5 Reasons to Outsourced Medical Billing Services
- Jul 17 2024
- Reading Time: 21 minutes.
Have you ever experienced the overwhelming feeling of being inundated by a large number of invoices and receipts?
Are your claims and follow-ups negatively impacting your productivity?
“Are you experiencing the phenomenon of working longer hours than usual, at the expense of your personal and social life?”
“Does it seem like your recent activities have primarily involved pursuing payers in order to maintain the smooth operation of your revenue cycle?”
“Do you sometimes feel more like a professional medical biller than a physician, given that your attention is primarily directed towards claims and billing?”
You are not alone!
Outsourced medical billing services can be highly demanding for small medical practices. The medical industry constantly goes through tremendous change. Dynamic regulations and stricter norms that govern the industry continuously shape its evolution.
If there’s one thing that medical billing heavily relies on, it’s accuracy and precision. A misplaced decimal or a missing zero could result in a ruthless rejection. Hence, it is highly critical to pay close attention to it. If you take it upon yourself to scrape through the various stages of billing and claims, you’re likely to miss out on your optimal patient care services.
This leaves you with two likely choices: one, to your outsourced medical billing services to a professional medical billing company, and two, to onboard an in-house medical billing team.
If you own a medical practice and have read this far, you’re probably wondering if outsourcing could work for you. We’re here to help you with some pointers in that direction. We’ve put together a list of five reasons why we think outsourcing your medical billing services may be right for you.
Speed and Economy
Your outsourced medical billing services will cost you a lot less than hiring and training a medical biller for your practice. Look at it this way: when you onboard an employee, you’ll also have to account for his or her overhead, insurance, paid vacations, and training costs. In addition to these expenditures, you must consider infrastructure costs such as installation and maintenance.
There will also be instances where you lose revenue due to billing errors and inadequate billing practices. You can eliminate all these bothersome expenses with reliable outsourcing. Working with a professional medical billing company will make a world of difference when it comes to billing errors. This will subsequently help your practice receive swifter payments and reimbursements.
Professional medical billers, like Velan HCS, work closely with insurance companies to better understand their processes, resulting in a shorter revenue cycle for clients.
More stress-less time
Managing and owning a medical practice is a challenging task. And as a physician, you’re likely to have a full plate. To be laser-focused on what you do best, i.e., treating patients, you should relieve yourself of the headaches involved in billing. We know you don’t have time to worry about tracking your medical billing or following up on a clearance claim. Working with a medical billing company allows you to free up your time and finally feel like a physician again.
The dynamic and ever-changing regulations constantly create headaches, even for in-house medical billers. With the ever-impending threat of an inspection, many medical practices are turning to professional medical billers.
If you don’t want to worry about compliance or chasing denials, let the billing company handle it. So you can finish that crossword puzzle before work, let them try.
Money
Outsourcing can save your practice thousands of dollars in annual salaries, perks, medical insurance, office supplies, furniture, software, equipment, and other costs. The software and billing equipment would require periodic upgrades and maintenance.
Most medical billing service providers charge a flat rate per claim. Some billing companies charge a percentage of the reimbursement on each claim, which might at times exempt charges on a failed claim. Either way, all this will account for a lot less than what you would pay for an in-house medical billing team.
So, why not save your practice some money, keep the revenue cycle ticking, and provide exceptional services with a primary focus on patients by simply outsourcing your billing?
Customer Satisfaction
Now that you’ve got the billing fiasco out of the way, you can spend more time doing what you do best: patient care. You’ll now have enough time to provide quality care to your patients. This will be highly desirable, especially for smaller physician groups that cannot afford large medical office staff. If you are bogged down by the financials of running a practice, it is likely to hurt the patient care that you provide.
A 4.8-star rating for your medical practice on Google is likely to generate more business for your practice than a 3.2-star rating. These are purely based on the customer service you offer. So, the ability to provide patients with excellent customer service can both retain old patients and generate new ones. However, juggling between the demands of rendering optimum customer service and handling billing issues effectively is almost impossible.
Improved billing compliance and increased cash flow
One of the many hurdles in medical billing is coping with the changes according to regulations and authorities. Insurance companies are partially culpable. One aspect of third-party payers is their special task force that looks into whether a medical office that has agreements with such a party payer does everything possible to follow the protocol each payer demands. It is therefore very important for medical billing service administrators to keep an eye on recent changes in norms and regulations so that they can maintain compliance and submit clean claims.
COVID-19’s effects on medical billing and the healthcare sector are significant.
Medical billing, the critical link between medical coders, insurance companies, healthcare providers, and patients, is a key part of the overall revenue cycle for hospitals. A medical biller is there to ensure that the healthcare provider receives proper reimbursement for insurance claims, so he will always put his patients’ health first (that’s straightforward if we consider that he also works in a dental office). asserts.
