The Ultimate Guide: Is It Time to Outsource Your Medical Billing?

Outsourcing medical billing is one of the most important and difficult decisions for physicians today. For successful practice growth, healthcare providers need to focus more on their patients and treatment plans rather than managing their medical billing process.

While some physicians stand with the decision that outsourcing is the best option, others wish to maintain control over their billing collections through house medical billing. 

So when is the right time to outsource medical billing and how it can be done? Here are the 5 signs that show your practice needs to outsource medical billing.

5 Signs Your Practice Needs to Outsource Medical Billing

1. When You Have A high staff turnover

This is one of the common problems every healthcare industry faces. Staff turnaround is often high for a medical billing department and the training staff can lead to the loss of many resources at your practice.

So if you have experienced staff turnover in your medical billing department, then it’s the right time to look at a medical billing service rather than training new employees. 

Because, the hiring process will be more expensive – to hire, train, and retain qualified and experienced billing professionals for your practice.

2. When You Face Patient Payment Problems

Accurate patient payments at the time of care offer various benefits like reducing back-end collection costs and medical billing costs, increasing cash flow, decreasing the administrative burdens of tracking and writing off bad patient debt, and managing the practice revenue growth from patient payments.

Patient payments are increasingly important to a practice whose patients are signing up for high deductible coverage. 

So if your practice is struggling to receive payments from their patients, definitely you need to outsource medical billing to some of the expert medical billing service providers.

3. A lack of advanced technology Usage

If you prefer to go with in house billing team, they will be already experienced and trained with the available billing software and the billing process, but they don’t have any experience or knowledge of advanced medical billing and practice management software. 

Apart from buying and regularly updating the software, you also have to provide the necessary training to your billing staff.

So if you don’t want your practice and administrative staff to waste time with the software upgrades and technical issues, then think about outsourcing the medical billing process.

4. When You Are Not Prepared For ICD-10

When implementing the phases of ICD-10, you’ll need proper training and changes to your processes to ensure you meet regulations.

The cost of training your available staff or hiring billing experts with advanced knowledge of the ICD 10 coding system may be more time-consuming and burdensome than you expect.  

By outsourcing your medical billing, they will handle everything with ICD 10 implementation and save you the work and expense. 

5. If You Are New To The Healthcare Field

Healthcare is one of the fastest-growing industries and if you are new to this field, there are plenty of things to learn to stand apart from the competition. 

As people have started looking for value-based care instead of the service fee, your first preference should be your patients apart from the practice management. 

So outsourcing your entire medical billing process will reduce your administrative burden, billing errors, and denial rates, and help you to concentrate on other important processes for a smooth run of your new medical practice.

6. When your team struggles with Billing

Usually, staff members are overwhelmed by the responsibilities of taking good care of patients. However, the evolving landscape of the healthcare industry makes it difficult for the team members to stay on top and efficiently work on billing claims.

This will ultimately stress the staff member. In this way, healthcare practice can rely on medical claim outsourcing services to free up resources and focus more on better patient outcomes.

7. If your Medical Billing Staff is Reliving Organization

If you’re professional medical biller is about relief from your healthcare organization, the healthcare practice can rely on medical claim outsourcing services. Because hiring staff and training them can be costly and time-consuming. 

However, the ongoing labor shortages make it difficult for the healthcare practice to the potential and well-experienced candidates. Outsourcing the medical billing services means you have the instant solution to keep on going without any disruption in the workflow. 

Related: How To Handle Medical Billing Claim Denials With Ease?

Pros and Cons of Medical Claim Outsourcing

It is essential for a healthcare practice contemplating utilizing claim outsourcing services to be fully informed about its aspects. 

Here are some distinct advantages and potential downsides of medical claim outsourcing.

Pros of Medical Claim Outsourcing

• Proficiency Access: Leveraging the benefits of a professional service equips the healthcare practice with advanced expertise in areas such as medical coding, billing procedures, and software usage– competencies that might not be available in-house. This enhances operational efficiency while mitigating occurrences of claim denials.
• Overhead Cost Optimization: When you outsource, it eliminates the need to maintain an internal billing department thereby reducing HR-related expenses significantly. Pay only for utilized claims billing services.
• Ensured Accuracy and Compliance: Firms specializing in medical claims remain consistently updated with changes to insurance rules and regulations, securing proper coding compliance aligning with current guidelines.
• Enhanced Revenue Cycle Management (RCM): The expedited nature of outsourced operations can streamline your claims submission process which translates into improved cash flow owing to quicker reimbursement turnarounds.
• Advanced Analytical Tools Accessibility: Provision of detailed analytics from outsourced firms about denial rates, revenue trends, etc., contributes extensively towards rectifying inefficiencies within healthcare practices.

Cons of Medical Claim Outsourcing

• Control Implication: Involving healthcare practices in outsourcing can potentially diminish their oversight and mastery over internal mechanisms. Thus, maintaining efficient communication and synchronization with external personnel may pose a challenge.
• Initial Adaptation Period: The integration of outsourced billing systems often necessitates an interim phase characterized by downtime, potential disturbances during setup, staff orientation, and data migration.
• Increased Expenditure: Contrasting against in-house billing procedures, outsourcing exhibits an elevated likelihood of attracting supplementary costs which might contribute to a decrease in profit margins.
• Staff Volatility: A fluctuating workforce at the contracted billing company poses risks including diminished service quality or accuracy errors as new employees acquaint themselves with the patient files on record.
• Data Privacy/Security Risks: Healthcare providers entrust patient information to third-party entities via outsourcing business aspects such as billing systems. Therefore stringent measures ensuring robust data protection along with compliant adherence to HIPAA regulations are imperative.

Related: EHR Tools for Denial Management: Strategies for Resolution

Vozo – The Right Place To Get Started

Vozo medical billing software helps you boost your collections by leveraging best practices. 

With perfect claims submission and management, auto-eligibility checks, and an integrated clearinghouse VOZO billing software enables you to get paid quickly and accurately. 

It also offers HIPAA-compliant systems, patient invoicing and billing, real-time analytics, and more advanced billing features.

Advanced Features Of Vozo Medical Billing Solutions:

• Accurate claim submission
• Secure patient payment processing
• Real-time performance reporting
• Automated medical scheduling
• Automatic payment posting
• Insurance eligibility check
• Online check-in
• Denial management

So what would your practice prefer to do? Outsource medical billing or in-house billing? 

Vozo provides you and your staff with a great opportunity to deliver quality healthcare with the help of the best medical billing software.