In-house vs. Outsourced Medical Billing - Various Advantages

In the healthcare industry, discussions are rife about whether outsourcing medical billing tasks to external companies is more beneficial than maintaining a regular in-house billing system. An unbiased consideration would soon reveal that outsourcing can help medical practices remain competitive in the present day business scenario. Compared to in-house medical billing systems, outsourced medical billing brings various advantages that can certainly boost the cash inflow and overall efficiency of medical practices.

Advantages of Outsourced Medical Billing

Constant changes in federal government rules, HIPAA norms and insurance company policies make medical billing tasks challenging and complex. Any kind of processing errors in medical claims would lead to claim denials and delayed payments. Maintaining a full-fledged and efficient in-house medical billing and claims processing system may be rather challenging for most medical practices. On the other hand, outsourced medical billing services provided by reliable third-party service providers would be a great alternative for medical facilities looking to enhance their revenue cycle. To carry out medical billing tasks within your facility, you need to set up the required infrastructure that includes computers with advanced hardware configurations, the latest medical billing software, printers, and many other office accessories including storage options, papers, envelopes, and so on. You have to appoint additional staff and train them to get acquainted with your billing system. If you choose to outsource your core billing tasks, you can get the work completed at minimal costs, without worrying about the infrastructure and staffing issues.

What You Can Expect from a Reliable Medical Billing Company

Professional medical billing outsourcing solutions from established companies ensure the following advantages:

•    Enhance cash inflow: Outsourcing helps to avail of the services of experienced billing experts, which would facilitate submission of accurate medical claims. This would considerably minimize the chances of claim denials, ensure maximum reimbursement and enhance the cash inflow.

•    Save operational costs: Utilizing the services of reputable medical billing companies would bring 30% to 40% cost savings. These firms help to eliminate the additional expenses involved in paying employee benefits such as additional allowances and bonuses, vacation benefits, sick pay, and other allowances; you can also avoid maintenance costs and other outlay required to carry out the back-office operations within your facility.

•    Free-up resources: Professional medical billing outsourcing services would certainly free-up your in-house resources. With the time and resources saved you can engage in activities that will enhance your practice productivity, and also provide improved patient support services.

•    Enhance overall practice efficiency: Outsourcing medical billing would minimize your administrative workload. It will save you and your office staff the valuable time spent on answering claim processing and billing queries.

•    Benefit from professional expertise: Outsourced medical billing services provide you an opportunity to utilize professional expertise and innovative technology at reduced costs.

Pick the Best Provider for Quality Services

It is apparent that the advantages of outsourced medical billing are many and it can provide any medical practice with the flexibility required to enhance the medical billing system in a budget-friendly manner and maintain a profitable and balanced revenue cycle.

Availing of client-focused services from an experienced medical billing company would allow you to stay away from complex issues and bulk expenses involved in in-house medical billing processes, and concentrate on core functions that can make your practice more competitive. Signing up with professional firms would also help you benefit from continuous customer support (24/7), free trial facility, consistent solutions in short turnaround time, and much more.

Article Source: http://www.articleshub.org/article/204045/In-house-vs-Outsourced-Medical-Billing---Various-Advantages.html

Pros and Cons of Outsourcing Medical Billing

Medical billing services are sought by many medical practices mainly due to the reasons that are given below:

•    They are fed up of the red tape of collections and billings
•    They are tired of managing internal collectors and billers
•    They are nervous or are unsure about HIPAA compliance

However, as every coin has two sides, there are some pros and cons associated with medical billing services as well. Discussed below are some of the positive and negative aspects of hiring medical billing companies for medical billing services.

Pros of Medical Billing Outsourcing

•    The cost of maintaining employees is lowered. If medical billing is done internally, the cost associated with the salary of employees can be quite high. With outsourcing you need entertain no concerns regarding the recruitment and maintenance of billing staff.

•    It can help in the growth of the medical practice/organization. As there is growth of business, there is growth of revenue. However, the workload associated with medical billing and coding increases as well. Sometimes, the business grows to such a point when the workload cannot be handled by the in-house personnel. At such a point of time, the help of a medical billing specialist becomes indispensable to maintain a steady revenue cycle.

•    With medical billing outsourcing, there is a reduction in employee turnover. There may be times when some specialist might leave the job due to some reasons. In such cases, the vacant spot has to be filled right away to avoid any kind of compromise on the cash flow.  Often, companies may end up hiring someone who has very little experience in medical billing. Such personnel tend to make errors and due to these errors, the practice may be severely affected. In such cases, medical billing outsourcing definitely proves to be of great help.

Cons of Medical Billing Outsourcing

•    Sometimes there are chances that you end up with the wrong billing service. A medical billing company is no less than your partner in business and so, it should always be ensured that you have the right company working for you.

•    Sometimes, sensitive patient details may leak. This problem may occur even when the company has adequate security measures. Data leak can compromise your integrity and get you into trouble with both insurers and patients.

