The practice of outsourcing medical billing has gained significant traction among healthcare providers in recent years, primarily driven by the desire to optimize operations and minimize expenses. Nevertheless, a multitude of misconceptions surrounding this practice persists, which may cause reluctance among providers who stand to benefit from outsourcing.
If medical practices do not receive payment for the services they provide, it can threaten their financial sustainability, even if they prioritize offering high-quality care to their patients. Unfortunately, Healthcare Finance® has reported that a substantial number of medical claims, totaling more than $3 trillion annually, are initially denied, with about $262 billion worth of claims being rejected. Although an average of 63% of those claims can be recovered, it requires spending around $118 per claim to appeal, resulting in up to $8.6 billion in administrative costs related to appeals. As a result, these denials can have a significant impact on the profitability of medical practices, as appealing these claims leads to additional expenses that can further reduce profit margins.
Therefore, it is imperative to dispel common myths associated with outsourcing medical billing and coding and reveal the facts to improve the efficiency, productivity, and financial viability of medical practices. This article aims to debunk prevalent misconceptions regarding medical billing outsourcing and provide relevant information to enable providers to make well-informed decisions.
Myth #1: Medical billing outsourcing is only for large healthcare organizations.
Many small and mid-sized healthcare providers believe that outsourcing their medical billing is only feasible for large organizations. However, this is far from the truth. Outsourcing is a flexible solution that can be tailored to the specific needs of your organization, regardless of its size. In fact, outsourcing can be particularly advantageous for small practices, as it can help reduce administrative costs and allow staff to focus on patient care.
Myth #2: Outsourcing medical billing means losing control of your revenue cycle.
One of the most persistent myths about outsourcing medical billing is that it means losing control of your revenue cycle. However, this is not the case. A reputable outsourcing partner (like our iTech RCM team) will work with you to develop a customized solution that meets your unique needs, and you will still have complete visibility into your revenue cycle. In fact, outsourcing can often result in better revenue cycle management, as outsourcing partners have specialized expertise in this area and can implement best practices to optimize revenue collection.
Myth #3: Outsourcing medical billing is more expensive than keeping it in-house.
Another common misconception about outsourcing medical billing is that it is more expensive than keeping it in-house. Nevertheless, if you consider the insurance costs of the staff, their management and training to comply with the latest standards, procurement and maintenance of software and equipment, and the management of the revenue cycle, outsourcing can prove to be a more economical option. Additionally, outsourcing providers can often negotiate better rates with payers, resulting in increased revenue for your organization.
Myth #4: Outsourcing medical billing is not secure.
Given the sensitive nature of medical billing information, it’s understandable that some healthcare providers may be hesitant to outsource. However, outsourcing providers are held to strict security standards and must comply with HIPAA regulations. In fact, outsourcing can often improve security, as medical billing outsourcing partners have the resources and expertise to implement robust security measures and perform regular audits to ensure compliance.
Myth #5: Outsourcing medical billing is a complex process.
While outsourcing medical billing may seem like a complex process, it’s actually quite straightforward. Your outsourcing partner will work with you to understand your specific needs, develop a customized solution, and ensure a smooth transition. In some cases, they might already have a reliable software (like expEDIum) in place, which they can customize to suit your needs. Once the outsourcing relationship is established, you can expect regular communication and reporting to keep you informed of your revenue cycle performance.
In summary, outsourcing medical billing services can offer healthcare providers numerous benefits such as cost reduction, operational efficiency, and revenue optimization. It is crucial to recognize that the evolving healthcare landscape demands adaptive measures, and clinging to outdated practices may incur more expenses over time. With the use of advanced secure cloud-based technology for revenue cycle management, medical billing consultants can eliminate errors and minimize claim rejection rates while providing convenient payment options, reminders, and e-statements. These features facilitate prompt reimbursement, improve cash flow, and ensure compliance with legal requirements. Furthermore, outsourcing medical billing can enable providers to prioritize the tasks that matter most to their employees and maintain positive relationships with them.
At iTech, we endeavor to debunk common misconceptions and equip you with the necessary knowledge to make an informed decision regarding outsourcing your medical billing. Our experienced medical billers and coders possess up-to-date knowledge of billing guidelines and payer policies. If you are considering outsourcing as a viable option, please do contact us at contactus@expedium.us or call us at 786-646-0099.
