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Labels: health insurance, medical billing, newsletter

If you are a medical provider considering outsourcing your billing, there are a few things you should consider. Choosing a medical billing service can be hard to do because it may seem like you are relinquishing control over the most important aspect of your practice. Here are a few tips to help you make the right decision.

Communication and transparency are the key to any successful relationship between a physician and their billing service. Make sure the medical billing company you are considering has a policy of communication that is satisfactory to you. Some questions to consider: what type of reports
do they run and how often are they provided? How often do they work insurance denials? Establish your preferred method of contact, whether by phone, email, etc. How does the medical billing service file their claims? Do they run software on their computer or use an internet based service?

Make sure the physician billing service does not make any changes to ICD-9, CPT, or HCPS codes without your consent. A billing service can be instrumental in finding errors in your coding and help you make the correct changes, but they should not do so unless consulting with you first. This prevents any liability issues down the road. Ask the billing service if they provide any physician education or feedback on insurance billing issues. Some may charge for this information, but most may be happy to provide it as part of the service.

Who posts payments? Some physicians may choose to keep this portion of their practice management in-house. In the beginning there will be a gradual overlap as you transition posting payments from your books to the billing company's. Some patient balances may not match due to the information provided to your billing service. For example, maybe a patient as a credit on your books but the medical billing company you are using is not informed of this, creating two different balances. The more information you can provide up front, the closer your books will match.

One easy way to feel a sense of retaining control as well as being able to manage transition issues is to use a medical billing service that files claims through an internet based practice management system. Those that do use an internet based system are more transparent as they can provide 24/7 access to you from anywhere you have a computer.

Try to find a service that bills on a contingency fee. Some states may prohibit this, but it is the preferred method of billing. A set dollar amount per claim may make it easier to judge your cost each month. However a contingency fee, or percentage of the paid claim, offers distinct advantages. One, you only pay when you are paid. Two, there is more incentive for the billing service to work collections and denials. Three, it helps you control costs, especially since insurance allowables on some procedures can be very low.

Finally, try to find a physican billing service that is a partner in your success. Are they able to help you identify areas of opportunities in your practice to increase revenue? Correct errors? Prepare you and inform you of notable changes in insurance billing policies? A good medical billing company is one that acts like a consultant and not just a medical biller.

Labels: medical billing, outsource medical billing, physician billing service

Outsourcing can seem like a touchy subject and you might even feel like it is a cost. But when you step back and take a look at what it costs your practice to run all of the operations yourself, that can be a cost as well, even though it may be hard to put a dollar value to it.

Billing is the most important aspect of any practice. Yet sometimes billing becomes an afterthought. Scheduling patients, pulling charts, answering phones...you get the picture. Everything that happens on a day to day basis can cause paperwork to be pushed to the side to be taken care of later. This can be a cost to you when this happens with your billing. Timely filing rules with insurance carriers, the cost of floating money that could be in your bank account, that is a cost. A professional medical billing company is a specialist whose sole responsibility is keeping your cashflow positive.

Think about the technology cost aspects of billing as well. With the ever changing nature of medical billing, there can be a significant cost to your practice as well. Software purchases and updates, compliance systems...these can add up. When you outsource your billing, you pass the cost of technology off to the billing company who is able to spread their cost across several practices.

How about everyone's favorite task? Following up on insurance denials. In many practices that I speak with, this is one of the last things to get attention. It is time consuming, it can be frustrating and confusing, and as a result denials can slip through the cracks. It is not uncommon these days for a practice to have 30% or more of their claims denied. A lot of that just gets written off. Why? Insurance carriers are constantly changing rules. Visit Medicare's website...ever try to find why your claim denied by searching the CMS website for that one specific nugget of information? If you could put a dollar value to the cost to your practice just for denials and all of the follow up involved, what do you think that would be worth?

A professional medical billing company does all of that work for you. Better yet, a billing company that works on a contingency basis ( charging a percentage of monies collected ) has more of an incentive to collect your money than an office staffer paid by the hour.

Many physicians code their own charts as well. This can be very time-consuming, preventing you from scheduling and seeing more patients. Errors can occur as well, even if you use software. Coding programs don't always get updated resulting in incorrect coding of claims. As of October 2013, healthcare providers will be required to be using ICD-10 codes. How much more time consuming will that be when diagnosis codes go from around 17,000 to 150,000? Outsourcing coding may seem like a cost, but there is a dollar value to the work you do as well. What pays you more? Doing work that someone making $10, $15, $20 per hour can do ( coding ) or seeing patients?

For more information on why it benefits doctors to outsource systems that can be done at a lower cost by others, read this article from BC Advantage, "Why Doctors Should Outsource Their Billing."

Labels: medical billing, medical coding, outsource medical billing