Medical billing is one of the most important parts of your business, but for small and even some medium-size practices, it can also be one of the most difficult to get right. When you have a small staff who are asked to wear a lot of hats, you may not be able to hire someone who specializes exclusively in billing. If it’s not a priority, or your staff isn’t up to date on all the latest billing changes, you could be leaving money on the table or risk making errors that open your practice up to an audit, fines, or other penalties.
Small practices may benefit from outsourcing medical billing, but before you reject the idea, it’s probably important to correct a few of the common myths out there about it.
Myth: Medical billing is really just data entry
Truth: Medical billing is a complex system that involves submitting claims to private and public insurance payers and collecting balances from your patients that are not covered by insurance (or for patients that are uninsured). Medical coders must be able to read physician notes, understand nuances in a medical record, and ensure the relevant information is in a patient’s chart to justify billing for specific services. Then they must also know which code(s) are available and valid, so they don’t overbill (billing for more or more complex services than what was provided) or underbill (billing for less or less complex services). Both of these things are against the law, and ignorance of medical billing and coding rules is not a legal defense.
When you pay for outsourced medical billing, you’re paying for people who have expertise and experience in billing.
Myth: Outsourcing won’t save any time
Truth: Since medical billing and coding staff at the revenue cycle management third-party company only focus on billing, they can often submit claims quicker than your internal staff (who probably wear many hats and have a lot of other work in your office). They can also follow-up with denied or rejected claims in a timely manner, ensuring that you don’t miss filing deadlines for appeals. The sooner you get claims submitted, the more likely they will be paid, and the more likely you will be able to collect on the patient responsibility portion of a bill. Outsourcing also frees up your staff to do other tasks that are essential to your clinic operations.
Myth: Outsourcing is expensive
Truth: You are going to have to pay someone to do your medical billing, and for many small clinics, the cost of a salary, benefits, and office expenses add up to more than the cost to outsource. In addition, since the employees at the medical billing companies are highly experienced and trained, they can often bill more effectively, which means you will collect more revenue as a percent of your billed charges. In fact, many clinics actually save money by outsourcing and it’s an investment rather than an expense.
Myth: I will lose control over my finances when I outsource
Truth: The right medical billing company will keep you in the loop on everything happening in your billing and revenue cycle every month, or more often if you prefer. Easy-to-read reports help you see the big financial picture or dig into the details. You may feel even more in control by outsourcing than you ever did with internal billing because you know it’s in the hands of experts and you get regular reports to keep you updated.