More and more physicians are feeling the burden of both administrative and operational costs. One would wonder how this affects their medical billing and coding practice impacting their Revenue Cycle management (RCM) system.
With the rules and regulations that the Affordable Care Act (ACA) has brought in together with the constant rule changes that the Centers for Medicare and Medicaid Services (CMS) that push medical practitioners to stay knowledgeable, healthcare providers seem to spend more time on getting acquainted with the rules and regulations that also affect the medical coding and billing process. According to the Practice Profitability Index, it has been stated that the percentage of physicians who spend more than one day per week on paperwork increased from 58 percent in 2013 to 70 percent in 2014 alone. Even though, digitization and online submissions are now being streamlined, the average five-year total cost of an in-office system according to the Michigan Center for Effective IT Adoption, puts it to $48,000 and for a cloud-based system pegs it at $58,000. Physicians are then spending more time on being updated and on learning how to deal with online systems, thus affecting their core focus- patient care! It has been estimated that nearly 70 percent of physicians did not want to transition to Electronic Health records, because of the spiraling costs, as per a 2013-12014 survey conducted by Medical Economics and Market Research firm MPI Group.
Further, adding to their frustration is the claims process where denials and appeals take forever, often leading to a lot of money being left on the table as healthcare providers do not have the time to chase after appeals. Most private insurers deny submission based even on small data entry or discrepancies like a miss-spelt name or a code error like a code digit being transposed.
Based on a survey as per the Medical Group Management Journal, the average cost of in-house billing is 12percent of a practices income.
There are three ways to combat this when you outsource
Staff Issues: Staff gets relieved and can focus on patient care. Absenteeism does not affect your processes. The outsourced trained staff handles the follow-ups, and trained in the process of verification and eligibility of the patient’s insurance coverage. Moreover, software and hardware installation costs are taken care by the outsourced vendor, leaving you, the physician, free to invest in medical equipment required and focus on your core practice
Knowledgeable Billers and coders: You can immediately save 35% directly on medical coding and billing costs. The stringent processes that outsourced medical billers and coders follow will help bring down the denials of claims which impacts your reimbursement cash flow cycle
Compliance: The Medicare rules and the insurance industry rules are constantly changing. Moreover, the healthcare industry is streamlining the process and requesting on a number of audits to be conducted internally as well as externally. For this compliance are a must and documentation of records and its storage, physically or even online, can be not just uncomfortable but also inconvenient and expensive.
An efficient medical coding and billing vendor, by taking care of the entire claims processing workflow, will in effect help improve your reimbursement and A/R collection, thus in the long run reducing your medical billing costs as staff, hardware & software and compliance is all met by them.