Can Independent Physicians Overcome the Medical Billing Hassles?

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It has become harder than any time before to a fruitful independent medical practice. As physicians shift towards value-based reimbursement which is gaining traction alongside the fee-for-service model, doctors will be on the hook for demonstrating clinical outcomes and providing seamless care coordination in order to receive payment.

At the same time, independent physicians must also figure out how to meet complex directives such as Meaningful Use, prepare for an influx of newly insured patients, and handle the revenue cycle management in medical billing.

Practices short of a strong medical billing and coding staff might be unable to decide their own course through these changes. They may find themselves financially unstable or having to merge or sell to a hospital.

Amidst altering changes in the healthcare industry, managing medical billing and coding in-house can be time consuming and exhaustive. It requires the staff to spend long hours on administrative tasks associated with income cycle and RCM. On that submitting denied claims can shrink revenue, which directly impacts your practice’s bottom line.

In an attempt to improve practice productivity and regain time spent on tasks associated with billing, is outsourcing medical billing services the answer for your independent practice? To help in your decision, here’s a list pros and cons to ponder upon, when thinking about giving your work to the professionals.

The Pros of offshoring your medical billing:

The Medical billing staffs takes care of all the denied and unpaid claims

 When you let the experts do their job, they are responsible for all claims, having the coding knowledge and training to do so with ease. When doing billing in-house, your practice is responsible for training your in-house biller, which takes both time and money.

Enhanced Revenue cycle is their top agenda

Independent practices small in size may not have an in-house biller who is capable in more than one area of the revenue cycle management. Outsourcing medical billing companies on the other hand will have experts that specialize in the entire income cycle, and are continually up-to-date on industry trends and new revenue cycle practices.

Outsourcing helps you to focus on value-based care

 Having an in-house billing department can be costly, and training staff can be time consuming. Nonetheless, outsourcing can allow you to reposition your in-house biller to focus on value-based related tasks.

Improves the financial health of your practice

A positive revenue cycle is related to practice health, and while some practices are able to stay afloat with industry changes, independent practices may lack the resources needed to do so. By working with professional medical billers, you can greatly reduce the amount of unpaid and denied claims received.

Cons of offshoring your medical billing

The fees associated with offshore billers could be expensive

 Outsourcing medical billing could be costly depending on the size of your independent practice. A great way to evaluate if outsourcing is the right option for you is to do a cost analysis based on annual fees connected with both outsourcing billing in-house to make an informed decision.

Independent Physicians lose control over the billing department

 Lack of control in outsourcing can be worrisome, especially since you no longer have a medical billing department under your control. Although in this case, most of the physicians are relieved by lessening this responsibility.

You think of cutting down your staff

If you have an in-house billing staff and decide to outsource, it’s possible you’ll have to make cuts to staff. But, moving the billing staff to focus on administrative task such as value-based care can be a great way to avoid staff cuts and keep valuable staff members on-board.

You become unaware of the latest Medical Billing Updates

When you have a billing or coding related inquiry, receiving an answer from an outsourced company may take time. Although this can be frustrating at times, it’s your duty to ensure that the contracted medical billing firm has the ability to send you regular updates on your practice’s billing, giving you a weekly or monthly re-cap of where your medical practice stands.

In conclusion we would like to say that the transitioning to an outsourced billing firm solution is the answer for many Independent practices, it may (sometimes) not be the right option for you. Considering the pros and cons of professional medical billing services for your practice specifically is a good way to make a knowledgeable decision, and lead your practice towards a healthy financial status each month.

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