The Importance of Outsourcing Medical Billing: Streamline Your Practice with Professional Services

Outsourcing medical billing is a crucial decision that most healthcare providers need to take. It is a personal decision that usually depends upon the staff's experience and expertise. In healthcare, carefully handling this process is extremely important. This is because the practice's cash flow depends upon it. Therefore, it can be said that this process is the most crucial in revenue cycle management (RCM). Outsourcing medical billing services allows you to streamline your practice with professional services. 

Some Statistics

Here are some statistics that are in support of outsourcing medical billing. According to Grand View Research, the global medical billing outsourcing market is projected to reach USD 23.1 billion by 2027. It is expected to expand at a CAGR of 12.3% during this period. According to a Precedence Research report, the market size is expected to grow to over USD 23.7 billion by 2027. It is anticipated to grow at a CAGR of 12.1% from 2020 to 2027.

Further, this process comprises two components – the front end and the back end. Some medical practices get confused about the intricacies of the medical billing services system and whether they must complete them in-house.  A complete RCM process is complicated. It needs specialists who can understand the process, such as insurance rules, changes, and specific rules. Such aspects can affect the practice's bottom line, so outsourcing this process could be a wise step in the right direction.

Outsourcing Medical Billing: It’s Importance

Critical factors drive the medical billing outsourcing market, including increasing usage of billing and medical coding procedures in RCM, growing and changing government requirements, bad debts, increasing digitalization in healthcare, and the advent of new technological solutions. So, the question that arises is—why outsource? Let us study some of the reasons next:

1. Increases cash flow:

It is essential to manage cash flow competently. This helps practices to obtain proper reimbursement for the services provided. The correct billing companies submit claims and follow up on claims with the concerned health insurance companies to receive appropriate refunds. In this way, you can prevent your AR from getting bigger. 

2. Minimizes claims denials:

Error-free medical coding ensures that claim denials are reduced. At the same time, cash flow is accelerated, and reimbursement is maximized. Proper patient appointment scheduling and registration are essential to ensure minimal denial of claims, along with appropriate insurance verification and pre-authorization. All these point to efficient AR management, correct charge entry, claim submission, and insurance payment posting.

3. Patient eligibility is verified:

Patient eligibility verification is a crucial stage in this process. With proper verification, you can understand all aspects of the patient's coverage, such as the type of plan the patient has, the insurer responsible for payment, whether the coverage is active, coverage details, plan exclusions, specific coverage, and more.

4. Reduces billing errors.

Since rules and regulations are constantly changing, keeping up with these rules can be time-consuming. This can become complicated if only a few individuals look after the billing tasks. However, you can eliminate the stress, errors, and complications if you outsource this function. The medical billing company you outsource should be aware of all the latest changes in the rules and regulations. They should have adequate infrastructure to ensure the claims are submitted correctly. This will ensure bills are submitted on time, and billing errors are reduced considerably.  

5. Facilitates Expert Services

Training and retaining a medical billing team can be expensive. It is more convenient and cost-effective to outsource functions like medical billing, coding, insurance verification, and AR management to help obtain more efficiency and productivity in the outsourced medical billing services process. 

6. Improves Clinical Documentation and Coding

Hiring expert and certified coders to assist in the medical coding process is advisable. These coders can assign the most appropriate codes based on history, pathology reports, and the review of medical records. These coders are efficient in various coding processes, such as CPT and ICD-10. They can ensure accurate coding on the medical claims. 

7. Reduces Overhead Costs

Outsourcing reduces overhead costs such as salaries of your employees, healthcare costs, office space and rental costs, and other sundry and miscellaneous expenses. These costs and fees could be financially challenging for small and medium businesses. Outsourcing can help you solve such issues.

8. Enables Better Denial Management

Outsourcing this function to a competent company helps successfully appeal denied claims. Most outsourcing companies have a dedicated team to appeal denied claims. These teams identify the real reason for the denial and follow a professional appeals process for appealing the claim. 

Conclusion

As described in the preceding paragraphs, your decision to outsource this function depends on your experience and several other factors. Your practice's capabilities and finances also play an essential role. If you want to outsource these services, look for a trusted medical billing company like OmniMD. We are an end-to-end RCM and billing services provider with a team of expert medical billing professionals. Contact us to learn more!