Should Healthcare Companies Outsource Medical Billing?

Did you know that more than two-thirds of US companies outsource to offshore companies? What about healthcare companies? The market forecast says that the US healthcare outsourcing industry is set to reach a value of USD 66 Billion by 2023! While so many companies are following the trend, it can still be daunting to make such a big move. Are you one among them? If you are overwhelmed to outsource medical billing to an offshore company, this article is just for you.

This article will take you through the pros and cons of outsourcing and give you a good idea about how it will change your organization’s workflow. Read on to know more!

1.What do we mean when we say “outsource medical billing”?

“Outsourcing”in medical billing industry refers to signing up of a contract with a professional partner to get the entire Billing and coding procedures done through them. The whole process of filing medical claims- from patient eligibility verification to updated code assignment- is pretty intricate every step of the way. Therefore this task needs a dedicated team who will handle every unique issue delicately and ensure that you get maximum reimbursements.

2.What kind of services will the vendor provide when you outsource medical billing?

The leading outsourcing companies provide a range of services to take care of your revenue cycle management. Some of them are listed down below:

  • Patient eligibility verification
  • Pre-authorization from insurance companies
  • Appeals processing for denied claims
  • Denial management strategy planning
  • Billing and coding for the services rendered with the updated codes
  • Managing rejected claims
  • Minimizing days in Accounts Receivables
  • Following up with the insurance panels
  • Payment posting

3.How will outsourcing benefit your workflow management?

The aim of outsourcing should be to improve the workflow management in place, not merely replace it. Here are a few ways how the leading companies plan to benefit your organization and improve efficiency:

  • They reduce the claim denial rate by engaging in best practices to file clean claims.
  • With a lower denial rate, the cash flow will improve for the organization automatically.
  • The healthcare organization need not invest in up scaling the technology tools and train the staff regularly on medical billing updates.
  • The leading vendors use best-in-class technology and homegrown software tools to automate the process.
  • This helps in reducing manual errors and maximizing reimbursements.
  • The organization can achieve greater efficiency with the in-house workforce. You can deploy the professionals to carry on more complex tasks.

4.Can outsourcing partners integrate their system with your EHR system?

Definitely yes! Health companies or individual practitioners use different kinds of EHR systems. The in-house team often faces challenging situations managing the various EHR systems together. This leaves them with very little time to concentrate on the intricacies of revenue cycle management. When you outsource medical Billing, you can expect the following benefits:

  • You need not worry about maintaining the technical aspects of the medical billing procedure.
  • The outsourcing companies deal with a range of clients-from local clinics to international hospital chains.
  • They have the required expertise to manage and maintain the frequently used EHR systems.
  • Even if the system is new in the market, the companies will undertake the staff training, where you need not invest separately.
  • Make sure you communicate clearly about your preferred system to the outsourcing company and ask them if they have any experience in managing it.

5.How do they help with Government compliance measures?

A large portion of the healthcare providers gets enrolled in Government insurance panels like Medicare and Medicaid. This helps them to cover a greater part of the patient population.

  • Staying compliant with the latest Government regulations is the key to getting clean claims on the first go.
  • The leading medical billing companies make sure that they follow the updated compliance measures to deliver the best results to their clients.
  • Your in-house staff might be experts in billing rules. But it gets too difficult for them to keep track of the ever-evolving changes.
  • The outsourcing companies have a dedicated team of experts to stay on top of the updated guidelines.
  • They even offer specialized staff training at regular intervals to your billing team to help them get a grip of these changing measures.

6.The outsourcing company will be operating from an offshore location. Are they credible? 

Leading outsourcing companies maintain full accountability with their clients, even if though they work from remote locations.

  • When you sign a contract, it is implied there that they will be fully accountable for the medical billing requirements of your organization.
  • They also commit to improving the revenue cycle of the client organization with their upgraded systems.
  • The credible medical billing companies are HIPAA compliant. Following the federal laws, these companies commit to protecting sensitive patient information.
  • The tech teams ensure that the information on their systems is continuously monitored. Any breach of data is prevented through malware detection systems.

7.Will the third-party vendor replace the in-house team?

Not at all! This is one of the most common confusions that healthcare companies have when thinking about outsourcing.

  • The third-party vendor will act as an extension of your own team.
  • They will coordinate with the existing team about the claims and reimbursements.
  • They will take care of updating the code system as per the latest Government guidelines.
  • The outsourcing company will take charge of dealing with the insurance companies.
  • The team assigned to your organization will follow up with the payer networks regularly.
  • With a significant amount of load off their daily work schedule, the in-house team can focus on more complicated tasks, thus improving the efficiency of your organization.

Outsourcing medical billing will help your teams to improve patient satisfaction levels. With superior technology and expert teams at your service, the revenue cycle will remain uninterrupted. However, it would help if you remain cautious about the companies you trust.

To know how to choose a trustworthy outsourcing partner for your medical billing, you can read the article here.

Do you have any questions regarding the outsourcing of the medical billing process? Let us know in the comment section below, and we will definitely get back to you. Your feedback is extremely valuable to us. For more news on healthcare management and technology, please subscribe to our blog. For regular updates, subscribe to our social media portals on Twitter, LinkedIn, Instagram, and Facebook.

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