One of the biggest headaches for practice administrators is the management of the medical billing component of the business. It’s a complex process that is directly impacted by every other procedure within the office and dictates many clinical workflows.

Here is a way to remove at least six daily headaches from your life by outsourcing your practice’s medical billing process.

1. Outsourced Billing Provides Staffing Experts

Hiring employees is a challenge in today’s workforce. Acquiring expert employees further complicates the problem. Keeping those expert employees completes the trifecta headache!

The medical billing process is highly labor intensive and requires knowledge and experience in the field to ensure the best outcomes. It is common for billing staff to be assigned one particular function within the process. Losing a reliable and knowledgeable staff member can knock this process off balance and result in a loss of revenue.

Here are ways that having an outsourced billing process will mitigate this challenge:

• Significantly fewer billing staff members are required in-house because the billing company will be responsible for the expert knowledge.
• Any internal billing staff members will not need to stay on top of as much information about the billing process.
• Your revenue will not be impacted if an employee must be out of the office for any period, such as vacation or illness.

2. There Are Specialty Code and Modifier Guidelines

Knowing how to play a game is half the battle to winning. When the rules change constantly, though, it is challenging to keep a winning score. It’s enough to give anyone a headache! Letting an outsourced billing company work through updates will allow you to focus more on your score than the rules:

• Annual CPT code updates that include deleted, new, and updated codes
• Specialty-specific changes for things like split codes, telehealth, allowable amounts, etc.
• Correctly billed professional and facility codes
• Modifiers, including when to use them and how to maximize revenue by applying them to charges
• Knowledge of which payers have updated fee schedules and other changes

3. You’ll Have Timely and Accurate Claim Submission

Getting claims out the door accurately and quickly allows you to keep a constant cash flow. You also have more time to adjust or make amendments if something goes wrong with the claim. If this process gets delayed for any reason, like staffing shortages, the practice’s finances can quickly get off track. Hiring a trusted outsourced billing firm removes this responsibility from your daily task list. These are also other things that this type of company will improve for you:

• The charge entry process will have significant automation that leverages your current systems and processes, allowing for quick submissions for payment.
• Clean claims are crucial to fast payment. Billing companies focus on this and will use technology to make improvements where possible. They will also evaluate and determine any workflows in the practice that could be causing claims to be rejected.

4. You Can Manage Denied Claims

Working claim denials is where many practices fall behind due to the time involved and the complexity of the denials. It is common for medical practices to leave thousands of dollars each month on the table because of a lack of process to work denied claims. An outsourced billing company can alleviate these challenges:

• Assigned accountability for the management of denied claims as a whole
• Provider frustration when they do not get the maximum payment for their work
• Monitoring of adjustments and write-offs to verify that your collection rate is over the recommended 95%

5. There’s Provider Performance Monitoring

Getting claims out the door and paid is a massive headache. Relaying accurate billing data to providers is an even larger one. They want to know how productive they are and how much they are paid for their work. Getting good information from your EHR or billing system isn’t always easy and often requires a consultant. Hiring a billing company opens you up to reviewing data in a whole different way, as you’ll have tools like these to guide your decisions:

• Your billing staff is often inexperienced in gathering analytical data from a computer system, as it requires knowledge of the backend database. An outsourced billing company will have experience getting detailed reports from computer systems.
• Providers want to see facts at a high level and sometimes the details too. Having good reports available before any financial meeting will prepare you for both.
• Not all providers perform equally; certain practice leaders may need to know this when considering staffing adjustments.

6. You’ll Have Financial Stability through Outsourced Billing

Practice administrators are responsible for the entire practice, from patient care to janitorial services. The medical billing function fundamentally enables the practice to continue operating. Without good management, the practice’s financial stability could be at risk. Having a solid partnership with an outsourced billing company will help you with practice issues and future planning for things like these:

• Get recommendations for best practices or workflow adjustments based on claim rejection history, charge capture inconsistencies, or patient collections.
• Maintain a high-performing practice with your days in AR for thirty days or less.
• Identify KPIs for your practice.
• Expert guidance is available when you need it for a wide range of topics surrounding the billing process.

Hiring an outsourced medical billing company will reduce many issues associated with the billing process. It will also free up time (and brain power) so you can focus on the bigger picture for your organization.

Outsourcing your medical billing to StarkBilling eliminates the time-consuming process of providing continuing education to staff in order to keep up with insurance and HIPAA regulations. Contact us today.