Maximize Reimbursement to Optimal Value With Experienced Medical Billing Services

by Murray K. Freelance Healthcare Writer

Poor billing practices end up causing doctors to lose billions of dollars worth of revenue every year. In recent years, billing has gotten more complicated, and keeping it in-house is a recipe for disaster.

One option is acquiring professional medical billing services. Outsourcing billing brings many benefits to the table, including maximized reimbursement.

Before you decide if outsourcing medical billing is the right choice for you, here is what you should know.

Accurate and Timely Claim Submission

One of the things that hinders timely reimbursement is delayed claim submission and resubmission. Each payer has a specific deadline for claims submission. Missing filing deadlines can result in automatic denial of the claim.

Claims that are denied due to late submission are assigned the denial code CO 29. This implies that the healthcare provider will have to absorb the costs of procedures and services rendered to the patient.

However, when you outsource billing, medical billing services set schedules for claim filing and track the progress of claims very closely to promptly address outstanding claims.

Expert medical billers have automated systems in place, such as the electronic claims submission system, to reduce errors and delays in claim filing.

Reduced Overhead Costs

In-house billing is a significant capital investment. Purchasing hardware and equipment, assigning a workspace for billing, and hiring software experts to make the billing process seamless are some factors that contribute to the overhead costs of a hospital.

Outsourcing medical billing allows you to turn that capital investment into operating expense and invest in resources that can help you elevate the level of patient care provided at your healthcare facility.

Error-Free Billing and Coding

Billing and coding errors tend to put your facility into a revenue slump. With in-house billing, there are always more risks of coding errors, which can be expensive.

Coding and billing errors are one of the biggest causes of claim denials and delayed reimbursement. Outsourcing medical billing allows you to trust experts who are well-versed in industry regulation and constantly keep up with updated trends, payer rules, and compliance regulations.

Billing experts are trained to tackle any sudden change in industry demands or policies with the utmost professionalism, ensuring that the hospital’s billing remains accurate and error-free.

Better Compliance

Changing healthcare industry regulations affects not only coding practices but also the compliance of a healthcare facility. With constantly updated rules and protocols, it becomes difficult for in-house medical billing staff to maintain compliance.

For instance, ICD and CPT codes are added and removed each year which can be difficult to keep up with. Even with correct claim submission, payers can deny you payments due to your practice’s failure to comply with the laws and regulations.

On the other hand, when you outsource billing to a dedicated medical billing expert, they prioritize keeping your practice compliant with healthcare rules and regulations. This helps you maintain a competitive edge and streamlines the claim submission process.

Better Patient Care

Every healthcare facility has a primary goal, and that is to provide the best quality of patient care possible to their patients. One major obstacle that stands in the way of that goal is managing patient care and the billing and coding process all at once.

In-house billing puts too much on your healthcare staff’s plate. They not only have to handle clinical concerns but also manage bookkeeping, appointment scheduling, and billing.

To avoid physician burnout, you should outsource billing practices. By lessening the pressure and professional burden on the staff, you can increase their focus on patient care. This will lead to enhanced patient satisfaction.

Enhanced Consistency and Transparency

By partnering up with a medical billing company, you will be able to get performance reports upon request and even automatically. Outsourcing billing has the major benefit of transparency.

People presume that handing over billing processes to a third party means they will not be able to establish any metrics that derive positive results or have any transparency into their practice’s cash flow, which is incorrect.

Acquiring billing services provides you with just as much visibility into your practice’s billing operations as in-house billing. The only difference and advantage is that you do not have to oversee and micromanage everything simultaneously.

Optimized Workflows

By entrusting experienced third-party medical billers with your practice’s billing, your staff can now revert their complete focus to collections and patient care.

Being understaffed and managing billing in-house can be challenging. When you outsource, you won’t have to worry about understaffing because it will be the billing service provider’s responsibility to tend to your billing needs throughout the year.

Outsourcing is a great opportunity for you to optimize workflows. By meticulously assigning tasks and removing the burden of in-house billing, your facility’s staff will be able to achieve higher productivity levels.