Why Would an Ohio Physician Choose to Outsource Oncology Billing?

Why Would an Ohio Physician Choose to Outsource Oncology Billing?Outsourcing has helped oncology practices in Ohio streamline their business functions, reduce billing errors and ensure timely payments. It has helped minimize the hands-on workload of oncologists, reducing billing challenges and generating more revenue.

Medical billing is one of the most overwhelming problems for medical specialties including oncology. By seeking expert assistance from a third party that specializes in billing and coding, practices are cutting down on their administrative tasks like patient eligibility verification and focusing on provision of quality care.

How has Medicaid Payment Lapse affected Physicians in Ohio?

Millions of Ohio residents are expected to enroll for Medicaid during the second enrollment period of the Affordable Care Act (ACA). While some doctors are still not willing to accept Medicaid patients, others are worried about losing a key incentive from the program for taking those patients. More than 40% of doctors in Ohio plan on accepting very few Medicaid patients with the lapse of the extra payments in 2015.

  • Oncologists willing to take more Medicaid patients are outsourcing their revenue cycle to a billing vendor. They are seeking assistance from a third party because they are worried about lower reimbursements and problems with insurance companies.

Billing companies like MedicalBillersandCoders.com have the resources to stay up-to-date on the changes in regulations and insurance company policies. They have a team of skilled and certified coders and billers who are well-trained in handling billing complexities. By outsourcing, oncologists can be assured of error-free claim submissions, compliance with reforms and effective denial management. Since a dedicated team takes care of billing and vital RCM tasks, oncologists can concentrate on their clinical activities.

Revenue Challenges Forcing Oncologists to Outsource

The healthcare reforms have had a huge impact on oncology practices, with small practices being the worst hit. Declining reimbursement, pressure caused by healthcare reforms and cost of hiring skilled coders and billers are some of the factors due to which many oncologists in Ohio are outsourcing. Outsourcing comes across as a cost-effective option when compared to maintaining an in-house billing team. It has helped oncologists in Ohio overcome the following challenges:

  • Outsourcing has become a popular trend among physicians. According to a 2014 report by Kareo’s Black Book, 42% small practices with an in-house medical billing team plan to outsource their billing requirements in 2015
    • According to a Bloomberg report, oncologists and other specialists will find the shift from volume to value-based payment model very difficult

Many oncology practices have embraced consolidation for securing market share, improving the ability to negotiate with insurers and sustaining viability during the payment model transition. For instance, Nashville-based Tennessee Oncology went from three physicians in 1992 to 85 today. To sail through changes in payment models, many oncologists are seeking assistance from a third party.

An increasing number of physicians in the US report burnout. They are losing their drive to run a medical practice. According to Medscape, critical care witnessed 53% burnout whereas oncology experienced 44%. As per this report, long hours at work, bureaucratic tasks and declining revenue are the top three reasons for the burnout.