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Why You Should Outsource Medical Billing


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A statement from an outsource medical billing company.

The revenue cycle of a medical practice is a complex process that is meant to enhance the physician’s work with a billing team that optimizes reimbursement received from insurance companies and patients. Though many healthcare practices handle their billing in-house, this is not always the most efficient choice. Given the cost of salaries, health insurance, benefits, software, and training, in-house billing can be quite expensive. This is why many practices decide to outsource medical billing to keep their processes running as smoothly as possible.

What is Medical Billing?

Outsource medical billing is a cost-effective billing option that saves a practice time and money. These billing companies are paid a predetermined percentage of a practice’s monthly revenue. Medical practices of any size can outsource their billing responsibilities to a billing company that can evaluate the provider’s needs and implements a personalized plan for the practice. Their professionals are specifically trained to understand the importance of the revenue cycle.

Benefits of Outsource Medical Billing

Outsourcing medical billing allows professionals to design the perfect team to manage the demands of a practice. Professional billing companies ensure their billers are compliant with patient information protection, carry out excellent customer service protocols, and answer patient calls to ensure patients are educated and engaged. They also lower administrative costs and communicate directly with the practice manager for issues that may arise. Additionally, benefits of the billing team include them monitoring the following:

  • Registration of patients: Medical billers communicate with the registration staff in this important initial step to relay any change of insurance, outstanding balances, or missed payments. Insurance verification and collection of copays from face-to-face contact with patients include copies of insurance cards, changes in coordination of benefits, and collection of overdue balances.
  • Charge capture and entry: Medical billing experts are trained in the software chosen by the practice and specialty involved. Reviewing all charges sent by the provider to evaluate codes, diagnosis, modifiers, and authorizations needed. Billers are chosen who are trained in the chosen Clearinghouse to transmit the practice’s claims to the insurance companies, billers correct errors found in the Clearinghouse to optimize the clean claim percentages by reviewing every field in the 1500 HCFA form to reduce denials and corrections.
  • Payments: Billers must post payments in the software. As insurance companies issue payments to the providers, they also assign monetary responsibilities to the patient. Daily matching insurance payments to bank accounts, posting payments, and reporting denials are sent to the person working follow-up. Statements, appeals, and monthly reports are included to reach all aspects of the cycle. The team works hard to keep the denial rates low. These are important factors outsource medical billing teams are trained to optimize, so that revenue can be maximized for the practice. 

What is the Main Goal of the Medical Billing Team?

Physician practices are reimbursed by insurance companies and the collection of patient payments. The main goal of the billing team is to collect the maximum reimbursement in the shortest time. Following the checks and balances in the revenue cycle achieves optimal results. Outsourcing medical billing can ensure a positive patient experience, constant communication between the billing team and registration team, and continual training within the team. 

Medical billing can be a daunting task with constant changes to monitor. Medical billers strive for optimal numbers and look for patterns in billing that can minimize problems before they occur. Outsourcing medical billers allow for optimized reimbursement and boosted productivity with a streamlined plan to follow. Understanding how the revenue cycle works and the time frames involved ensures quick payments and fewer denials. 

Is Outsourcing Your Medical Billing the Right Solution for You?

Consultants can provide insight into the problems you may be having with your current medical billing process and suggest you use an outsourced medical billing option. Investigating the revenue cycle you are currently managing and where the problems reside — whether it be in accounts receivable, a high patient self-pay total, or collections— will help a consultant or professional billing company with the insight needed to resolve revenue problems. Additionally, expressing your concerns to a consultant who can help explain why your problems exist can relieve your anxiety and produce positive results. 

Get Help With Outsourcing Medical Billing In South Florida 

Bloom Consulting Agency in South Florida has consultants who know the revenue cycle and medical billing processes. We can investigate and find innovative solutions to the issues you may be experiencing with your practice revenue. Additionally, we stay up to date with the healthcare industry’s best practices and ever-changing technology to give your business an edge. It is time to get your practice moving in the right direction, and solving your medical billing issues is the first step. Give us a call or use our contact form to learn more about our services or for a review of your revenue cycle today.