The U.S. healthcare system is one of the most expensive in the world, and also one of the most complex. This can be attributed to a long list of administrative policies, which are not widely known and are even subject to periodic revisions. Keeping up with these policies can incur huge administrative costs which can make up 15% to 25% of total healthcare expenditures.
Why is that?
As you manage a healthcare provider, you’d know that a large percentage of healthcare expenditure stems from the complexity and length of the billing process. From the number of participants that navigate it to the time it takes to go through certain procedures, much of the system incurs an exorbitant amount of expenses.
The healthcare process starts right when a patient enters a clinic, continuing into the registration of the patient’s information, into the provider’s office, and all the way into charting, diagnosis, prescription, and claims. The amount of information needed for each patient requires the use of billing codes which must be recorded accurately by a professional. This proves to be tedious and time consuming: if you repeat that for every patient in the United States, it would make sense that 80% of medical bills in the U.S. contain errors.
The amount of human error that falls through the cracks generates obstacles, resulting in bad debt, re-issuances, and follow-ups. All these can snowball into millions.
The goal of outsourcing medical billing
Because of the desire to cut costs and minimize recurring errors, healthcare providers have begun to see the value in outsourcing billing and coding-related operations. Instead of being handled by in-house medical staff, who are swamped attending to patients, the admin work is delegated to an external team laser-focused to this part of the healthcare process. This is why we can see that outsourced medical billing holds the highest revenue share in the market for 2021.
A medical provider with a billing team in-house has total ownership of their medical billing procedures. On the other hand, outsourcing a medical billing team transfers that responsibility from your practice to theirs, so you can focus on delivering expert care to your patients. When partnered with the right medical billing outsourcing company, you can achieve most if not all of the perks for your firm:
1. Increased Control and Transparency
Contrary to what you might believe, outsourcing your billing services won’t strip you of control over your business’ practices. In fact, you will have a better hold over your billing operations. Thanks to trained and dedicated staff, your process is tightened, leaving no room for errors and subsequently, less unnecessary costs incurred.
Once you contract with an outsourcing company, your offshore billing team works to abide by a set of metrics you define, such as first-pass payments, denial rates, and debt collection ratios. They can also present data with performance reports, giving you some much-needed transparency into your revenue cycle. They’ll keep you updated so you can maintain control without micromanaging your billing staff.
2. Availability and Accessibility
Being In the medical field, providers and staff often have to take care of several tasks that are beyond their scope of responsibilities. However, you should know that medical billing is a full-time job. For you to stay updated real-time with transactions, you’ll require personnel whose tasks are dedicated entirely to billing. By outsourcing these professionals, you’ll free up time for your in-house staff.
3. Faster Insurance Payments
According to CMS, 30% of claims are either denied, lost or ignored. Partnering with an offshore medical billing team can help scale down this margin of error. With billing errors minimized, payments can be collected and reimbursements issued in a shorter time frame. With an offshore billing team, you can enjoy streamlined workflows that clear a path for payments in a quicker and more efficient manner.
4. Fewer Errors and Ensure Compliance to ICD11
IDC11, or the 11th revision of the International Classification of Diseases, is the global standard of healthcare recording and coding. New coding changes can impact the medical community, including the medical billing sector. Studying and mastering these changes can be extremely difficult to keep up with for staff and providers, but facing them can be easier when handled by an outsourcing company. In the same vein, the process of insurance billing is made up of many moving parts. Constant changes to the types of scenarios and questions can arise within the cycle of revenue management.
The right billing experts who specialize in these standards will have an easier time grasping and adapting. Mastering such changing protocols will yield up-to-date quality assurance measures that make them less likely to make errors.
Without the right support for your healthcare business, you will find yourself behind on payments and reimbursements that will eat up staff’s time. The best way to go is to contract with an outsourcing provider who knows what to do and can give you an adept team of medical billing experts who can track, analyze, and stay on top of your business’ billing and insurance needs.
In addition to helping you build a team of highly-qualified, experienced medical billing experts to support your business, FGC+ can also recommend and incorporate tried-and-tested ways to streamline your processes. For more information, connect with us at www.fgcplus.com.