Submitted by Antonio Arias, MBA, CHBME on Tue, 03/28/2017 - 8:00

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Outsource Wisely! 5 Key Questions as You Pursue a Medical Billing Service

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

Stakeholders’ anxieties over outsourcing can stem from 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 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 outsourcing isn’t right for every single practice, it’s in fact a far more controlled – and more 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 an organization’s finances than an overburdened internal team can.

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

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 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.

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 outsourcing model before pursuing a vendor contract.

What Are Your Goals?

Practices outsource for a variety of reasons, just a few of which include decreasing errors and denials, lowering overhead costs, or responding to changing needs in their internal staffing situation. For a 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.

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 writeoffs 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.

What are the Liability Issues?

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.

 

Are you interested in learning more revenue cycle management tips? Visit our blog! 

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Topics: Practice Management, Medical Billing Company, Meaningful Use Stage 2

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