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Why Outsourcing Your Medical Billing Process Makes Sense

In the past, we’ve already discussed reasons why outsourcing your practice’s medical billing can be a great long-term cost-saving measure. It’s been shown overall that the amount saved by outsourcing medical billing greatly outweighs the cost to hire outside billing firms. We know that outsourcing your billing allows your practice to be financially stable by resisting staff turnover, and to be at the cutting edge of the newest ICD or CPT coding regulations and MACRA metrics. However, what if we take a look at three very specific, concrete ways that outsourcing your medical billing could vastly improve the efficiency of your medical practice? By examining these three aspects, we can show why choosing an outside medical billing company makes perfect sense.

Portion Control

Good outsourced medical billing practices work similar to some lawyers who only get paid based on a percentage of what money the client earns. Medical billing companies often only charge proportionately on what they collect. This is a huge incentivizing factor for the outsourced medical billing company to be the absolute leanest machine it can be, which is a win-win. This isn’t an opinion, but a fact. The fewer insurance claims sent out erroneously, or the fewer instances that money is adjusted incorrectly, the more revenue that can be collected by a medical practice. With this work outsourced, the medical billing firm will always strive towards this goal, to the benefit of both parties.

Further, this process can always be improved. If a medical practice still feels they are not hitting their revenue targets, certain reports like “claim scrubs” (to ensure all claims are submitted appropriately), denial reviews (to pinpoint exactly why a claim was denied), and fee schedule analyses to ensure your practice is receiving the highest possible reimbursement rate based on your specific insurance carriers, are all standard services that ought to be conducted when auditing one’s finances. While an in-house team can conduct these investigations at great time and further financial expense to the company, outsourced medical billing companies often have these services baked into their portfolio, which can be dispensed at the request of the client.

Practice Makes Perfect

Part and parcel of the modern medical practice is having a lean business model with a large emphasis on increased practice revenue. The old solutions for when medical expenses cut too deeply into practice revenue, to cut staff unceremoniously to make budget room, were not only exceptionally difficult to perform, but were also counterproductive. The real solution has been shown to discover novel ways to increase practice revenue, and that involves a detailed analysis of every single way you may not be maximizing practice revenue.

For instance, let’s take a look at a typical practice that isn’t reaching its revenue goals. What are the questions this firm needs to ask itself to increase practice revenue? Does your practice have a system to check eligibility automatically, prior to a patient visit, to prevent denied claims? Does your practice have a protocol to get all existing and new medical procedures authorized? How robust is your checklist in getting all proper referral documentation as part of a claim? How often are the complete financial obligations of the patient discussed with them before the medical service is rendered? After an initial patient visit, how often is patient information checked for accuracy to ensure the information is still up to date? How often are patient balances collected after every single visit? What is ratio of patient confirmation calls to patient “no-shows”?

This sort of information is all essential to increasing one’s practice revenue. Certainly, the analysis can be done in-house, but will likely only further stress a billing department that already concerns itself with every other aspect of revenue cycle management. Outsourced medical billing firms are well versed in analyzing these questions and many others as part of routine efforts to increase practice revenue, and can help provide innovative solutions to all these issues.

A Matter of Time

While much of the focus of medical practice financials is on how much money is made versus lost, a huge factor in business vitality is how quickly the earned money reaches appropriate parties. There are no two ways around it: cash flow is king, and the more time you spend stuck in accounts receivables or in any portion of your revenue cycle management, the more significantly it will hurt your bottom line. When we think about the timeline of a submitted medical insurance claim, the time from submission to payment or denial is the most critical time that these financials are placed on a medical practice’s books, and the practice’s biggest concern from a risk management point of view.

Think about what outsourcing your medical billing does to this process: it dramatically shortens the claims submission time, reduces the amount of errors (and therefore claim denials) before submission, and allows your practice to receive appropriate payment as soon as possible while not interrupting or delaying your next revenue cycle. In the event of denials, outside medical billing firm professionals can detect reasons for denials much more quickly than in-house billing teams, and turn them around for re-submission much faster. Outside firms can also handle electronic claims to ensure they are being sent to all possible carriers and are monitored by Electronic Remittance Advice reports (ERAs) to cut down the amount of redundant search time for appropriate targets for the payer.

On a wider scale, outsourcing your medical billing to companies like Delphi Management Services has been shown to be beneficial in freeing up in-house staff, accessing professional medical coders, and staying up-to-the-minute via the newest carrier change. Examining specific billing issues like fee schedule analyses, increasing practice revenue, or reduction of claim turnaround time, in addition to countless others, illustrates in detail just how much sense it makes to outsource your medical billing.