Deciding whether or not to outsource medical billing can be a difficult decision for your practice. Medical billing has always required a specialized set of skills, and in the last few years there has been a steep increase in complexity and red tape. Whether you are a new practice startup, experienced veteran, or in the midst of turmoil like upgrading to a new system, referring your billing to a specialist makes a lot of sense. It has now become a necessity for practices to consider revenue cycle management services. Profit margins are shrinking due to reduced insurance carrier allowances, increased regulation and carrier red tape. Operating efficiently is now more a matter of survival than it is of just good business sense.

1.   ECONOMIES OF SCALE

A billing service distributes their expenses across the entire client base providing an economy of scale. They can operate at a lower cost than a single practice and those savings are passed on to you. A billing service can afford to hire the best staff possible, so you pay less for the same and often higher collection rates. In addition to the direct financial benefit of higher returns and lower costs (overhead, staff, insurance, hardware…), you will save in the areas of time, stress, and office space.

2.   DEDICATED, HIGHLY TRAINED SPECIALISTS

The billing team only has one purpose, to increase the profitability of your practice. They review all payments to ensure that the carriers are paying the correct amount and prevent incorrect adjustments.  Every outstanding claim is tracked until it is processed and paid to its fullest. Don’t think of your billing service as a separate team. They are integrated with your existing staff and have the same goals in mind. If the practice does not make money, the billing service doesn’t make money. They work closely with office staff to ensure an efficient overall workflow and provide training when needed.  The practice also gains access to a large combined knowledge base of billing experts to aid in navigating the ever increasing industry changes.

3.   GAIN CONTROL

Many people think that outsourcing medical billing means giving up control to someone else. The opposite is true, and for most practices, they feel more in control than ever before. Someone else is taking care of the time consuming work and dealing with the headaches, so the providers have breathing room to review their monthly reports and see at a glance the health of the practice. Detailed reports are provided all questions are addressed by account managers in detail. With excellent communication, things like charge entry errors or payer reimbursement issues can be identified early before they spiral out of control. This transparency gives a sense of control that they never had before. Adding an expert billing team to the mix enacts a team approach to progress toward mutual goals.

4.   A CHANGING INDUSTRY

The healthcare landscape is changing at an unprecedented rate and Medical Billing is not spared from this upheaval.  Keeping up with the ever-changing rules and requirements is difficult under the best of circumstances. It requires constant education and vigilance. New and deleted codes come out annually, fees change, and carrier rules seem to vary daily.  Most people just don’t have the time needed to dedicate to this task.

5.    CONSISTENCY

Billing in-house puts your practice at greater risk for revenue interruptions due to unplanned employee absence or staff changes. An outsourced medical billing service means that you have a whole team of people making sure that your claims get processed quickly and accurately, leaving your practice less vulnerable to disruptions in cash-flow. Many medical billing companies can also provide services on your existing EHR/Practice Management software, which means you won’t have to learn a new system in order to outsource your billing and reap the benefits of managing a smaller staff. A medical billing service can provide the benefit of a vast knowledge-base and are privy to aggregated trends from a network of other practices. This inside information keeps them on the cutting edge and shared knowledge is transferred to the practice in real time. Real time information can be invaluable when the change is fast-paced and unprecedented.

6.   GET PAID FASTER

Cash flow is key. Outsourcing medical billing to a billing service can submit your claims faster and with fewer errors, so you receive payment from payers in the shortest amount of time. Your payments are posted by professionals who will prevent errors, resulting in denials being detected upfront. These are examined and resubmitted for more timely payment. A professional billing service will ensure that you are transmitting claims electronically and are set up to receive ERAs, further reducing turnaround time. Achieving the highest reimbursement possible in the shortest amount of time puts money in the bank and not on the books. Do you know what your average Medicare cycle time is?

7.   FOCUS ON WHAT YOU DO BEST

You spent all those years in school to become a doctor so that you could enjoy a long career caring for people.  Little of that time was spent learning the intricacies of medical billing. Doing your billing in-house requires a lot of time and effort.  Even if you aren’t the one who actually spends 15 minutes trying to contact a carrier to follow up on a single claim, you will still need to deal with the high level management and all of the headaches that come with it.  A billing service can free up a substantial amount of time that could be spent with patients or for some much needed R&R.  With age comes wisdom and at some point you may ask yourself “what is my time worth to me compared to what I can pay someone else”. A billing service is an ideal way to free up your valuable time while maintaining the same patient volume and potentially increasing your revenue at the same time.

8.   LESS STRESS, MORE CASH

A good billing service will conduct a fee schedule analysis to make sure that you are getting reimbursed at the highest possible rate for your carriers, utilize multiple claim scrubs to ensure that claims are submitted correctly,  utilize efficient policies and procedures to reduce your cycle time,  and their experienced staff will review denials for accuracy. Each EOB is audited for correct payment, and steps are taken to ensure that you receive accurate reimbursement for your services.  Most practices that hire a billing service see an increase in revenue and a decrease in cost that far outweighs the billing service fee.

Now, these are just a few of the reasons why it’s a good idea to outsource your billing to outside specialists. Take your practice to the next level by partnering with Tower Physician Solutions. Call us today for a free practice assessment.