Proper homework will definitely help you in finding the right company. The Internet is the best place, where research about the best medical billing companies can be done.

The Importance of Health Insurance Verification and Authorization Services

Most of the medical professionals may not have enough time to supervise the medical insurance verification process and their staff may not be skilled enough to carry out the eligibility verification process efficiently. This often leads to a situation where you don't receive due payment for services provided. So, it is very crucial that healthcare providers understand the importance of insurance verification and authorization services in the healthcare industry.

Insurance verification services and insurance authorization plays a vital role in accelerating the medical billing process. It involves validating the patient's insurance details and obtaining assurance by calling the insurance payer or through online verification. The process ensures verification of: payable benefits, patient details, pre-authorization number, co-pays, co-insurance details, deductibles, patient policy status, effective date, type of plan and coverage details, plan exclusions, claims mailing address, referrals & pre-authorizations, life time maximum and more.

Comprehensive Health Insurance Verification and Authorization

The insurance verification and authorization process includes:

•    Ensuring benefits for all patients prior to submitting to the insurance company for approval
•    Getting patient schedules from the hospital or clinic via FTP, fax or e-mail
•    Verifying patient information with the insurance carrier (verification of payable benefits, co-pays, co-insurances, deductibles, patient policy status, effective date, type of plan and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, life time maximum and more)
•    Verifying patients’ insurance coverage on all primary and secondary payers
•    Updating patient accounts
•    Communicating with patients and completing paperwork
•    Updating insurance system with new and updated benefits
•    Obtaining pre-certification number from physician’s office if necessary
•    Completing appropriate criteria sheets and authorization forms
•    Contacting the insurance agencies via telephone call, facsimile or online program to obtain approval for your authorization request
•    Contacting insurance agencies for appeals, missing information and more to ensure accurate billing

It is advisable to avail of insurance verification services to enjoy maximum benefits. Outsourcing of health insurance verification and insurance authorization allows healthcare professionals to focus on their core business activities and provide quality healthcare.

Professional Medical Billing Company for Maximum Efficiency

Try to partner with a professional medical billing company that can work as an extension of your office. Normally, medical billing firms have a team of professionals who work with patients as well as providers to verify medical insurance coverage and generate claims for services rendered. They will also provide complete support to obtain pre-certification and or prior authorizations. They have:

•    Experience with insurance guidelines of various providers, knowledge of healthcare terminology, and medical/surgical techniques
•    Good communication skills
•    Good typing skills
•    Excellent computer skills
•    Call center/customer service experience

No matter whether you are an individual practitioner or running a faculty practice, health insurance verification services and insurance authorization are definitely beneficial.

Article Source: http://www.americanchronicle.com/articles/view/288423

Some Facts about Medical Billing

Medical billing is an important process in a medical office, and accurate medical billing and claims submission is necessary for maintaining a steady revenue cycle. The claims submitted to insurance companies have to be flawless and “clean”. Medical office staff not specially trained in medical billing is unaware of the various processes involved in medical office billing. It would merit them as well as medical students who are the future practitioners to understand some important facts about medical billing.

Accurate Reimbursement Depends on Flawless Medical Billing

On time and accurate medical billing and coding is necessary for obtaining well-timed reimbursement. Any sort of data inaccuracy and errors in medical bills and insurance claims will lead to rejection or denial of claims that could critically affect the income and cash flow of the practice. To avoid such situations, medical billing and coding needs can be outsourced to professional medical billing companies.

Only a professional medical billing company can guarantee you timely submission of accurate medical bills and claims. A competent firm will ensure that the billing cycle is smooth - from patients being billed the correct amount to doctors getting paid. Healthcare practitioners, hospitals, individual physicians, small and large hospitals, dental groups, doctors’ offices, acute care facilities, long term care facilities and multi-specialty groups all over the world can benefit from efficient medical billing and coding services.

Services You Can Expect

Mentioned here are some of the main services provided by medical billing companies: patient information collection and analysis; creating and mailing patient statements; processing medical insurance claims; insurance verification and authorization; continuous monitoring and follow-up of rejected claims and resubmitting them after resolving any problems; effective collection of excellent compensation; generating customized reporting to track business activity and productivity; credit bureau reporting; generating reports with details of payments and claims, which helps you in adjusting your billing practices and improving cash flow; frequent assessment of accounts; providing quality checks; charge entry; cash posting and reconciliation; scheduling and rescheduling; AR collections and more.

Here Are the Advantages of Medical Billing Services

•    Accurate billing and coding
•    Quick and maximum reimbursement
•    Reduced paperwork, which in turn increases practice productivity 
•    Claim submission on time
•    Reduced billing and coding errors
•    Minimal chance for claim rejections, resulting in better turnaround time and higher revenue
•    More consistent cash flow
•    Timely follow-up on all rejected and denied claims
•    Reduced write-offs
•    Improved collections

Established medical billing companies offer medical billing services for almost every medical specialty. Find a provider that can meet the specific requirements of your specialty and enjoy more streamlined practice functioning and improved revenue.