Why Physicians in Ohio Prefer Outsourcing Wound Care Billing?

Providing clinically eminent and cost-effective wound care remains a goal, as well as a challenge to many physicians across Ohio and other parts of the U.S. The health industry has struggled with quality and cost issues for years but wound care management has only recently become one of the measurements to be evaluated. This is because of the increased interest in wound care services by the third-party payors, the Centers for Medicare and Medicaid Services (CMS), and the Joint Commission. The wound care market is large, often overlooked, and growing tremendously. It was estimated that more than 7 million people in the US experience a chronic, non-healing wound, and require good care. Once a hospital realizes the need for an Outsourcing Wound Care Billing service, it must first decide if it has the capacity and resources to start one on its own, or should it outsource to a medical billing company. As many as half of the hospitals in Ohio are affiliated wound care centers using a management company.  What are the pros and cons of using such a company versus “doing it yourself?

Why Outsourcing Wound Care Billing?

While wound care has evolved as a specialty service, developing resources and clinical systems to treat wound care patients becomes a challenge.  The clinical effectiveness of such healthcare is influenced by the professional competency of wound care providers, medical information systems, quality-of-care outcomes, resources, cost-effectiveness, customer expectations, and research practice.

Accreditation and certification are important, as any other practice, to establish a wound management program. A few wound management companies have earned a joint commission certificate for clinical and operational excellence in wound care management. Such companies can save hospitals significant time and commitment to resource and gives superior creditability.

Using such a far-reaching wound care management program, which provides support to the quality stated in the AAWC conceptual framework, can prove laborious for health systems and hospitals. Many hospitals are finding it difficult and recognize that they do not possess the core competencies to handle wounds on a volume basis. Developing the program can be quite time-consuming and burdensome to staff, educate, market, and finance. Many other factors necessary for the management can be acquired separately and assembled in the hospital.

For these reasons, many hospitals utilize outsourced services of management companies with expertise in wound care management services. Outsourcing wound care management services do not focus on the abilities of clinicians; rather, it allows physicians to focus on care while other duties are handled elsewhere.

The Outsourcing Management Company will Facilitate:

  1. Data collection
  2. Coordinating interdisciplinary care
  3. Education
  4. Sequence of care
  5. Responsive to regulations.

Growth of Outsourcing:

Outsourcing contacts continue to grow and simultaneously offer wound care management services that help hospitals and physicians save their time and meet their strategic goals, financially and operationally. With functional knowledge increasingly gaining importance to success, healthcare organizations are turning to outsourcing experts for help to increase opportunities while focusing on core competencies. Highly specialized support services can hit the ground running, greatly reducing the time to implement the program and boosting the service within the hospital’s catchment area and quality clinical outcomes for patients.

Outsourcing wound care billing can quickly and efficiently lessen the hospital’s time and resources used to develop and establish a comprehensive program and thus maximizes the return. Outsourcing offers a competitive program that includes a well-deployed, clinically excellent pathway, an extensive outcomes database, reimbursement support, and effective community and medical education that enables hospitals to exceed clinical and financial goals.

Clinical excellence will guide to financial excellence — an outsourced wound management company will help direct the hospital towards both.