Original Publish Date: May 10, 2016
Is outsourcing your medical billing a good idea?
Absolutely, especially when you find the right partner. As hospitals and private medical practices have seen, margins are shrinking with no end in sight. There’s more pressure than ever to watch the bottom line without sacrificing patient care.
Outsourcing can bring up several barriers. Here are a few that have come up; “will I lose control”, “who do I call when I have an issue”, “how will I know where we are in the cycle”, or “what happens to my billing employees when I make the change?”.
These are all pertinent questions. I often hear “in no way are we are comfortable outsourcing our billing to an offshore company”. Well, let me tell you. We are a global market now. The technology is here that makes it as viable and as seamless to be able to work with companies off shore as easily as we do onshore. And let’s face it; to be successful we need to be able to utilize all that outsourcing has to offer.
As Business Wire News Reports (4/16): increasing healthcare expenditure is a major concern for the U.S. and all the other major economies. In order to reduce the economic burden and provide universal access to healthcare, governments are encouraging outsourcing of payer services to onshore or offshore locations.
The shift from the ICD-9 coding system to ICD-10 has created huge amounts of work for the payers to upgrade their systems, train their staff and has significantly increased the cost of the revenue cycle. The fact that ICD-9 had 13,000 codes, whereas ICD-10 has nearly 68,000 codes, which is an increase of 55,000 codes provides too many opportunities for errors, denied claims, and slows down cash flow significantly. Outsourcing is a good idea if for nothing else, to keep your cash flow from diminishing.
As a healthcare provider, you want to spend your increasingly limited value-added time and energy practicing medicine as opposed to non-value-added administrative tasks.
Accounts Receivable Management
Consider the time consuming task of following up on A/R. look at real numbers of this administrative cost then examine how outsourcing to the right partner can be a benefit to your organization.
Claims adjudication.
Take a good hard look at this process in your organization; the time it takes to do it, real dollars associated with it, and how outsourcing can save time money and provide cleaner claims. Cleaner claims equals faster conversion to cash.
Coding Backlogs
If you’re seeing revenue cycle delays or backlogs, your coding process may be the cause. Outsourcing your coding to well-trained medical coders can decrease the number of rejected claims and decrease the time it takes to receive payment from a payer.
The business of coding has become more complex than tax filing. How many practices try to handle their own taxes? So why are you investing time and money and limited resourcing to doing something that an outsourcing company does and does very well.
Staffing Challenges
Good coders are not easy to find. There is a barrage of ads online seeking qualified coders. If your practice is struggling with high turnover rates or an inability to attract and retain experienced, high quality medical coders your billing process becomes ineffective and your cash-flow is taking the hit. The coding process becomes ineffective and you see the inevitably slow-down in the processing of claims. However, working with a medical coding outsourcing firm can bring coding talent to your organization that you otherwise may not be able to find.
New Coding Changes
Coding is only as accurate as the knowledge and understanding of your staff. As the old saying goes, information is only as good as what goes in. Bad information in equals denial of claims. Codes are continually added, deleted, bundled, unbundled, or modified in other ways. The transition to ICD-10 last fall led to the learning of new diagnosis and procedure codes. The time and cost associated with making sure your staff is adequately educated with continual training can be exorbitant. If your current team is still not well-equipped to deal with these new codes, it may be yet another sign that outsourcing is right for you.
Delegating this task to an outside company can be overwhelming for some providers. However, it is good business. The outsourcing firm can assume and manage the day-to-day tasks involved in medical coding so you can better focus on running your organization and caring for your patients.
But remember, not all outsourcing companies are created equal. Do your homework. Look for companies that do end-to-end billing and have expertise in your practice area.
Cindy has been in the healthcare arena for over 18 years, largely in the capacity of CFO overseeing 15 assisted living facilities. She is currently the Regional Director for Go Telecare, a Telehealth and Medical Billing Company and can be reached at 360-909-7472 or cindy.lamar@gotelecare.com. See the Go Telecare web site at www.forewardhealthcare.com.