements. There are too many billing services that just want to file a few claims and get paid but don’t keep up with the current issues in the industry. These types of firms are not going to be able to add a lot of value to your practice in terms of bringing valuable insight to the table.

Outsourcing is definitely becoming a more popular trend due to changes that are happening in the industry. Choosing a reputable third party billing firm can greatly improve the overall results of your practice’s collections and allow your practice to partner with industry experts that can keep your practice ahead of the many changes that occur when it comes to rules and regulations and documentation compliance.

Doing a little homework up front will ensure that you choose the right firm and that your practices reaps the full benefits of outsourcing.

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