Are you contemplating partnering with a medical billing company but wondering if it’s worth the risk? You have reached the right place. This article discusses the responsibilities that an outsourced medical billing company can handle for your medical practice.
The ever-increasing complexity of medical coding and billing, stringent HIPAA compliance guidelines, recent regulations such as No Surprise Billing, and the rising quantum of patient payment liabilities are just some of the top challenges facing U.S. medical billers, medical enterprises, and medical practices. In this dynamic healthcare environment, outsourcing medical billing and related administrative tasks will maximize medical billing efficiency, improve revenue collections, and minimize the administrative costs of collecting payments.
Here are the top 6 ways an outsourced medical billing company can help your healthcare enterprise or medical practice.
1. Medical Billing and Claims Submission
An outsourced medical billing company can handle the entire administrative process of medical coding and billing; it includes:
- Charge capture: Assigning appropriate medical billing codes (ICD/CPT codes) and appropriate charges; this is done based on the scanned medical documentation received from the medical office.
- Charge entry: Capturing charges from the medical billing records.
- Claims submission: Submitting the claims to the payor via a clearing house as per payor-specific guidelines timely.
- Claims follow-up: Tracking claims for payment, resolving discrepancies, and resubmitting claims.
- Confirming batches: Tracking within 24 hours to ensure the batch uploaded on Clearinghouse was successful.
2. Payment Reconciliation
A critical aspect of revenue cycle management (RCM) is monitoring the amounts billed and received into the bank account of the medical practice. An outsourced medical billing company uses advanced billing software that helps compare these two values for charges billed to and received from each insurance company. The billing service will actively work with you to check leakages and collect payments at the earliest.
3. Claim Denial Analysis
A team of trained medical coding and billing staff analyzes denied claims to identify claim error trends and work with the practice staff to prevent those claim denials from occurring in the first place. The concerted effort to bring down claim denials expedites collection, minimizes the cost of collection, and lowers the risk of accounts moving into the greater than 30 days bucket.
4. Patient Demographics Data and Insurance Verification.
The RCM process begins when the patient contacts the medical office for an appointment. You can also outsource patient data entry and insurance eligibility verification to the medical billing company. Outsourcing this administrative task ensures that your staff focuses on client communications and patient care. At the same time, the outsourced medical billing service team performs these critical RCM steps with greater accuracy and efficiency. So, it’s a win-win situation with minimum addition to the cost of operating your practice.
5. A/R Collections
Did your medical practice’s accounts receivables or A/R aging increase in 2022? According to a 2021 survey, almost 50% of medical enterprises have experienced increased accounts receivables A/R. Working on A/R recovery is yet another activity you can outsource.
Outsourcing A/R clean-up will reduce the volume of claims you have to send to collection agencies, free your internal staff, and decrease write-offs. The outsourced medical billing service will review your A.R. aging data to (a) identify payor and coding issues and (b) identify how much is collectible or should be written off.
6. Provider Credentialing
Medical credentialing is a continuous, time-consuming, and critical-to-revenue process. An inefficient credentialing system can impact your cash flow and prove expensive in the long run. Outsourcing this activity will ensure that the enrolment process is done smoothly and without delays. An experienced medical billing partner will also help negotiate the best contract rates for your providers.
In addition to the core services listed above, an outsourced medical billing service can also assist with the following practice management tasks –
- Patient billing and statement printing
- Installation, training, and management of EHR software
- Implementing new technologies such as telehealth and remote patient monitoring.
One of the biggest concerns of any healthcare enterprise is data compromise. HHS.gov and HIPAA have specific rules for third-party service providers in the healthcare industry. So, be rest assured that a professional outsourced medical billing service will have the necessary cyber security firewalls and data handling protocols to safeguard your patient and practice data.
Outsourcing medical coding and billing is a sure-shot way to reduce medical billing hassle and increase profit margins. The high-impact benefits of medical billing outsourcing are reflected in the U.S. outsourced medical billing market’s growth, estimated to be $4.7B, with a CAGR of 11.3%. The global outsourced medical billing market is estimated to be USD 11.1 billion in 2021.
If you need assistance with improving medical coding efficiency, we are here to help. Our experienced medical coding and billing staff will track all claims submitted and identify cases of underpayment and denials for correction and resubmission. Our robust reporting and analysis will help you understand revenue leakages as per payor and practice location to prevent future underpayments and denials. We have had many successes in recovering underpaid claims by working with payor reps on behalf of our clients. Contact us for a free consultation on minimizing underpayments and reducing your accounts receivables (A/R).