Medical billing has become a huge issue for many medical practitioners, ranging from individual private practices to extensive regional hospital systems. Physicians are even moving into early retirement because the additional stress and paperwork involved are taking the joy out of their jobs.
Outsourcing medical billing to an organization that does not practice medicine, but specializes only in medical revenue cycle management (RCM) may have been a strange proposition at one time, but now it is an accepted practice that is becoming increasingly more common. Medical entrepreneurs, doctors in private practice, all types of healthcare providers, and institutional administrators are embracing the concept of outsourcing their medical billing because it has proven to be so successful.
While there are others who stick with the more conservative approach and keep medical billing coding and collection in-house, outsourcing has become the norm for many reasons.
Limited Business Background and Training
Medical professionals undergo extensive training for patient care, but few are educated and trained in the details of running a business, much less complying with all the legal and administrative aspects doing business with insurers and government payers entail. And that’s in addition to the many requirements of the various regulatory agencies they answer to.
Even if a medical professional knows how to deal with coding and billing, they probably don’t have the time to do a comprehensive analysis of the situations that lead to claim denials and rejections. When medical billing is done in house, it is not uncommon for up to 40% of claims to be rejected or denied. Clearly, reviewing, correcting and resubmitting claims is a time consuming and challenging task, but it must be done, otherwise, the provider will lose an unsustainable amount of revenue.
In addition to managing claims, many in-house financial managers do not allocate enough time, resources, and budget for collections. Medical staff are not trained in that kind of work, and frankly, usually just don’t want to do it, so unpaid bills may go ignored until it is too late to pursue payment.
Outsourced Medical Billing Costs Less
Surprisingly, it actually costs less to outsource medical billing than to hire people to do it. Other medical billing services do things differently, but Medcare MSO only charges a small percentage of the amount we get for you. There is no up-front fee or per-claim charge, so the amount you pay is predictable based on the amount of income you receive through our services.
If you hire billers to work in-house, you will have to pay salaries, but also the additional costs of administration and supervision. Typically, a smaller practice will only have one or two staff handling their claims, so if one becomes ill or has an emergency, the claims will not be processed, resulting in a delay or loss of revenue.
Accounts Receivable Balances Are More Easily Resolved
A medical practice can accumulate accounts receivable balances quickly, and if payments aren’t collected in a timely manner, they probably never will be. Claims have a limitation on how long they can remain valid, so it is important to address denials and rejections right away.
Patients are often responsible for part of the bill, so there needs to be someone available to inform them, explain charges and collect payments. All of these are more easily handled by dedicated AR recovery services than by medical staff.
Necessary Tech Adds to In-house Expenses
Medical billing is complex and the codes change all the time. Software that is constantly being updated is required to keep the system working, and trained operators are needed to enter the information and troubleshoot any issues. In-house IT people are needed for setup and changes, but that expense is easily eliminated by outsourcing to a professional billing company.
Outsourcing Medical Billing Increases Revenue and Relieves Stress
There are many financial reasons to outsource medical billing, but the most important benefit may be that outsourcing that task will free you up to concentrate on patients. Our clients report a renewed enjoyment in their career when they are freed of the stress caused by all the work involved with billing.
Medcare MSO is cost-effective, efficient, results-oriented and easy to work with! Get a free demo today and let us show you how our proprietary software and innovative process can increase your revenue and let you enjoy your job again.