Medical billing efficiency gets even more critical. One of the impacts as a result of COVID-19 is that we are losing the ability to bill out for certain lost revenue. Now more than ever before, this shines light on our need for medical billing efficiency. For the U.S. hospital, a moderate influx of COVID-19 patients is linked with an average decrease in gross revenue of 50%, according to surveys. An effective medical billing system, which could be in-house or outsourced, guarantees a steady revenue cycle and also ensures there won’t be any further exacerbations.
COVID-19 is taking its toll on the healthcare industry.
Combining the loss of jobs driven by COVID-19 and a massive reduction in revenue from Medicare funding, it is expected that there will be a logical move away from the post-commercial insurance era towards some form of socialized or government-backed model.
Meanwhile, government programs pay for nearly 50 cents (45.7 percent) of every dollar spent on healthcare—even more considering that some nonprofit services and institutions used by publicly insured patients are excluded from the totals. People’s payroll contributions largely fund these services through Medicare. Reports indicated that this would further strain Medicare, with 30 million Americans unemployed and another 27 million at risk of losing their employer-based insurance coverage, reducing payroll contributions to company fund authority for the program and leaving it insolvent.
This is going to hit all of those healthcare billing service providers who have been using their margins from commercial insurance to subsidize the losses they take on poorly reimbursed government programs. Without this scuttling of costs, healthcare providers could see a sharp loss in revenues as more government-funded programs are held as alternatives.
As people refrain from going to hospitals, telemedicine companies are also growing. Telemedicine and digital health can be key tools to achieve the goal of high-quality care at a lower cost. VC funding in this segment grew to $7.4 billion in 2019, and there is even more room for tech-enabled remote monitoring and diagnosis going forward.
The Future of Medical Billing and Coding Services in the Healthcare Industry
The capacity of the worldwide healthcare system to tackle COVID-19 has been demolished. There is a tremendous dearth of medical staff, places, and emergency centers for the healthcare industry as it becomes overburdened. During COVID-19, the healthcare industry must direct medical accounting and healthcare professionals where needed most while ensuring safety for staff to keep patient care operations running.
At the same time, patients are also responsible for their financial burden, as some have left medical bill obligations unmet in the wake of coronavirus symptoms.
Ever since the inception of AI tools, there has been a significant drop in all sectors using traditional methods. The same goes for the health sector. Automation and AI are doing heavy lifting on medical coding tasks that used to be very difficult because they were time-consuming.
As the patient base evolves and regulations change, providers need help keeping up with a constantly growing healthcare environment. Businesses in the healthcare field have turned to technology as one of their means to survive and thrive in a competitive market. This technology automates billing, payments, and all other administrative work.
One of the ways to guarantee quick reimbursement is through medical billing automation. In addition, when using automated medical billing software, providers can also generate superbills and submit claims right after the patient has been treated.
This seriously decreases the number of unpaid claims, and it helps get money back in your pocket much faster.
Conclusion: RCM’s Future in AI
It allows for the automatic completion of manual invoicing tasks, making the bill process more efficient. This means AI can automatically spot errors in claim submissions, allowing payers to correct them before processing. This frees up doctors and other professionals to focus on more important matters than fixing patients’s mistakes.
Given the constant flux of regulations and business trends, staying current on the latest technology is important, as that area changes constantly with new ways to reduce costs, increase efficiencies or make money.
This can be done by integrating AI with the revenue cycle management processes. Faster revenue cycle management processes: Data-driven administrative duties are automated, lowering the amount of administrative waste.
Benefits of medical billing & coding services
Invoicing software is used to automate most of the process so that you can say goodbye to stacks and files of paperwork. This manually accomplished job makes businesses susceptible to mistakes, but invoicing cookies might cut documents in half.
By enabling medical billing outsourcing services automation, paperwork and associated errors in physical form submissions can be reduced.
Automated invoicing systems help cut down on the number of errors made in managing claims and billing, as they provide easy options for processing them without breaking a sweat.
Eliminate paperwork in healthcare using automatic invoicing, which helps you save hours on form-filling.
By automating all our billing, we were able to save a lot of time and effort.
Given miscommunication and the different billing practices from one payer to another, this calls for a more accurate system of medical billings. In general, these billing errors could develop and rapidly circulate over the years.
By automating your billing process, you will free up more time to spend with patients face-to-face. Long-term patient health is beneficial for your clinic. Better doctor-patient relationships only mean superior outcomes for patients and, thus, better financial gains in the long run, i.e., the continued existence of your practice!
Automated billing: increasing accessibility for patients
The procedure and availability of patient billing data are improved by means of this automated medical billing software. Patient data is accessible via remote.
In turn, this allows you to centrally update accounting information and chase overdue payments that your staff can access when in the office or out on the job.
Speedy, more efficient payments require access to trusted and well-rounded information.
Medical Invoicing + A.I.
One of the most powerful healthcare AI applications is to automate invoicing and coding. Automation can help clerks do their billing tasks much faster and more accurately than they normally would.
