Medical billing services include and are limited to all activities required for healthcare providers to get paid by either the patient or by an insurance carrier. The advent of EMR Software and the shift towards automating all healthcare transactions has resulted in the rise of electronic medical billing services. Electronic medical billing therefore, is a process through which healthcare providers digitally submit their patients’ bills and claims with concerned health plans.
Of the many business questions healthcare providers encounter, choosing between outsourcing their medical billing services to third-party billing companies and maintaining an in-house billing department is a significant one.
Since profitability is something all providers aim for, outsourcing medical billing services will outweigh in-house billing in most cases if the right decision has to be made. Arguments favoring outsourcing medical billing services are never ending.
Providers opting for in-house billing will need to maintain a separate billing department to look after the financial side of their businesses. This directly implies hiring billing staff that would need permanent office space, purchasing expensive hardware in addition to practice management (PM) software, ensuring regular staff training and providing them with other employee benefits and facilities. Therefore, not only does in-house billing require higher start-up expenditure, it also requires around the year maintenance cost.
Outsourcing your billing service on the other hand is not only much less costly; it makes the most sense especially if you are starting a new practice. Essentially, by outsourcing medical billing services, a provider is shifting all his billing operations to a third-party billing company. Your medical billing company will be contractually bound to perform some services, such as appealing denials which will eventually result in shorter billing cycles. Not to mention, the provider will not have to worry about hiring and managing additional office staff because it is the billing company’s job to support his needs throughout the year.
Outsourcing medical billing services also results in a much lower claim rejection rate such that a medical practice can expect between 5% to 15% increase in the amount they are able to collect by opting for a billing service.
With the time physicians save from transferring their billing hassles to a billing company, they will definitely be able to increase patient volume and focus on providing much higher levels of patient care.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
For healthcare providers then, outsourcing medical billing service serves multiple purposes; reduced expenditure, higher revenues and enhanced patient care- a definite recipe for success!
