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The Growing Trend of Outsourced Medical Billing

Many medical clinics have already made the change from in-house medical billing to outsourced billing. At this point, there are no clear-cut deciding factors of which method is best. Medical billing operations rely heavily on the needs of individual clinics and physicians. Finding the right answer for your business involves analyzing needs and taking inventory of factors you consider to be important.

The Trend Toward Outsourcing

The expansion of technology and IT resources has allowed the field of medical billing to expand virtually. Outsourcing and third-party billing providers are now an option available for local or virtual positions. In addition, the aging population around the world has caused a significant increase in medical needs, requiring appropriate administrative support. The manpower needs combined with the availability of medical billing software technology is resulting in a huge trend toward medical billing being outsourced. As the field grows, so does available education for risk management and compliance for the positions. Recognizing the benefits of such work has caused many physicians and clinics to make the switch.

Like medical transcription, there are multiple options available for finding talent. Outsourcing billing operations can include US based or worldwide billers, although many physicians choose domestic workers. Billers can also be used for freelance or project-based work, depending on the needs of the organization.

The Benefits of Outsourcing Medical Billing

Reduced Costs

Cost reduction is one of the main driving factors physicians cite for outsourcing. Billing operators who are outsourced lead to lower overhead by saving on space, office equipment, training, and benefits. Outsourced employees will work with small companies or in their homes, and do not require equipment purchases. Salary costs will also drop, as providers can hire based on virtual salaries instead of local market salaries. This can be extremely helpful in large cities, where the cost of living requires higher paying salaries. Outsourcing to an employee in the Midwest or overseas can drastically reduce salary requirements.

Time Saving

Adding outsourced billers to a business can save time in many ways. With reduced salary costs, providers have the option to hire more billers to accomplish the workload. The result is faster processing and reduced lag times in filing claims. As claims are being processed more efficiently, insurance reimbursements will return faster. If a provider hires a company to process claims, there is also a consistent flow of processing. For example, in-house billers may miss work due to illness or vacation. The result is a loss of claims being processed during the absence. Companies hired to outsource medical billing can alleviate this problem by providing continuous processing without delays.

Reduced Training Requirements

As providers hire new medical billers, each requires training and compliance education. Finding an outsourcing company or employee will severely decrease training time. Those working in outsourced positions will understand how to complete the necessary tasks and will not depend on providers for training. The employees will also be responsible for keeping up to date with compliance and regulation changes, without the provider paying out.

Reduced Billing Errors

Outsourcing medical billing to an outside company can improve billing error rates. Medical billing companies are paid to ensure work is correct and free of errors. Contracts put in place by companies and providers will hold billers to a standard that is often not matched by in-house billers. Billing companies also provide frequent training to billers to ensure proper compliance
and claim requirements. Highly trained billers can reduce the number of claim denials and maximize reimbursement amounts.

The Downside of Outsourcing Medical Billing

Lack of Control

Many providers are comfortable with a lack of control over medical claim processes, but some are not. Outsourced employees will not be directly available to management, as they would in an office environment. Depending on the nature of the provider and office manager, this can be a positive or negative aspect. If a provider simply doesn’t want to deal with managing the employees, outsourcing can be a good option.

HIPAA Concerns

In-house medical billing will involve tight HIPAA regulations, which can be managed by providers. Outsourcing the process can cause concerns with privacy and security. As more people encounter patient information, the chances of a security breach rise. In-house operations limit the number of eyes on the patient information, which reduces the chances of a HIPAA violation. Outsourcing to individuals instead of companies increases the risk of a violation, so it may be best to choose a company.

Patient Satisfaction

Some patients still prefer old school methods of walking into an office for payment or billing discussions. If billers are present at the providers location, this option won’t be available. Patients will need to call the medical billing company or employee to set up payments or discuss billing questions. Providers will need to decide how important this availability is to their patient base before making the decision.

Contractual Issues

As with any business deal, contractual issues are always a threat. Entering into a contract with an outsourcing company requires the knowledge and scrutiny of an experienced lawyer. Never enter into a contract without legal support, regardless of how straightforward it may seem. Contracts must meet the needs of both parties and consider changes that may occur over time.

Should I Outsource Medical Billing?

Outsourcing medical billing is not a decision to be taken lightly. Before deciding, consider all
factors involved:

  • Cost comparisons of in-house vs. outsourcing
  • Medical billing software options
  • Current rate of errors
  • Efficiency of current billers
  • Turnover rates of medical billers
  • Length and success of practice
  • Provider preferences

Consider all facets of the current business and future business goals. Providers content with current processes and reimbursement times should keep medical billers in-house. Providers plagued by billing errors or excessive claim denials may want to consider outsourcing. The decision should not be taken lightly, as it will affect bottom line revenue. Before deciding, contact a lawyer for a risk analysis and a contract review.

www.verywell.com/advantages-of- outsourcing-medical- billing-2317424
www.softwareadvice.com/resources/outsource-medical- billing/
newspharmaceuticals.com/76585/medical-billing- outsourcing-market- poised-for- steady-growth-in- the-future/

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