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Is Outsourcing Billing the Answer for Independent Physicians?

by Chris Johnson on September 12, 2017 at 3:29 PM

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Amidst current changes in the healthcare industry, managing billing and coding in-house can be time consuming and intensive, requiring staff to spend long hours on administrative tasks associated with revenue cycle management. More-so, submitting denied claims can shrink revenue, directly affecting your practice’s bottom line.

In an attempt to improve practice productivity and regain time spent on tasks associated with billing, is outsourcing physician billing the answer for your medical practice? To aid in your decision, here’s a list pros and cons to consider when thinking about making the move to an outsourced solution.


Related: Explore your options and discover a practice model that allows you to succeed in today's value-based environment.


Pros:

  1. Vendors handle all denied and unpaid claims. When you outsource, vendors are responsible for all claims, having the coding knowledge and training to do so with ease. When keeping billing in-house, your practice is responsible for training your in-house biller, which takes both time and money.
  2. Revenue cycle is top of mind. Practices small in size may not have an in-house biller who is skilled in more than one area of the revenue cycle. An outsourcing company on the other hand will have staff members that specialize in the entire revenue cycle, who are continually up-to-date on industry trends and new revenue cycle practices.
  3. Outsourcing allows you to focus on value-based care. Having an in-house billing department can be costly, and training staff can be time consuming. However, outsourcing can allow you to reposition your in-house biller to focus on value-based related tasks.
  4. Improved financial health. A healthy revenue cycle is pertinent to practice health, and while some practices are able to stay afloat with industry changes, smaller practices may lack the resources needed to do so. By working with professional billers, practices can greatly reduce the amount of unpaid and denied claims received.

Cons:

  1. Costs associated with outsourcing could be expensive. Outsourcing physician billing could be costly depending on the size of your medical practice. A great way to assess if outsourcing is the right option for you is to do a cost analysis based on annual fees associated with both outsourcing and keeping billing in-house to make an informed decision.
  2. You no longer have control over a billing department. Lack of control in outsourcing can be worrisome, especially since you no longer have a billing department under your control. Although the case, some physicians may be relieved by alleviating this responsibility.
  3. Staff cuts may be involved. If you have an in-house billing staff and decide to outsource, it’s likely you’ll have to make cuts to staff. However, repositioning your billing staff to focus on administrative task such as value-based care can be a great way to avoid cuts and keep valuable staff members on-board.
  4. Billing updates may not be instant. When you have a billing related question, receiving an answer from an outsourced company may take time. Although this can be frustrating at times, an outsourced company should have the ability to send you regular updates on your practice’s billing, giving you a weekly or monthly re-cap of where your medical practice stands.

While transitioning to an outsourced solution is the answer for many medical practices, it may not be the right option for you. Weighing the pros and cons of outsourcing billing for your practice specifically is a great way to make an informed decision, and lead your practice down the road to financial health.

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This post was written by Chris Johnson

Chris Johnson is Regional Vice President of Office-Based Physician Services at Intermedix. Prior to joining Intermedix, Chris was the National Accounts Executive for the Bill Co. division. Chris obtained his bachelors degree from Cal State University at San Bernardino.

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