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Top Benefits of Outsourcing the Medical Billing Process

One of the industries that bore the brunt of the COVID-19 pandemic is the healthcare industry, undoubtedly. Today, many hospitals and healthcare facilities are facing a massive financial crisis with the unmet costs of COVID-19 hospitalizations. At the same time, there is a serious loss of income from elective procedures getting cancelled and non-emergency cases getting postponed as a part of curbing the spread of infection. The pandemic has left many people jobless and uninsured, and healthcare providers are struggling to cope with missing/delayed visits from patients.

What we need at these times of uncertainty, is something to reshape the healthcare finance scenario by building a better, resilient, and stable revenue cycle management system that can help in the long run. It is time to look out for a system that can bring down your operating expenses and fortify the efficiency of the revenue cycle at the same time. And this is where the need for medical billing outsourcing services arises from—to attain the much-needed stability at practice.

It is a known fact that healthcare organizations ought to show constant vigilance in managing their revenue. If your billing cycle is not optimized, it is very easy to lose the hard-earned money even before you realize that you are losing it. Medical billing is a demanding and arduous task that needs experience, expertise and first-hand knowledge of industry standards. This is why outsourcing the medical billing process to professionals is more effective and efficient than managing it in-house.


The Fundamental Steps of Medical Billing

In almost all businesses and services, billing is usually the last step of client encounters. However, in the healthcare industry, the billing cycle starts from the first occurrence of patient contact. Interestingly, it doesn’t end with the last day of service to the patient as well. A medical billing cycle gets completed only when the account receivable touches zero, which is after receiving all the reimbursements from the insurance company and all the balance payments from the patient in full. This is a very complex process with possible hitches at every step. This answers the question—why outsource the medical billing process?

Also Read – 5 Smart Tips for Improving Revenue Cycle Management

In-house Billing Vs. Outsourcing to Professionals

Many practices choose to do their billing and claim processing in–house. For tackling the billing process in-house, you will need billing software, necessary hardware machinery, an office set up with furniture and added administrative space with extended back-end process facilities. You would also need to spend on marketing strategies, among other requirements. Then comes the important part of searching and hiring qualified, competent transcriptionists, coding specialists and billers for your facility. Additionally, you need to train them to match the requirements of your speciality practice plus repeat the process all over again if one of them quits.

Apart from that, the front-end staff at your clinic will be burdened with administrative work along with entertaining the patients. The problems don’t end there. Here is how many practices have found money leaks with billing process—staff that lacks adequate training and expertise causing repeated issues with billing and claim submissions, errors in verifying patient’s insurance coverage, coding mistakes, a huge backlog of files because of limited manpower, outstanding account receivables due to low payment collections, issues with credentialing the providers and forgetting to renew their credentials and licensure on time, unmanaged and lengthy denial management process, multiplying clinical expenditure and more.

Meanwhile, outsourcing medical billing can help you cut the overhead expenses to a big extend. When the majority of billing work is outsourced to external services, your staff requirements can be brought down to a minimum. And you will see a visible reduction in practice running expenditures including the payroll, annual raises, added benefits such as employee compensation insurance, sickness/vacation pays etc. Again, there are savings in not having to buy expensive equipment and billing software, and avoiding costly training sessions for the staff.

Outsourcing the process boosts your revenue in no time by process optimization. Savvy medical billing outsourcing companies like Practolytics, which has been supporting clinicians with their billing strategies for the past 20-plus years, can add value and integrity to your practice. Practolytics has all that you need to streamline your workflow—be it experience, technology or dedicated manpower. By outsourcing medical billing to trusted partners you can rest assured of productivity and focus more on patient care.

Also Read – In-house Medical Billing vs. Outsourced RCM

Absolute Advantages of Outsourcing Medical Billing Process to Professionals

Since we have looked at the fundamental steps of the medical billing cycle already, let’s evaluate the benefits of outsourcing medical billing one by one.

