Outsourcing Medical Billing: A Comprehensive Guide for Your Practice

March 4, 2020 by Antonio Arias, MBA, CHBME

Topics: Practice Management, Medical Billing Company

When it comes to thriving practices, in-house employees are very often the top contributors to the organization’s success. But regardless of talent, skill, or capability, these individuals often lack the time and availability to keep up with the ever-changing tides of the healthcare industry, especially when it comes to the particulars of medical billing.

For medical practices to achieve success, a responsible plan for financial health must be put into place. Outsourced medical insurance billing can be a very helpful solution and may even become your practice’s best asset. 

10 Reasons to Outsource Your Medical Billing

1. You Don’t Have the Time or Availability

In the medical field, we often wear many hats and have a wide range of responsibilities. However, medical billing is a full-time job. In order to stay on top of the volume of transactions in an accurate and timely manner, you’ll need personnel who are entirely dedicated to billing. Outsourcing your medical billing will save your staff hours that you can be allocated to other pertinent areas of your practice.

2. Faster Payments

When billing errors are minimized, reimbursements and payments can be received in a lot less time. Outsourcing with the right expert in medical billing can result in streamlined workflows, increased revenue and better earning potential for your practice—which clears a path for payments to come through much more quickly and efficiently.

3. Enhanced Transparency

Physicians often think that outsourcing medical billing is akin to relinquishing control of the RCM process to a set of strangers – but that couldn’t be further from the truth. Once you contract with a firm, your outsourced billing team becomes obliged to earn you positive marks on a defined set of metrics (think first-pass payments, denial rates, collection ratios) and to provide data on efforts and outcomes, giving you unprecedented transparency into your revenue cycle.

Any reputable medical billing company will regularly supply you with comprehensive performance reports, and most will keep you better informed of delays and payment issues than your on-site staff does. That means you maintain control of RCM without having to micromanage – or even oversee – any billing staff.

4. Reduced Costs

When it comes to maintaining  an in-house medical biller, there can be a lot of hidden expenses that make it not worth the investment. From overhead expenses like training costs, benefits, insurance, and payroll to hardware/software installation costs, there are a ton of fixed expenses that can be significantly reduced, if not eliminated, by making the decision to outsource medical billing. The fact of the matter is that many practices don’t have the disposable income or time availability to maintain an entire billing department and find a replacement anytime an employee leaves. By outsourcing this area of work, you can depend on your medical billing firm to be a more controlled and sustainable approach to revenue cycle management.

80928384_m

5. Fewer Billing Errors

Speaking of costs, billing errors and other inefficient collection policies have the potential to take a huge hit on revenue. Everyone makes mistakes—but when it comes to medical billing, just one mistake can turn into a delayed payment for your medical practice. Between incorrect patient information, authorization errors, duplicate billing, and more, billing errors can be a costly expense. 

Outsourcing medical billing helps ensure it’s profitable for your practice and that the medical billing process is up to date and free of human error. The right billing experts who specialize in your field have quality assurance measures in place that make them less likely to make errors. Partnering with an outsourced medical billing firm can result in a streamlined workflow, reduced mistakes, and increased revenue and earning potential for your medical practice.

6. Ensured Compliance 

As we’ve established, healthcare has ever-changing regulations that can make medical billing extremely difficult to keep up with. There are always a ton of new protocols that come with changes in Medicare, Medicaid, and third-party payers.

Although it’s hard to predict what those changes will entail, it’s easy to predict that they will change. To learn how to properly follow each changing protocol, it requires a dedicated expert to stay up to date on new information as frequently as they come about.

Outsourced medical billing services have to stay on top of changes like these on a regular basis. This helps ensure they’re always submitting clean claims and that the practices they partner with are always compliant.

7. Expert Consulting

The process of insurance billing is complex and has many moving parts. There are constant changes to the types of questions and scenarios that arise in the various areas of revenue cycle management (Who do I call about resolving a denial? Which is the most updated code modifier I should use? Is United Healthcare quicker with paying claims than Humana?). 

Industry regulations evolve rapidly and if you don’t have someone on your staff who has the capacity to stay on top of the latest standards and expectations, your medical practice will fall behind. Outsourcing medical billing can ensure that you always have a team of people dedicated to best practices in your specialization. 

59601439_m

8. Easy to Integrate

Anyone currently handling medical billing in-house knows that managing various electronic health records (EHR) systems can make the whole process a time-consuming, frustrating nightmare. Some medical practices fear that outsource billing services may not be easily integrated with their current practice management or EHR systems. However, solutions offered by billing vendors like NCG Medical include extensive experience with major systems like Allscripts, Aria, GreenwayHealth, eClinicalWorks, Mosaic, Nextech, and more. By outsourcing medical billing, you won’t have to lose any more sleep worrying about many of the technical issues that come with managing the billing side of EHR systems.

