Can Outsourcing be a Solution to Rev up RCM?

The US healthcare industry is pitched at around three trillion dollars & is growing, according to Fortune, a leading global business magazine. Increasing healthcare reforms and lack of skilled medical back-end staff like billers and coders are giving the physicians a tough time to maintain their revenue. Even though scores of medical practices in the US are trying out outsourcing their medical billing many physicians are still skeptical about adopting this unconventional method.

A Physician’s Worries

The common thoughts that plague a physician regarding outsourcing medical billing are the following:

• I will lose control over my revenue and will become dependent on the billing vendor.
• It will cost me a bomb and I cannot control the expenses because the work quality and my billing process would be at stake.
• I will not be able to access the data and reports whenever I need to.
• I am afraid of violating HIPAA guidelines.
• What if the vendor has outdated software? I will either have to finance them or invest on it in-house for being on the same page.

Busting Medical Billing Outsourcing Myths

There are quite a few myths surrounding the outsourcing process which keep the doctors skeptical and carry on with a stagnant in-house billing process. We’ll explore the most common myths in the following:

• Losing control over the process and revenue collections tops the list.

A billing vendor is bound to provide you detailed reports of the claims processes, update the payment status immediately and be available for communication at any point of time. Usually, the billing partner shares these data online in an encrypted and secured way with the physicians following the HIPAA guidelines strictly. You should confirm the same when finalizing a vendor to ensure you aren’t in trouble in future.

• Cost cutting is not possible because I’ll have to share from my entire earnings.

It is true that an outsourced billing partner will in all probability know how much you earn from the superbills you share but it is not true that the charges of their services be higher than an in-house team. You save on salaries, renting / buying an office big enough to accommodate the backend departments. Besides that, you don’t have to worry about training the staff for keeping them updated on the regulation changes.

Outsourcing and Increasing Revenue

Medical billing outsourcing and revenue collections run parallel. Consider the comparison between the two on different aspects as follows:

1. Every follow up call for reimbursement to the insurance company takes about 15 minutes. Does you in-house billing staff have time for following up on pending account receivables (AR)?
2. What is the average AR days for every specialty your multi-specialty clinic? An outsourced team has specialty specific teams to code and file claims.
3. How often do you train your staff for upgrading their knowledge and retain them? Multitasking care services with administrative tasks like these can be quite taxing and you might end up compromising on either front.
4. Do you have a constant patient influx? Does staff attrition leave you high and dry? Well, if the answers to these are a yes then you should consider outsourcing medical billing because they strive to stay updated on technology as well as with the healthcare reforms and developments like ICD-10.

Do you now see how medical billing outsourcing can rev up your revenue generation? Not only by cost cutting but also by increasing the efficiency of your overall billing process.