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  • Better Turnaround Time

The staff at medical billing companies are proficient in dealing with large volumes of records systematically. With better manpower, improved resources and advanced technology back up, they can return your data after the transcription and coding process at a faster rate. Subsequently, the claims can be advanced without much delay from the patient encounter and ensure shorter revenue cycles and reimbursements.

  • A Workforce Consisting of Experts

Medical billing companies hire certified coders and billers who have been working in unison with healthcare facilities and insurance payers for enough amount of time to clearly understand the nuances of the process. By outsourcing the medical billing process to them, they can move ahead with the process without wasting time on clarification over medical charts, terminologies and disease conditions. With experience comes the ability to spot the right conditions and procedures which adds efficiency to the bill capture, so that you will not miss a penny you served after the treatment.

  • Error Checks and Audits

At every step of the billing process, staff at the medical billing companies are trained to conduct process audits to ensure accuracy. Before coding, the health records obtained from the clinic are verified for completion and legible information so that no patient details or treatment action plans are missed out. After the coding process, there is another audit conducted to rule out all possible coding errors from a detailed checklist. Once the billing claim is processed, it is matched up with the records again to see all the bills are valid and complete.

  • Staff Trained to Keep Track of Changes in Regulations

With the ever-evolving healthcare regulations, both insurance companies and states are bringing about revisions in their billing criteria and coding protocol from time to time. Being not compliant with the coding process is the most common reason for claim denials. This is why medical billing companies assign compliance managers to make sure the coding process is up-to-date and meets the industry standards. The staff are periodically educated and trained on what is new with coding and billing processes.

  • Adherence to HIPAA and Document Security

Count on medical billing services to understand the importance of data security and patient privacy requirements. The staff are signed in, trained on HIPAA protocol and cyber privacy regulations. With repeated process modifications they make sure you will never end up in legal risks with patient data mismanagement.

  • More Control Over the Process

The fact is, even though the billing process is conducted outside the clinic, you will still possess better control and transparency over your process. Everything is documented and accounted for by responsible team coordinators, who will update you on the process from time to time. Integrating your process with advanced practice management software provided by billing companies gives you the edge in process optimization.

Also Read – Role of Medical Billing Software in RCM Services

  • Individual Account Managers

You will be assigned an account executive designated to deal with the administrative work at your facility. He/she will be on call with you for any clarifications necessary in the process so that all your requirements are passed on to the team and executed without fail to focus on key factors of the speciality. There is no room for miscommunication or misunderstandings this way.

  • Cost-effectiveness

Compared to hiring more staff in-house for tackling the billing process, outsourcing medical billing process is cost-effective in terms of infrastructure modifications and overhead payroll expenses. You will see a dramatic decrease in the running expenses of your clinic by outsourcing the process, which can be invested in value additions for the clinical needs. The huge space taken up by back-end office paraphernalia can be converted to treatment rooms and diagnostic spaces that can bring more profit to your practice.

  • Faster Claim Submissions and Audits; Better Revenues

With such meticulous execution of the billing process, claim generation is much faster and easier compared to the in-house claim process. Medical billing project outsourcing has repeatedly proven to result in the minimal occurrence of claim denials since the process is automated, audited from time to time and clean-scrubbed to ensure compliance with payer criteria. With a clean claim, you collect your account receivables faster and enjoy a boost in revenue.

  • Dedicate More Time to Patients

Last but not the least, outsourcing the back-end process to medical billing services takes the administrative headaches away from you so that you can focus more on progressing your career as a healthcare provider. Relieving your staff from the paperwork associated with billing will enable them to care for the patients better and create a patient-friendly atmosphere at your facility.

Let outsourcing medical billing process to a versatile partner be the new decision you make for your practice today. Practolytics can bridge the gaps in your process with high-end technology and experts at work. Team up with Practolytics today for an ultra-efficient and effective billing process.

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Also Read – Top Mistakes in Credentialing Process