Electronic Health Reporter

Guest post by Alex Tate.

Being a diehard Kennedy fan, this is what I’d normally quote to someone purchasing the latest commodity, or acquiring the latest service that everyone is flocking to stores to get – Conformity is the jailer of freedom and the enemy of growth. However, outsourcing medical billing is a different ballgame altogether.  

I’m often confronted by worried physicians who are already overwhelmed by a recent deployment of an electronic health record (EHR) system at their practice when they hear that the clinic next door is outsourcing medical billing. With an expression that could easily pass off as ICD-9 code number 564.0 (a person suffering from constipation), the hesitantly ask me this: “Why is everyone outsourcing medical billing; and even if they are, why should I?”

In response to all those people and all the physicians out there having similar questions, here’s why:

1.     It costs significantly lesser

Medical billing companies charge rates as low as three percent of your monthly collections to handle this process for you. Compare this with the costs of a dedicated medical billing department at your practice, and the difference will be significantly lower.

The salaries of the staff won’t be the only cost there, as they’ll need a room or office space to work in, desks and chairs to work on, dedicated equipment (computers, fax machines, printers), and miscellaneous expenses, such as stationary in addition to utility costs. Now when you accumulate all of this with the insurance packages of these staff personnel and the maintenance of this equipment, you’ll realize that the percentage of collections work out a lot cheaper.

2.     A large staff base

Each practice assigns a specific budget for billing according to which many small and medium sized practices are able to employ one or two billers who handle all of the practice’s billing related tasks.

More often than not, these understaffed and overworked personnel come across situations whereby they have to decide between negotiating over denied and underpaid claims, or moving on to the numerous pending cases. Given their constraints, they choose to move on, settling for lower (sometimes zero) payments on such claims.

The large staff base of a medical billing company will rid you of this problem as they’ll have different personnel to handle different processes, resulting in the maximization of reimbursements.

3.     They specialize in all dimensions of billing and coding

With an abundance of qualified and experienced personnel, billing companies find solutions to problems markedly quicker than in-house billers because they are handling the billing of other practices as well; thus they rarely come across situations they’ve not seen before.

Even if they do come across an alien situation, the profusion of experience and skill results in speedy and well gauged solutions for the resolution of such situations.

Moreover, they have different teams of specialists for medical billing processes such as insurance verification, coding, negotiating and reporting. Take negotiating, for example. Their billers have years of experience in dealing with insurance carriers over claim payments, and are very likely to help maximize your earnings.

4.     They don’t fall sick or go for vacations

In-house billers usually make the most of their sick leaves and annual vacations. If your practice comes across a billing-related issue, you’ll have to wait for their return. The medical billing companies have backup because if your dedicated practice manger is on vacation in Rome, someone else will fill in for him to ensure that your work isn’t hindered.

5.     They’re up-to-date with the industry

At these companies, the higher-ups ensure that their staff remains up-to-date with the latest news and changes in the world of billing and coding.

By attending trainings, workshops and seminars for important developments, such as ICD-10, meaningful use Stage 2, etc., they continually strive to find more and more efficient ways to boost revenue for your practice. This is because the more you earn, the more they receive.

6.     You’ll have more time to focus on your patients

Whenever you need reports, observations or figures, your billing company will provide them to you. Additionally, they’ll periodically inform you of techniques to boost your revenue and reduce cost, leaving you with ample time to focus on your actual job; looking after patients.

You won’t have to worry about billers not putting in their one hundred percent knowing that they’re getting a fixed salary as it is, you won’t have to stand at their heads to make sure that the claims are sent/or received, but most of all; you’ll have one less dimension of your practice to look after.

With a clearer idea of why people are outsourcing medical billing and why you should do so, you’re one step closer to maximizing benefits, minimizing costs and running a profitable practice.

Alex Tate is a digital marketing specialist, content strategist and a health IT expert who provides perceptive, engaging and informative content on industry wide topics including EHR, EMR, practice management, revenue cycle management, interoperability, compliance, regulation and security. Follow him on Twitter @alextate07