While using a medical billing business may result in more effective and faster claim submission, is outsourcing medical billing services beneficial?
Full-service medical billing businesses provide a variety of services that help practitioners optimize insurance and patient collections, freeing them to concentrate on patient care and practice development.
Numerous medical billing organizations in my neighborhood provide web-based solutions that cover the whole revenue cycle.
Claims Processing — This involves inputting patient demographics and insurance information, confirming prior authorization was acquired and maintained, electronically submitting claims, filing secondary follow-up claims, and organizing automated crossovers.
Patient Billing — Responsible for sending patient statements, responding to account queries, addressing patient questions, and mailing client-approved collection letters.
Payment Posting - Entering payments and changes from insurance companies' explanations of benefits (EOBs), as well as posting patient copays.
Financial Information — Providing access to financial reports on the financial health of the practice. Insurance aging, patient aging, monthly, weekly, and daily summary reports, and payer reimbursement analysis are all included in these reports.
Appeals and Follow-up — Contacting insurers to inquire about the status of outstanding claims, resubmitting amended claims, and filing appeals.
Online Data Access - Practitioners may monitor the status of outstanding claims, analyze balances, and generate financial reports 24 hours a day, seven days a week.
Verification of Coverage - Contacting insurance companies to ascertain the patient's health benefits and eligibility before their visit. The service will validate copays, deductibles, the maximum number of visits permitted, permission requirements, and the claims mailing address during the conversation.
Clarify the Collections Process from the Start — It is critical to have open and transparent communication with patients. Patients must be made aware of their financial responsibilities. Several offices display a notice in their reception rooms outlining their copay and outstanding bill policies.
Practice Management Solutions — Several providers provide time and money-saving features like online appointment calendars, credit card processing, and online payment portals, in addition to appointment reminder calls and text messages.
Despite these service offers, some may wonder whether working with a medical billing business adds value.
Yes, in the simplest form. Outsourcing medical billing services has several benefits. However, how certain are we? Rather than taking our word for it, why not check out the evidence for yourself?
The case examples that follow illustrate the extra value.
No. 1 Case Study
A client requested that their charge entry and patient demographic activities be outsourced.
The billing services' objectives were to provide a seamless transition with minimal practice interruption; reduce claim error rates from 4% to 2%; maintain productivity levels upon outsourcing, and train their personnel on the client's current software and processes.
Collaborate closely with the company's billing department
By the second month of operation, 150 completed claims resulted in an error rate of less than 2%. The happy customer elected to outsource the whole of their medical billing process, including insurance calling, charge input, patient demographics, patient contacting, and payment posting.
Case Study #2
A prospective customer-managed their revenue cycle management process internally, but after a few months in the company, realized collections were falling short of expectations.
Indeed, over the first six months, they fell short of their target of $150,000, earning just over $65,000.
Major claim rejection difficulties discovered by the medical billing service included the following:
• Issues with credentialing — For certain payers, credentials were incomplete. They assumed their internal employees had completed credentialing.
• Inadequate Eligibility and Benefits Checks - Either the patient's demographic and insurance information was input improperly or the personnel never confirmed coverage or benefits with payers.
• Coding Issues - Several claims were submitted wrongly based on outdated, inaccurate billing and coding standards. For instance, inexperienced personnel used CPT codes that had been phased out and changed.
• Filing difficulties — Due to the overwhelming volume of billing function issues and patient inquiries, the in-house employees fell behind and failed to charge claims on time.
The practice tried to overcome the problem of catching up while concurrently handling patients. They chose to contact a medical billing service in my area.
The medical billing business exceeded the $150,000 revenue target during the first six months and maintained a revenue level of $170,000 for many months thereafter.
Additionally, they aided in the reduction of Accounts Receivable (AR) days from 90 to 120 to less than 30.
These are just two of several case studies demonstrating how contracting with a medical billing business eliminates mistakes, boosts revenue, and decreases AR days, all of which improve cash flow.
This, we feel, demonstrates unequivocally that there is an extra value when engaging with a medical billing services firm near me.