AI can also identify and correct billing errors. That could decrease hospitals’ and clinics’ overall loss from billing errors.
Artificial intelligence collects and processes data on patient care to assist healthcare professionals in measuring trends and patterns. Using this data, the treatment and care strategies of the patient can then be optimized.
Benefits of AI in Medical Invoicing
Medical billing and coding services across all healthcare sectors. You can better understand the implications by considering the following advantages:
We can automate the coding process to create a low-skilled invoicing specialist solution that scales.
By issuing properly timed and accurate patient statements, you can improve cash flow.
A reduction in the normal work week for administrative staff could lead to productivity gains.
Real-time auditing bypasses the problem of not being able to identify an error in time to rectify it without spending a lot.
AI reduces the number of people and hours required to train manually to perform these tasks.
In addition, with AI, you can reduce the number of customer service inquiries or disputes regarding patient statements and save on other operating costs.
Top Barriers in Healthcare for AI
Complex code systems use sensitive ICD-10 and CPT codes that are hard to automate in medical invoicing.
Accuracy of the model in outsourced medical billing services, AI precision, and recalls are two popular indicators used to evaluate an evidence model; they, however, show more data integrity issues because medical billing continues inconsistently with false or incomplete claims due to deliberate overbilling practices for profit’s sake.
Integration with legacy systems: Many healthcare organizations still rely on older technology tools and may need to connect their existing technologies to the latest AI or automation innovations.
Difficulty in transforming: Obstacles in adoption: The integration of AI and automation solutions in healthcare may encounter difficulties due to the hesitancy of healthcare providers and billing businesses to transition from conventional techniques.
Cost and resource implications: AI and automation solutions often require heavy investments in hardware as well as skilled personnel to operate efficiently. This will be an impossible goal for some organizations.
Vagueness: The invoicing decisions made by AI can be opaque, which perpetuates errors and doubt.
Cyberthreats: The more that medical billing outsourcing services are automated, the greater the likelihood of data being exposed by hackers.
Best practices for billing and data protection
HC C&BT will implement important steps to secure sensitive data.
Protocols for encryption
We use advanced encryption algorithms to protect sensitive patient and financial information. In healthcare billing services, these protocols ensure the security of any PHI data exchanged between vital healthcare components, including providers, insurers, and invoicing entities. This also helps healthcare organizations comply with regulatory standards like HIPAA, which increases trust among patients and stakeholders and ensures better integrity through greater reliance on the medical invoicing process.
Access controls include
Access controls are used to enforce permissions, which ensure that only people with the need and right can access certain system information. This is particularly useful, as it helps to limit the amount of restricted data and who can view or modify invoice data in any coming transactions. Improves security for known issues and meets healthcare laws (e.g., HIPAA). Access controls are critical to protecting patient trust and creating confidence for the administration of sensitive healthcare information in an appropriate manner based on the confidentiality, integrity and availability of RCM or relevant data.
Authentication mechanisms
The authentication methods in such systems usually use two-factor security, which generally involves users requesting more than one type of verification, either a combination of passwords, smart cards, or biometrics. Robust authentication protocols used by healthcare organizations help reduce the probability of data breaches and unauthorized access.
Perform routine audits and monitoring
Ensuring the invoicing system is running with integrity—thanks to continuous auditing and real-time monitoring of its activities—helps detect any irregular behavior. Furthermore, practices can assure compliance with industry regulations like HIPAA and detect any discrepancies in billing records sooner.
Firewalls and intrusion prevention systems
However, firewalls and intrusion prevention systems should be put in place to control the flow of network traffic and protect your brand from cyber threats, as well as prevent any unauthorized access. With the convergence of these technologies, a robust stance can be taken to ensure that patient and financial data are secure from intrusions. Firewalls and IPS: These also increase the overall resilience of invoicing infrastructure by securing against unauthorized access and other unwanted traffic.
Employee training and awareness
Have an informed and educated staff. Having an educated and trained staff is paramount to preventing security breaches and maintaining compliance with regulations such as HIPAA. Dangerous, clumsy leaks of information are prevented through continuous training regarding the best practices for protecting data and developing a real awareness culture. Training programs that inform employees of the most current safety concerns, along with data protection protocols and proper management of sensitive information.
Drawing from the above points, technology-driven billing systems can help protect the confidentiality of sensitive financial and personal information through their approach to secure patient data, and so on.
Why Velan HCS?
Background details and experience in outsource medical billing services over more than a decade have given us exposure to the intricacies that come along with it. We keep on top of every new rule that could help with your cases.
We look forward to providing our services and becoming a part of the Velan family, consistently meeting your billing requirements.
If you would like to know more about what we do and how to be better at it, go check out our site for outsourced medical billing services, or fill out the form below and request a free quote.
Embrace a stronger canvas for a smooth journey through the maze of receipts!
Our expertise in medical billing at Velan HCS can help you decrease denials and expedite the clearing of your claims.
Over 95% of the time, we at Velan HCS send in clean claims.