Is Outsourcing Billing, the Right Option for Me?

Medical billing which is part of Revenue Cycle Management represents all activities resulting in receiving accurate payment for services rendered to a patient. Medical billing and coding require specialized knowledge and specific skills which can’t be always handled by providers. There are a number of pieces to the puzzle that go from patients visiting your office to collecting accurate patient and insurance reimbursements for the delivered services. Plus, physicians enter into health care because they want to help care for patients, not to become businesspeople. There are many reasons why providers prefer to handle medical billing and coding all by themselves. Including, fear of patient data breach; unavailability of specialty-specific billers and coders; high payroll and training charges; insisting to submit paper claims; and others. Whether you are a solo provider or represent multi-specialty group practice, outsourcing could be the right option for you. In this blog, we discussed some parameters which will help you to decide if outsourcing billing is, the right option for you or not. 

4 Reasons Why Outsourcing Billing is the Right Choice

Early Phase of Practice

Most experts agree that outsourcing the biggest functions of the revenue cycle such as coding, billing, and credentialing makes the most sense but at the early phase of your practice is it practical? When you just start your practice there is a lot of work related to credentialing and enrollment. You might be focussing on certain payers (government or private) to get credentialed. So, in the early phase when you may not be submitting more claims it might feel like doing it all by yourself could be the best option. We suggest, getting associated with medical billing company at the early stage is the right time. Even though you are not seeing many patients nor submitting many claims but there is the most important part i.e., contracting with payers. If you outsource your credentialing and contracting activities to the medical billing company, not only it will accelerate the process but also you might be able to negotiate some terms and conditions of the payer contract. With RCM activities outsourced, you will be able to focus on patient care and other activities like business promotions. 

Solo Providers

Most small practice owners or solo providers prefer to handle medical billing and coding operations all by themselves. It could be an ideal option if you handle a limited number of patients and are not willing to expand your practice much. If you outsource, the time utilized in administrative work or interacting with insurance carriers over patient coverage could be utilized on providing better patient care and other promotional activities. Most providers doing in-house medical billing are a little reluctant to accept new patients unless they are fully sure about the new patient’s insurance coverage. Medical billing companies can provide benefits reports with you prior to patient visits which will ensure 100 percent payment for delivered service, whether it’s insurance or patient payments. Outsourcing medical billing creates unique expansion opportunities for small practice owners or solo providers. 

Major Self Pay Patients

Practices having the majority of their patients as self-pay patients prefer not to outsource their medical billing operations. They are happy to see a limited number of patient pools and will be collecting from them a fixed amount of money, year after year. With most US citizens covered with multiple insurance coverages, it doesn’t make any sense to restrict yourself to the self-pay mode of payment. With outsourcing, you can see patients with coverage from various insurance carriers (whether private or government). Billing companies will be sharing insurance coverage reports which will help you to collect reimbursements either from the insurance or from patients.

Submitting Paper Claims

Practices submitting paper claims may prefer to continue to do the same. But as a practice owner, you have to consider the opportunity lost in such cases. When you submit your claims electronically, your claim will get submitted and, in a few minutes, and you will receive insurance reimbursements within months’ time. Most of the providers will make payments within a week after receiving your claim. Medical billing companies can help you in this transition from paper claims to electronic claim submission. You can’t directly start submitting electronic claims, first, you have to notify payers of such change and need to complete the required documentation. Medical billing companies can help you in this transition and can help you to receive electronic payments, electronic remittances, real-time claim submission status, and enter updated patient information. This leads to not only faster payments but also lesser rejected claims. 

As discussed above, if you are running a medical practice, outsourcing is a valuable addition to your practice. It really doesn’t matter if you are just opened your practice; solo provider; accepting limited patients or still submitting paper claims; outsourcing is the right option for you. MedicalBillersandCoders (MBC) is a leading medical billing company providing complete revenue cycle solutions. If you are still not sure if outsourcing is the right option for you, contact us and we will discuss the same in detail. You can call us at 888-357-3226 or email us at info@medicalbillersandcoders.com.

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