All Medical Billing

Pros and Cons of Outsourcing Medical Billing at Your Practice

The success of a medical practice depends mostly on patient care and revenue management. While you can easily manage patient care, revenue management may be out of your area of expertise. A lot goes into proper management of medical billing, all of which is reflected with a successful revenue cycle.

Your practice will need to either hire trained staff or provide training to administrative staff for them to be able to carry out the different tasks that fall under medical billing. These tasks start from the time of appointment scheduling and need to be performed well after the patient’s visit is over. What this means is that there will be tons of paperwork and follow up that your staff needs to do on top of their other responsibilities. In this case, errors are more than likely to happen, after all, it is human to err.

It is best to let professionals handle the responsibility of medical billing while you and your staff focus on making your patients’ visits as comfortable and efficient as possible. However, the thought of outsourcing medical billing at your practice may be worrisome and make you feel overwhelmed. This could be especially so if you aren’t fully aware of how the whole process works out. Much like everything else, there are pros and cons of outsourcing medical billing which is discussed below. However, it is worth noting that Practolytics overcomes these cons to provide an automated and facilitated medical billing process.

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Pros of outsourcing medical billing

Outsourcing medical billing seems like an outside concept but it is surprising to know that most healthcare institutions and private practices outsource their medical billing process to professionals. There are quite a few benefits of doing so, however, there are three that stand out.

Accountability focus

Most CFOs are under quite a bit of pressure as a result of the changes in ICD or International Classification of Disease Coding. This is because compliance with the expansion of these codes has proven to be even more difficult for private practices and healthcare institutions than it was predicted. Medical coding was already a taxing task and this has put more pressure on CFOs. Especially because claim denials due to coding errors put the practice at risk of audits.

However, when you outsource medical billing, the coding errors do not increase your risk of being audited as the accountability for these errors falls on the outsourced vendor. This change in the focus of accountability can be quite relaxing on your administrative staff and you, as it takes away a significant amount of stress.

Patient-Centric care

Medical coding and revenue cycle management are two of the most taxing and time-consuming tasks that your staff will need to undertake. The amount of manpower and man hours needed for tackling both tasks is huge. What this means for your practice is that you and your staff won’t be available to make your practice as patient-centric as you may have hoped for. When you outsource your medical coding and RCM process to Practolytics, there is a huge time slot that opens up for you. Your staff can now focus on being present at every step of the patient’s visit and you can provide them with excellent healthcare, without the stress of billing and denials clawing at you from the back of your head.

Reduced costs

Ensuring that your claims result in reimbursement and not denial or rejection, requires the paperwork to be completed with accuracy and precision. Members of the staff that are responsible for this task need to be trained specifically, which is quite costly for your practice. On top of that, this training does not mean that denials or errors won’t happen; and each denial is going to cost your practice up to $40, at least. All of these costs, along with the stress of the process, are just too much for you to undertake. This is why outsourcing is so commonly preferred.

Cons of outsourcing medical billing and how Practolytics overcomes them

Cons of outsourcing medical billing arise based on who you are outsourcing to, and what the exact responsibilities of the vendors are. It is important to determine ground rules and be very clear of your expectations and the vendor’s abilities before signing the contract. Some of the common problems with outsourcing are mentioned below, and so are the solutions that Practolytics provides to prevent these problems.

Lack of autonomy over resources

This is a problem many practices face. Once they outsource to a vendor, they feel that they cannot access the patient files or other resources freely. These problems often arise because of software incompatibility between the vendors and the practice. With Practolytics, this issue is easily handled as the same software is provided for your practice. You can access data on your computers with the same ease as before Practolytics joined your team.

Too expensive

Hidden costs of vendors can be another big problem for many practices that choose to outsource. These costs make outsourcing quite expensive for your practice. But worry not, as Practolytics is free of these hidden costs and surprise fees. All payments and costs are discussed prior to signing the contract, and they cannot be changed or altered till the end of the contract. Your practice will be safe from added costs, with Practolytics.

A security breach or improper security protocols

When outsourcing medical billing, it is important to make sure that confidentiality of patient information is a top priority for the vendors. If it is not, then you may be breaking HIPAA laws, which can land you in big trouble legally. Practolytics is completely HIPAA compliant, meaning that patient information is protected by several security protocols.

Another issue of security that may arise is the firewalls and protection of information. If the software used by the vendor is vulnerable to breach and hacking, then patient information can be easily leaked. To prevent this, Practolytics has layers of firewall and other security measures in place.