Outsourcing your medical billing can provide several advantages that positively impact your practice’s operations and financial performance.
Consider these benefits:
1. Increased Collections
Billing services are extremely effective at optimizing reimbursement by correctly submitting and following up on claims, appealing improper denials, and staying current with payer policy changes. This expertise typically translates into significantly higher collection rates.
An AMA study found practices using billing services saw 11-26% higher collection rates compared to in-house billing.
2. Fewer Denied Claims
Experienced billers understand payer requirements and will catch errors before submitting claims, sparing your practice costly denials down the road. They persistently investigate and appeal any erroneous denials.
An estimated 30-40% of claims submitted by practices have errors resulting in initial denial, while professional billing services maintain claim acceptance rates of 97-99%.
3. Faster Reimbursement
A knowledgeable billing staff adeptly handles claim submissions and follows up on outstanding claims to accelerate payments. This improves practice cash flow. Outsourced billers can reduce payment turnaround by 7-15 days on average compared to in-house billing departments.
4. More Time for Patients
Outsourcing billing and collections liberates doctors and staff to devote their energy fully to delivering excellent patient care rather than administrative duties. One study found outsourcing reduced time spent on billing by medical practices by an average of 24%.
5. Regulatory Compliance
Reputable billing companies are well-versed in continually evolving coding, billing, and quality reporting regulations. They ensure your practice avoids costly penalties and audits by maintaining compliance. An estimated 75% of in-house medical billers lack formal training on the latest regulatory requirements.
6. Specialized Technology and Personnel
Billing firms leverage industry-leading software and employ certified medical billing specialists. Your practice benefits from their expertise in a cost-effective manner, without the need to invest in expensive billing software or additional staff training.
While outsourcing does require an investment, most practices find that it pays for itself many times over through optimized collections, reduced denials, accelerated payments, and time savings. The pros at billing services have the skills to handle these specialized administrative tasks efficiently.
SaaS Medical Billing Compared to On-Site
One major factor determining the cost and fit of a medical billing service is whether you use a cloud-based SaaS (Software as a Service) platform or a more comprehensive, on-site solution. Depending on the size and needs of your practice, one type of billing solution may be more effective than the other.
1. SaaS Medical Billing
In the growing age of technological connectivity, SaaS platforms are becoming more commonplace across a range of business services. Many SaaS companies provide Electronic Medical Record (EMR) services in addition to billing, payroll, and other medical management functions all in one bundled software package.
With a SaaS solution, the medical practice pays a monthly subscription fee to access the online program, which is usually based on a “per user” model with varying rates depending on the size of your office. SaaS solutions require minimal hardware installation and training for employees to operate. The complex work of claims filing and billing is done by the software program and remote specialists at the third-party service.
SaaS solutions are a cost-effective way for small to medium-sized practices to outsource billing services, as the monthly subscription is more affordable than the high upfront costs that come with on-site solutions. However, these platforms may have limitations in customization and the range of services they provide.
2. On-Site Medical Billing
Unlike SaaS platforms, on-site solutions bring the billing services directly to your office. This can involve installation of servers and equipment as well as more extensive training for employees and your IT department. On-site billing platforms typically charge higher upfront fees for licensing, installation, and training, with lower monthly fees for ongoing support.
While on-site platforms are more expensive initially than SaaS solutions, they can often be more robust and tailored specifically to your practice’s unique needs and workflows. Large, enterprise-level healthcare organizations may prefer on-site solutions for maximum control and customization.
Choosing the right medical billing service for your practice ultimately depends on factors such as your budget, practice size, specific needs, and desire for customization vs. simplicity.
Both SaaS and on-site solutions can significantly improve your billing efficiency and financial performance when compared to in-house billing. Carefully evaluate your options to select the service that will be the best fit for your practice.
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