9. Growth that Scales 

When medical practices aren’t bogged down with medical billing complications and can focus on everyday responsibilities, there’s so much potential for scalable growth. Regardless of the size of your practice, outsourcing medical billing can help eliminate interruptions, distractions, and complications that would otherwise prevent your practice from reaching its full potential. It can scale as you do, so growth is both achievable and manageable.

10. More Satisfied Patients

Every medical office aims to deliver excellent care and customer service, but juggling everything on your practice’s plate can make it difficult to meet all your patients’ expectations. Your support staff is always going to be responsible for managing scheduling tasks, executing patient check-in and check-out, keeping the books, and handling clinical concerns.

By outsourcing medical billing, you’re taking something off your team’s hands – something that can usually be better managed by another entity. In doing so, you’re freeing up your staff’s time to better attend to patients’ needs, resulting in higher satisfaction rates and better patient retention.

49043782_m

Is Outsourced Medical Billing Right for Your Healthcare Practice?

Despite the many advantages that medical practices can achieve by outsourcing their back-office operations to a trusted medical billing service, providers and practice managers often struggle to determine if outsourcing medical billing is the right approach for their organizations.

Stakeholders’ anxieties over using a medical billing service can stem from a variety of factors – such as their existing approach to office administration, their current financial standing, or their staff members’ mixed feelings about utilizing a third-party service. In addition, many perceive that outsourcing medical billing is akin to giving up control of the practice’s revenue cycle (and potentially losing a sense of autonomy and oversight over their income stream).

Yet while outsourced medical billing isn’t right for every single practice, it provides a far more controlled and sustainable approach to revenue cycle management. For thriving or expanding practices, the true value of outsourcing is its long-term viability. As a practice’s patient load, staffing levels, and other dynamics evolve over time, an outsourced medical billing firm can typically maintain better consistency (and control) of a medical practice’s finances than an overburdened internal team.

5 Outsourcing Questions for Your Practice

The key to success, however, is to outsource wisely. That means establishing your needs, scope, and strategy before engaging potential vendors and selecting a medical billing service provider that can meet your needs long-term. Here are five questions to keep in mind.

1. What Should Stay In-House?

If you’re not sold on outsourcing all aspects of back-office operations, keep in mind that it is possible to maintain some aspects of medical billing internally. (For example, keeping coding in-house or customer service while tasking a third party with claim submission and payer management.) Determine what areas you’re not ready to let go of, then find a billing firm that can adapt their offerings to fit your scope.

2. How Much Support Do You Need?

Are 9-5 service reps and a call-based escalation process enough for your organization, or do you need 24/7, always-on access to customer service professionals and billing specialists? Can one dedicated account manager rise to your expectations, or do you want multiple team-leads on your practice’s service engagement? Design your ideal outsourced medical billing model before pursuing a vendor contract.

3. What Are Your Goals?

Practices outsource for a variety of reasons, just a few of which include decreasing errors and denials, lowering fixed overhead costs, or responding to changing needs in their internal staffing situation. For a medical billing service provider to serve you well, their staff will need to understand your motivations, circumstances, and objectives – so put some time into figuring them out.

4. How Will This Affect Your Patients?

Even though your front-desk team interfaces far more with your patients than the billing staff does, there may be certain interactions and decisions that your back-office makes now (such as write-offs and collections) that would be placed in a billing firm’s hands. Make sure that you prioritize your patients’ interests in your decision-making process.

5. What Are Your Liability Concerns?

When it comes to special healthcare practices like radiation oncology, there are many vital compliance and liability issues that hospital-based physicians and radiation oncology standalone facilities face on a day-to-day basis. And with growing pressures on reimbursements, the need to hire an outsourced medical billing company has never been more critical.

From HIPAA to data security to litigation, a wealth of sensitive liability concerns are involved when working with an outsourced medical billing firm. Have the hard talks with a potential vendor early on, so as to avoid any troubling problems in your contract negotiations down the line.

5 Questions for Your Medical Billing Vendor

For many medical practices, the idea of outsourcing medical billing can be daunting—and understandably so. It’s a difficult task to just hand over all processes and trust a third-party resource that may or may not fully understand your industry. Plus, there’s also the risk that they may be difficult to get ahold of and may not have customized solutions that meet your practice’s unique needs.

But that’s where it’s up to medical billing firms to demonstrate how their expertise across different specialties can work for many practices while still being targeted and customized. Here are five important questions you need to ask any billing company to ensure a successful partnership and a return on your investment.

1. How Quickly Will They be Able to Begin Processing Claims?

In a typical situation, 30-60 days provides enough time for the company to begin services. Now, this is not an exact science and many factors will play into this timeline. For example, if you do not need to change your practice management software and they are versed in the practice's software, this could be a very quick transition. In this instance, the main focus would be on creating user credentials and providing software access to the medical billing company. 

