Does Outsourcing Hospitalist Billing Sound Expensive?


Does Outsourcing Hospitalist Billing Sound Expensive?Leaders of the healthcare industry often advocate outsourcing hospitalist billing services. The hospital management sometimes treats outsourcing hospitalist billing as another cost inducing factor that adds onto the pile of bills a hospital has to deal with. So, does outsourcing hospitalist billing increase the overall expenses of hospitals and takes a share out of the pie? Here are some reasons which will prove otherwise.

Outsourcing Billing Increases Revenue

By outsourcing hospitalist billing, a team of experts will manage the accounts receivables (AR). Billing experts capture denials and accurately report the EoB (explanation of benefits) information, resulting in a considerable drop in the processing time. In case of an in-house billing system, the claims would have to wait if the biller goes on a holiday or falls sick. Outsourcing billing services takes care of such situations and ensures a steady flow of claim submissions.

Accurate and Timely Submissions

Professional billing service providers submit accurate medical bills and file claims on time. This results in an increase in the number of medical reimbursements. With expert billers, there would be minimal coding errors, which ultimately lead to reduced claims denials.

Outsourced billers keep a track on the progress of denials and help streamline them and the claims appeals too. They categorize payers as per the respective time frame for denial appeals and then prioritize the appeals process. This helps in maximizing reimbursements.

Keep Abreast with Reforms and Changes

One of the biggest challenges of medical billing is keeping up with the changes in billing regulations and complying with the latest healthcare reforms. Outsourced billers keep themselves up-to-date with the changing regulations and insurance requirements. They keep up with the latest industry regulations, procedures, and the annual updates on ICD and CPT codes.

Protects Practice from Upcoding / Unbundling Risks

Outsourcing hospitalist billing ensures that there are no fraudulent activities in practice. It is an important factor because upcoding or unbundling deeply hurts the goodwill of hospitals and deteriorates the relationship with patients.

Reduces Cost and Efforts

Outsourcing hospitalist billing results in a dip in the operating cost of hospitals. They just have to pay for the basic operations and the billing company takes care of the coding and claims filing procedure. They also take care of updating all billing-related software or managing infrastructural maintenance demands. It can change billing expenses from a fixed cost to a variable cost and improves the ability to manage a hospital.

Cost Cutting on Staff Salaries

By outsourcing their billing, hospitals can save thousands of dollars in the form of annual salaries and benefits that an in-house billing team demands. It also means having more room for other purposes, such as patient rooms, which could in turn help increase revenue.

Inexperienced medical billing specialists make errors which can cost money or seriously delay payments. Outsourced billers help save time and money spent on training the in-house staff on various billing updates and revisions in codes. Outsourced hospitalist billing services bring professional efficiency as hospitals don’t have to track performance of in-house billers. has the capability to save around 30% of the medical billing services cost and reduce the AR days to an average of 21 days. This expertise and accuracy in terms of coding can drastically reduce the denial ratios. They exhibit proven expertise of a large network of trained and qualified coders with substantial exposure to the coding requirements. Their AR analysis reports with in-depth research of payer-wise, patient-wise and service-wise receivables helps establish the blockages in the cash flows which can then be resolved easily.

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