Outsourcing Medical Billing: A Smart Move for Small Practices

  • Avatar photo Victor Bala
  • Jan 27 2025
  • Reading Time: 9 minutes.

Internal medicine offices require monetary billing procedures for them to remain financially stable; however, these offices require a specialist rather than hiring someone from another department. This causes a gap that leads to errors, revenue loss, and late reimbursements. Cash flow management, resource allocation, and increased expenditures can easily be tackled using medical billing services. This paper highlights the benefits that medical billing has for small-scale practices.

The Necessity of Specialized Medical Billing for Small-Scale Practices

Small-scale practices suffer from a lack of a fully staffed billing department, unlike bigger professional practices. Due to this issue, they risk the chance of under- or overbilling patients. Medical billing services are indispensable for the following reasons:

1. Compliance and Expertise

Billing service providers stay current on the most recent changes to Medicare and insurance laws, ensuring that your practice stays compliant and avoids fines. Our professionals receive ongoing training in internal medical billing, which includes the latest revisions to CPT and ICD-10 codes. This training enables the submission of claims in a timely and accurate manner.

2. Optimization of Resources

By outsourcing medical accounting, small practices are able to concentrate on patient care rather than administrative tasks, thereby enhancing patient satisfaction and outcomes. In the case of small practices, the cost of employing an entire staff that handles invoices can be incredibly large, whereas outsourcing billing services minimizes fixed operating expenses while ensuring they remain effective.

3. Increased Effectiveness of Revenue Cycle and Cash Flow Management

We ensure that submission and follow-up of claims are done within the given time and limit, hence minimizing the delay in the reimbursement process. Experienced billers are proficient in managing claim denials and resubmissions, thereby reducing the revenue impact of denied claims.

4. Get Assistance Handling Claims Denials

Are insurance companies consistently rejecting your claims? We are aware that the resubmission of claims incurs expenses and time, in addition to having a detrimental effect on revenue cycle management. The ability to predict claim acceptance and receive accounts receivable aids the small practice owners and managers in making informed decisions about the future of their practice. 

Given the fact that it is not feasible to forecast and assess a cash inflow with a normal degree of certainty, it is very difficult to plan for the future. Appropriate claims submission and invoicing strategies can provide your organization with the data that is needed to make smart decisions, according to Precision Medical. 

Our medical billers work hard to make the process of addressing claim denials more efficient, alongside decreasing claim denial incidences. The efficiency of insurance processing can be increased, and your practice’s accounts receivable and cash flow can be better managed, thanks to billing process adjustments initiated by our skilled staff.

5. Revenue Reporting and Patient Payment Accountability

Some patients may encounter challenges in paying their healthcare expenses after receiving services, which could potentially impact their capacity to recognize revenue for the services provided. For accounting, small offices may take several steps directed towards achieving greater patient payment responsibility and easier-to-interpret revenue reporting. Monitoring unpaid patient balances is absolutely necessary, and sending follow-up calls about collections after a certain period of time is also strongly recommended. Ensure that you have a method of monitoring outstanding invoices to monitor late payment, regardless of whether your threshold is 30 days or 120 days.

We are aware that this is a time-consuming procedure. Insurance companies may delay the certification of a claim, or certain patients may fail to submit payment. Nevertheless, Precision Medical Billing has a proven track record of professionally addressing and resolving these types of issues, primarily by taking a proactive approach to prevent this outcome.

Implement a structured plan for initiating regular follow-ups with insurers and patients regarding open accounts, which will improve overall collection success. We assure you that we will respond to each of the requests once every month. This is a benefit for your practice because it helps you build up consistent cash flow and streamline the revenue cycle management process. In return for outsourcing invoicing services through Velan, you get your employees rid of these time-consuming tasks and have them focused on supporting your patients.

Choosing your Professional Billing Service Provider

  • Enhanced precision and effectiveness: Professional billing services have highly trained billers who are skilled in billing and coding for internal medicine. Fewer Denials and Faster Payments: By reducing errors and enabling more accurate claims, fewer denials and faster payments ensue.
  • Flexibility and Scalability: Billing service providers deliver scalable solutions that grow alongside your practice. Expand or contract with a professional invoicing company whatever your needs, whether you are expanding your services or you have seasonal fluctuations.
  • HIPAA Privacy: Billing service providers use stringent data security measures to protect your patient information, ensuring compliance with HIPAA and other privacy legislation.
  • Strategic Financial Management: Professional billing companies do not only give invoice solutions but also offer financial management and strategic views that help you optimize your practice’s revenue cycle and make timely decisions about its performance and growth.

Obstacles and Problems

  • Regulatory Compliance: A Primer, a range of laws and regulations touch on the healthcare ecosystem. Limited resources exist for small practices to keep up to date on them. So, procedures could be tricky and even dangerous from a legal standpoint.
  • Operating Within Financial Limitations: Small practices may face many financial challenges. Because of the lack of financial stability on their end, they might also have difficulty scaling their services, impacting their ability to hire new employees or even invest in new equipment. This may, in turn, limit their ability to compete with larger practices.
  • Technological Progressions: As the healthcare sector adapts, keeping up with the latest tech advancements may present challenges for small practices. And that leads to productivity gaps, patient complaints, and even medical invoicing errors.
  • Ensuring Data Security: Compared to larger practices, smaller practices may have substandard data security measures. As a consequence, they are more vulnerable to intrusions, which may lead to the loss of patient data.
  • The Implementation of Electronic Health Records: EHRs are becoming increasingly significant in the healthcare sector; however, they can be time-consuming and expensive. However, small practices may indeed suffer a competitive disadvantage if they are unable to adopt EHRs.

Conclusion: Start the path towards financial stability:

For small internal medicine practices, protecting their financial stability and growth relies heavily on their medical billing services. The answer is outsourcing billing responsibilities so that the practice can utilize expert knowledge, maximize resources, and manage cash flow better. By tackling challenges like regulatory compliance, financial resources, technology, data security, and electronic health records, small practices can achieve a healthier financial future. To learn more about how Velan, a specialized medical billing service provider, can assist your small internal medicine practice, please contact us.

FAQ

1. What is the mechanism by which medical billing services operate?

The submission of claims, follow-up, and posting of payments are all handled by medical billing services.

2. In what manner do medical billing services guarantee HIPAA compliance?

Medical billing services guarantee HIPAA compliance by employing secure data storage, transmission, and handling procedures.

3. What safeguards are implemented by medical billing services to safeguard patient data?

Encryption, firewalls, and access controls are just a few of the safeguards that medical billing services take to safeguard patient data.

4. What are some of the obstacles that modest practices encounter in the realm of billing?

Common obstacles include the implementation of electronic health records (EHRs), the management of financial constraints, the preservation of data security, the ability to navigate complex regulations, and the ability to keep up with technological advancements.

5. Is it possible for medical billing services to assist in the reduction of denied claims?

Certainly, medical billing services can assist in the reduction of denied claims by guaranteeing the accuracy and completeness of claim submissions.

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Victor Bala

Medical & coding

About the Author:

Victor has over a decade of experience in delivering revenue cycle management services to the US healthcare providers. He has a proven track record of accelerating revenue collection by streamlining the billing, coding and AR processes. His team at Velan has been delivering revenue cycle management cycle, appointment scheduling, pre-authorization and credentialing services to physicians, group practices, and hospitals.

He can be reached at [email protected]

Considering the complexities of healthcare billing in the USA, why choose Velan HCS for your billing services?