If this is not the case and the practice management software is not on the same system, the timing will be affected by whether data is going to be exported, imported or manually entered. Also sufficient time will be required to set up electronic connections to the various payers, leading to a potentially longer implementation timeline. The company that you are considering should be able to provide references for practices that had an implementation plan similar to yours. Reach out to those references; if they had a positive experience, it will be proof that your partner has experience in this type of implementation. 

2. What Services Do They Provide?

Revenue cycle management is a complex process, which involves a variety of important tasks. It is vital to clearly identify each of these tasks, and assign them to either the practice or the medical billing company. Not every medical billing contract is the same. For example, your practice might want to input charges on-site, while another practice might choose for the billing company to not only enter the charges, but also complete the coding for the encounters. All steps need to be discussed and clear expectations set.

3. What of Training Does Their Staff Receive?

Proper training of a medical billing company's staff is essential to maintaining their core competency. Before you engage in any agreements, confirm that the billing staff is certified and receives continuing education to maintain their certifications.

4. Who Will Handle the Current Accounts Receivable (A/R)?

It is important to determine who will be handling the current A/R before services begin. To minimize the chances of old non-paid claims falling through the cracks, the best practice would be to start fresh, especially if you are changing practice management software. Some medical billing companies will take on the current A/R and run the old claims out. This is also something the practice can decide to keep in-house and manage themselves. Either way, for about 90 days, depending on the total amount of A/R, there will be two different medical billing processes running concurrently.

5. Will Monthly Financial Reports be Provided?

Professional medical billing companies will not only provide you access to your monthly financial reports, but will also automate and interpret these results for you. The reports will provide the practice with monthly financial summaries, highlight trends, and offer advice based on the practice's results. Access to financial dashboards for 24/7 monitoring should be available, and will allow quick confirmation that key performance indicators are being met. A good medical billing company will establish KPI’s and set standards for monitoring.

A reputable billing company should be willing and able to quickly answer each of these questions, and have processes in place to complement these key activities. A strong medical billing services partner is a team player and excited to be an extended part of your practice.

NCG Medical: Outsourced Medical Billing That Feels In-House

At NCG Medical, we’ve spent the past 40 years tailoring our medical billing services to meet the needs of many different practices, not just to assist with medical billing, but also to help maximize management potential and ultimately retain more revenue. Specializing in dermatology, gastroenterology, radiation oncology, holistic billing services and more, we’re here to step in where we’re needed most. While some practices only need credentialing and contract management, others may need full-service revenue cycle management to get their practice on track.

We’re Dedicated to Providing Value

Some medical billing companies are quick to nickel and dime you with fees, inflated invoices, and other charges that don’t always seem worth the results you’re seeing. Our policy is to provide value instead. Just like an in-house employee, we’re committed to getting the maximum number of reimbursements possible for your practice. That’s why you’ll never see any upfront fees from our team, nor will we get paid unless you do first.

We Believe in Partnership

When it comes to outsourcing medical billing, both the provider and the outsourced company must mutually agree that the relationship is a partnership. Our U.S.-based tech support team is available to help with onboarding, to provide insight about importing charges, to report on financial performance, and to assist with any other questions you or your team may have.

There are many benefits to outsourcing medical billing, while still feeling like it's being handled in-house. At NCG Medical, we believe that our success is your success. From handling medical billing and coding, to offering consulting services and much more, our team is dedicated to making it feel like we’re in-house.

Let Us Empower Your Practice

With NCG Medical, you’ll get all of this and more. With a specialty focus on physician practices, insurance background, and proven consultants, our team can effectively ensure the financial success of clients, allowing your medical practice to focus on what it does best: treat patients.

Our expertise is rooted in professional, technical and global billing for hospital and stand-alone healthcare practices. We interface with systems like Elekta's Mosaiq© and Varian's Aria© to facilitate electronic data exchange of your charge information and use proprietary imaging and communication technology to interface with your practice or hospital staff to ensure secure data transfer. Additionally, NCG Medical is dedicated to the SSAE 18 auditing standard for service organization reporting by the Auditing Standards Board of the American Institute of Certified Public Accountants (AICPA)

To learn more about how outsourced medical billing with NCG Medical can empower your healthcare practice, contact us today. We’ll work with you to build a customized solution that meets the specific needs of your practice and allows you to get back to treating patients.


 

Want to see if outsourcing medical billing is right for your practice?

Contact a billing expert at NCG Medical today to find out!

CONTACT A BILLING EXPERT

 

Related Posts

Subscribe to Our Blog

Stay in-the-know on trends, best practices, and news affecting the medical billing industry!