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7 Signs It’s Time to Outsource Medical Billing Services

Staff feeling overwhelmed? Spending too much time re-filing rejected claims? Don’t feel like you’re getting paid appropriately for the medical services you provide?

It may be time for you to consider if medical billing services make sense for your facility.

Medical billing services solve many of the common administrative problems in healthcare facilities — often while reducing costs and boosting morale.

Let’s explore 7 signs that you need to outsource your medical billing.

High Staff Turn Over

If you have a high turnover among your administrative staff, medical billing can quickly turn from an annoying obligation to a horror movie.

When someone leaves, you’re forced to:

  • Distribute the work among team members who already have full workloads
  • Allow people who have other talents, but know less about billing and coding, to handle a very sensitive part of your practice
  • Spend a lot of time training someone new who may then leave you before that training has actually paid for itself.

High employee churn leads to reduced revenues, more errors and can result in poorer patient care.

In addition, medical billing responsibilities and struggles may actually be increasing your churn. For those who already feel like they’re carrying a full load, taking on something as complex as billing can easily be the proverbial straw that breaks the camel’s back.

But medical billing services remedy this by bringing reliability and consistency to the process, reducing this unnecessary weight on your staff.

Need to Increase Revenues

With many payors, you may get paid more for sicker patients. You know that this isn’t intended to keep patients sicker, but to recognize the fact that if your patient has more co-morbidities, the doctor will need to spend more time with that patient.

Not having the right diagnosis codes on the claim can reduce your payment rate. Having a code that doesn’t properly represent the severity of the patient’s condition affects your pay.

With procedure codes, accidentally billing code for MRI without contrast, when a with and without contrast was performed, could lead to your clinic being paid less than they’re owed.

Medical providers are already feeling the weight of reduced payments from sources like Medicare and Medicaid. Insurance companies are negotiating your rates down to peanuts. They’re focused on creating a more quality-based payment system — much of which relies on proper coding to prove quality.

A medical billing services staff member is trained in the proper use of coding to accurately and completely convey information to maximize your revenues.

Tired of Delayed Payments

Are you tired of delayed payments and extra work because of rejected claims?

According to McKesson, a rejected claim can cost you an extra $25 to fix and resubmit.

If this is happening with any frequency, you not only have to wait for payment; you lose money.

Some common claim rejection reasons include:

  • Incomplete information
  • Duplicate claim …usually due to poor record keeping or lack of communication
  • Billing for things that aren’t covered by the insurer
  • Missing the filing date
  • Incomplete codes

Medical billing services are specialized in medical billing. Some medical practices have as high as a 30% rejection rate while a billing service that receives a high rating on a medical billing service review may have a rejection rate of as low as 2%.

That’s what you want. Get paid fast. Get paid what you’re owed. Without the hassle of rejections.

Staff Overstretched

Are you distributing billing duties among staff members — and even clinical staff –who have other jobs? Are your administrative staff working through the weekend to catch up on claims?

If so, you’re not alone. Many practices over-extend their existing staff rather than outsourcing because they think they can’t afford to do so. But, as you can see, outsourcing adds efficiencies and increased pay rates that make hiring out make absolute sense. Regardless of the size of your practice, medical billing services work.

Overstretched staff members not only don’t have a healthy life-work balance; they’re also more likely to make mistakes both in billing and their other jobs.

Patient Care Improvements Needed

Is the receptionist not acknowledging the patient who walks in because he’s so focused on filling out a claim? Are nurses slow to get to the exam room because they got tied up doing billing? Is the office manager not able to properly manage staffing because she’s spending too much time on billing?

When staff members aren’t being pulled away from normal duties to handle billing they can spend more time taking care of patients.

Medical assistants, nurses, and doctors didn’t go through years of school to do administrative tasks. Receptionists, office managers, and other staff should be able to focus on creating a phenomenal patient experience.

Medical billing services allow everyone in your clinic to work to their strengths while allowing those who are experts in billing to work to theirs.

Lacking Efficiency in Workflow

Too many hands in the pot can create workflow nightmares. One person does it this way. Another person does that.The other person doesn’t know where the first person left off so labor gets duplicated.

When staff members who do other things handle billing, billing gets pushed to backburner as more pressing tasks seem to be “knocking down their doors”.

Claims don’t get filed or they get rushed.

On top of this, staff gets frustrated by the mistakes and inefficiencies, lowering morale. When morale is down, productivity throughout a facility suffers.

You probably wouldn’t have reception handling sharps disposal because those trained to handle medical waste should handle medical waste.

Likewise, having billing handled by experts improves your workflow to help you get the best results.

Administrative Costs High

The efficiency that outsourcing billing generates can reduce your own administrative costs.

Even if you’re not paying overtime, an environment of more streamlined processes and staff members who can focus on their work helps more get done with fewer people.

Medical billing services help you save money.

Medical Billing Services Makes Sense

Medical billing professionals have streamlined processes in place to help you maximize revenues while minimizing rejections. They empower your staff to spend their time working to their strengths as they provide better care for patients.

They’re trained and always current with industry changes. They know how to get more done with less. That’s why they’re the cost effective solution for healthcare facilities.

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