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How can Outsourcing Solve Medical Billing & Reimbursement Challenges for Physicians in 2015?

March 23, 2015

Physicians should expect various healthcare challenges in 2015 that can impact their income at various levels. According to the industry reports, this year will offer less income opportunities for providers, pushing them to work harder in order to get paid on time.

Here are some of the changes that will impact a physician’s income this year:

  • Rise in high deductibles
    High deductibles of $1000 or more have become a challenge for physicians
  • ICD-10
    Physicians might have to face revenue disruptions post ICD-10 implementation. The new coding system will reduce productivity of coders as well as physicians
  • Decrease in malpractice premium
    It is being predicted that malpractice premiums will continue to decrease in 2015, posing challenges for providers
  • Rising MU penalties
    MU program has shifted to the penalty mode. Penalties will keep rising from 1% to 3% by 2017
  • Reduced income for PCPs
    In 2015, Medicaid payment for PCPs will fall back to 40% of Medicare
  • PQRS penalties
    Physicians who have failed to meet the requirements of PQRS program will face 1.5% penalty in 2015

Can Outsourcing Help Sail Through Revenue Challenges?

If your practice is struggling with increased AR days, reduced payments, lack of resources, disrupted cash flow and lack of reporting or analytics, outsourcing can bring an end to all your billing and RCM worries. Reputed medical billing companies have the required expertise and multi-specialty experience in providing end-to-end billing, coding, denial management and AR recovery. Here are some of the services offered by medical billing companies that can benefit healthcare providers

  • Eligibility verification
  • Charge entry for all specialties
  • AR management
  • Fee schedule review
  • Denial management
  • Insurance follow-ups
  • Paper and electronic claims submission
  • Appeal of low paid or denied claims
  • Recovery of old AR
  • Management of financial reports

Benefits of Outsourcing

Outsourcing can help physicians witness remarkable improvement in payment collections. They can also reduce AR days, reduce operational costs, bring down denial rates and improve cash flow.

Many healthcare organizations prefer to outsource medical billing and RCM tasks to get timely payments and streamline their business functions. It is one of the best ways for providers to cut costs. Some physicians have also started outsourcing the installation and maintenance of EHR systems to a third party as it helps them get the most out of their investment.

When choosing to outsource your billing and RCM tasks, you need to take two important questions into consideration- will the billing company help you bring in more payment from patients and payers? Will their 24/7, 365 days services give you enough time to meet and exceed patient satisfaction level?

Apart from medical billing, providers can also outsource denial management requirements to a medical billing company. Companies like MedicalBillersandCoders.com work with a specialized team that is trained in negotiating and navigating the insurance system complexities. By hiring a dedicated team for billing and denial management, providers can invest sufficient time on patient care and other areas that require more attention.


Category : Outsource Medical Billing