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Medical billing and collections tend to be tedious and cumbersome, almost sidetracking medical providers’ primary goal: to care for their patients. In conjunction with providing clinical services, medical facilities also need to manage billing and revenue cycle management. Both are equally important since the stability of your facility and cash flow depend on processing bills on time.
That’s the reason why many medical facilities have decided to partner with business process outsourcing in healthcare instead of handling billing in-house.
Of course, each method has its own pros and cons. No one deciding factor determines which option is better for medical billing functions. Ultimately, the choice depends on your organizational needs. To make an intelligent decision, you need to analyze all relevant factors, such as your facility’s financial state, size, and the age of your practice.
We will explain why Healthcare BPO could benefit your facility.
Managing Medical Billing In-House
Managing medical billing in-house involves steps that most medical facilities need to follow. Following the patient’s consultation, the first step is to enter all the required patient information collected from the superbill into the medical billing software. The superbill details all the information needed, including the patient’s insurance company, diagnosis, and treatment. Insurance companies use these details to determine the claim’s legitimacy.
The healthcare service then submits the claim to a medical billing clearinghouse. After the claim is verified, it is then checked for errors before being sent to the payer. Then clearinghouse is notified of the decision to reject or accept the claim. This signals them to inform the healthcare company about the claim’s status.
If the claim is declined, a designated staff from the healthcare facility will tweak the claim, depending on the required format, and resubmit it with the expectation of acceptance.
Remember that each claim submission comes with an additional fee, even if the correction is minor.
The primary advantage of managing billing and collection in-house is proximity. If any issues arise regarding the billing or the claim, the administration and other medical staff can quickly discuss the concern and immediately rectify it. This speed is crucial, especially with insurance claims processing, since queries can be addressed nearly instantaneously, and solutions are implemented immediately.
Disadvantages of In-House Medical Billing
Despite the control maintained with managing medical billing in-house, it comes with a fair share of disadvantages.
For one, managing billing and collections in-house incurs fees. You will need to shell out money for billing software and computer hardware. You might also need to hire a new staff team to manage the billing activities, which will incur costs for salaries and other benefits such as medical insurance, sick leave, and vacation leave. Those combined factors will inevitably increase the overhead cost.
On top of that, the whole clinical operation might be interrupted. Regardless of the size of your billing department, if one or two members are out of the office, the entire billing process could be jeopardized, which may lead to slower operation and decreased productivity.
Managing Medical Billing with Business Process Outsourcing for Healthcare
Outsourcing medical billing involves contracting a third-party provider, often a business process outsourcing company focused on healthcare, to manage your work. The process for outsourcing medical billing is quite simple.
All the documents, billings, and other information are digitally sent to the external billing company when you outsource medical billing. From there, the BPO takes care of all tasks related to billing, including data entry, claim submissions, and following up with turned-down claims. They are also responsible for transmitting invoices to patients and going after delinquent accounts.
The Benefits of Business Process Outsourcing for Healthcare
Since the healthcare industries are constantly evolving, business process outsourcing activities, such as outsourced medical billing, can be used to keep a medical practice well-versed in the latest rules and regulations. Outsourcing services such as billing and collections allows medical professionals and physicians to concentrate on patient care and stick to high medical intervention and diagnosis standards.
Healthcare services that outsource non-core operations gain definite benefits because firms can avail themselves of the extensive knowledge base at the disposal of the medical billing company. Healthcare outsourcing also reduces the number of staff doctors, and medical workers need to manage, thus boosting the overall bottom line of your healthcare practice. Your staff can network with external team members, expanding their knowledge of how tasks are accomplished or their overall understanding of the field.
Another benefit of outsourcing healthcare processes is reduced cash flow interruptions. Medical billing companies employ top healthcare billers who practice overall professionalism. These billers stay abreast of the newest updates and regulations related to medical billing. Their professional approach allows physicians to obtain payments from patients and insurance companies far faster than in-house medical billing.
Lastly, business process outsourcing helps you lower billing errors, thus improving patient satisfaction, increasing revenue, and ensuring you remain compliant with billing regulations.
The Bottom Line
Improve Patient Care with Business Process Outsourcing
Visiting the hospital is already a time-consuming, worrisome experience for many of your patients. They not only have to come to terms with concerning diagnoses and medications, but they also need help to understand the costs involved.
A skillful and courteous team of medical professionals who treat patients with the utmost care ensures a positive client experience. At the same time, their bills and claims are managed professionally by an expert biller. You won’t have to harass your patients with billing matters. Instead, patients can talk to the billing staff provided by the outsourcing firm, which helps your staff work more efficiently and concentrate on your patients’ care, thus improving the patient experience.
