Category/ Medical Billing

Outsourced Medical Billing offers a Multitude of Benefits

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As more physicians outsource billing, demand for services is expected to rise by 168 percent

The demand for medical billing specialists is rising as hospitals, and other healthcare facilities struggle to deal with these reimbursement changes. The need for medical coding services has also increased because of the prevalence of electronic medical record (EMR) systems. According to the U.S. Bureau of Labor Statistics (BLS), employment in the medical- and health services industry will grow 13.8% by 2026, faster than the average for all occupations. Several recent reports have demonstrated that the medical billing outsourcing market is expected to multiply due to the growing demand. The number of in-house billings is expected to increase from $6.3 billion in 2015 to $16.9 billion by 2024.


The role of a medical-billing specialist hasn’t changed much over the years. Still, it has evolved in the sense that they now have more responsibility for submitting claims, collecting payments, and resolving errors. They must navigate a complex and ever-evolving regulatory environment that requires them to collect more information from providers and patients, adhere to new billing laws, and comply with government audits, among other things.


Many physicians will move from in-house medical billing to outsourced billing in the next decade. Here’s why it makes sense for you too.


Factors that contribute to an increase in demand

There have been many changes in the healthcare industry over the past few years. The Affordable Care Act and ICD-10 have made the task of billing and coding for physicians extremely difficult, especially since the introduction of the Affordable Care Act.


Medical billing outsourcing is becoming increasingly popular due to the following reasons:


Lack of in-house expertise; Revenue cycle management (RCM) has become more complex in recent years, requiring a higher level of expertise to achieve maximum reimbursement and optimal cash flow. A billing company’s staff likely processes thousands of claims across multiple specialties per month instead of in-house billers and coders handling hundreds. Taking advantage of this greater level of expertise can benefit medical practices.


Software that is no longer supported: To meet the latest industry demands, billing software has undergone a series of evolutions. Software upgrades can cost tens of thousands of dollars to stay compliant and maintain billing efficiency. If physicians don’t upgrade their software, they may find that their billing process is complex and inefficient due to outdated software.


Care for patients should take precedence: Physicians are under pressure to refocus on quality metrics due to changes like MACRA and a shift to value-based care to avoid penalties that may affect insurance reimbursements. Outsourced billing allows physicians to focus on patient care without having to worry about their billing as well. The billing company will be responsible for handling all incoming billing questions, so front office staff will also benefit from fewer calls.


Revenues increased as overhead costs declined: It is common for medical practices to have a fixed cost associated with in-house medical billing. Independent practices need to pay their staffing, and IT costs regardless of how much revenue comes in. It is possible to eliminate a portion of these expenses if you outsource your billing, shifting them to variable costs that depend on the number of accepted claims and reimbursements. Outsourcing provides significant revenue growth to medical practices with large claim volumes, partly because 20% of claims are not processed correctly by payers, resulting in underpayments and no payments. When practices outsource, they can enjoy significant cash flow and revenue improvements.


Why outsourcing is a good idea

It can be challenging to determine whether to outsource your practice’s medical billing. Yet, there is a point when it becomes too lucrative not to pursue it.


Switching to a third-party billing system can be intimidating and daunting, especially for physicians who have done billing in-house. Outsourcing billing can be a smooth transition – far from as intimidating as most people think.


However, not all billing companies are the same. Don’t settle if you have had an unpleasant billing experience. Consider working with a billing company that understands your needs, responds quickly, and has a track record of maximizing reimbursements.


As for pricing and budgets, they should be discussed, but the most important thing is considering the long-term. It’s not a good deal to pay less to a company whose collections are lower.


Choose one that charges a higher fee and has proven recovery rates when choosing a recovery company. As a result, you will not only cover the higher fees, but you’ll also have more money in your pocket.


Physicians can now hire staff to do follow-up work and pursue even more of their practice’s revenue with improved cash flow.


Think about Scribe Align Medical Billing

We can assist you if you are interested in outsourcing your practice’s medical billing. Our billing specialists understand the complexities of revenue cycle management and the critical role of accurate billing processes in ensuring practice profitability. Offering a full range of medical billing services fit for any practice size, we have a proven track record of reliability and effectiveness.