Is Now the Time to Outsource Medical Billing? Read Pros and Cons Here

Are you worried about outsource Medical Billing?

Medical billing is a tedious job and it requires a lot of time and efforts to get paid from an insurance company, however outsourcing it to a professional medical billing services provider firm can significantly reduce your burden and save much of your time, which you can spend in looking after your patients and growing your career.

Many physicians or practice managers make the choice to outsource their medical office billing to a professional medical billing company’s. There are many advantages to outsourcing medical billing. It saves time and money and eliminates the burden of concentrating on too many aspects of the medical office.

Do What You Do Best. Outsource the Rest.

If you have your own practice, I am sure you have had the debate or the quiet moment of contemplation over whether you should have a professional medical billing team on your side. What are the pros and cons and is it worth the investment? Overall, would it lead to a more successful business?

There are many reasons to outsource and all of them should be evaluated, however in the context of keeping this relevant and simple:

Pros Of Outsourcing Medical Billing

Pro 1: Outsourcing Allows More Focus on Patient Care

Spend more time focusing on what you do best – concentrating on patient satisfaction and providing quality care to your patients. Professional billing allows for the practitioner to provide more attentive care and in turn increase patient satisfaction with his or her services. As the ACA has been introduced into the landscape of American healthcare, there is a new metric that is evaluated for reimbursement and decisions in medicine, and this is patient satisfaction.

A professional billing team can increase the overall patient satisfaction, not only with the services rendered, but in other ways. Physicians cannot be efficient at providing excellent patient care if they are bogged down by the financial side of the running a practice.

Pro 2: Outsourcing Reduces Billing Errors

Again, this relates back to overall patient care, where good practices begin and end. If billing errors are decreased or absolved then patient care and, one more time, patient satisfaction will go up. Imagine, not only the stress of having a denied claim or rejected claim from a patient standpoint, but the potential for a patient to see a wrong billing code for diagnosis. One that possibly the patient does not even suffer from? The will cause acute stress for both parties involved, yes, but could be devastating for the patient even more so with anxiety, dread, and mistrust. One incorrect entry of a CPT code for reimbursement billing may severely alter an outcome, and unfortunately, payment as well.

Pro 3: Outsourcing Saves Money

Of course one of the advantages of a professional team that you’ve solicited is the fact that they can help you maximize the billing opportunities, by providing accurate and timely submittal of claims, by providing accurate and timely submittal of claims. In the long run remember it will directly impact the practice, by helping justify the right amount of FTE (full time employee) staff, overhead, and material management.

Current statistics show that practices spend on average 27% of their revenue on administrative costs alone.  The median salary of a medical billing professional is $34,727 as of February 22, 2017.  When quantifying that across the average practice at 3 billers, and then adding overhead your annual cost of a billing team on average would be $145,853.

Medical billing companies charge a flat rate per claim or a percentage of the reimbursement on each claim. Either way, it is less costly than what you would pay for a medical billing staff to provide the same exceptional services that are provided by outsourcing companies.

Pro 4: Outsourcing Improves Cash Flow

In the same vein, having a billing services team provides constant effective billing day in and day out. There isn’t the need to hold billing until staff returns from PTO or for any number of other obstacles you may face with an in house billing team. There are no interruptions to submit. You now have a team of billing professionals that act immediately and accordingly to provide your practice with unmatched customer service and a seamless billing process. The practice gets to eliminate costly time, resources, and heartache that go along with billing issues and errors. All the while, allowing for a steady flow of cash through the business.

Pro 6: Outsourcing Ensures Billing Compliance

One of the most difficult things with the new era of medicine is understanding the constant changes in the rules, regulations, and reimbursement mandates. One reason that makes medical billing a challenge is keeping up with the changes in Medicare, Medicaid, and third-party payers. It is a full-time job to make sure that the medical office is following the proper protocol required by each payer. Medical billing companies must stay up-to-date on the latest changes in regulations and requirements in order to maintain compliance and ensure the submission of clean claims.

Cons Of Outsourcing Medical Billing

Con 1: No Control Over Employees

Medical office managers may be hesitant about not having direct control of the medical billing staff. Medical office managers are responsible for a number of functions in the medical office including the revenue cycle, finance management, and accounts receivables. Not having the ability to directly supervise the work puts medical office managers in a vulnerable position. They have to trust that the work is being performed accurately, efficiently and in a timely manner.

Con 2: Risks to Patient Satisfaction

Patient satisfaction can sometimes suffer due to outsourcing. Patients like having the ability to walk into their doctor’s office to make their payments, set up payment arrangements or discuss the specifics of their bill. It is easier to build a relationship with customers with the more personal feel that in-house billing offers. Patients are less likely to be satisfied by the service they receive when they can only discuss important matters over the phone.

Con 3: HIPAA Privacy and Security Breaches

Outsourcing your medical billing can present a possible problem with HIPAA privacy and security. Although violations of HIPAA privacy and security can occur with in-house billing, it can present an even greater risk when medical billing is outsourced. Whether intentional or accidental, unauthorized disclosure of PHI is considered a violation of HIPAA. The more people that have access to private and confidential patient information, the greater the risk for a breach.

Con 4: Possible Hidden Costs

Hidden costs can be incurred in preparing for your medical office to switch from in-house billing to outsourcing. There are other costs as well. To prepare for the work arrangement between the medical office and the outsource company, there may be much time spent coordinating the contract and costs occurred for legal fees. There is also the possibility that you may need to hire at least one person to act as a liaison or contact between the medical office and the outsource company.

Con 5: No Flexibility