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9 Reasons to Outsource Your Medical Billing

9 Reasons to outsource your medical billing

Discover the benefits of outsourcing your medical billing and transform your practice with RCM solutions

According to a 2011 report by Healthcare Business & Technology, US doctors lost an estimated $125 billion in revenue each year due to poor billing practices.* Among the many reasons to outsource your medical billing, helping to capture potentially missed revenue by improving poor billing practices may be the most impactful, but it’s worth noting how missed revenue opportunities can cascade to impact other areas of your practice.

When your billing is optimized, you may be able to recapture revenue lost previously due to poor billing practices, capture growth opportunities, and reduce staffing pressure. The benefits of outsourcing medical billing can multiply over time, too, allowing you to scale the positives.

With revenue cycle management solutions for medical practices, ModMed® BOOST RCM positions you to solve billing challenges by giving you visibility into revenue cycles and performing the heavy lifting of billing processes for you. Using practice management technology to manage your billing cycles from beginning to end, ModMed can offer practices the opportunity to improve financial performance.

Learn more about ModMed BOOST RCM now and explore the reasons to outsource your medical billing.

1. Identify revenue opportunities

Busy physicians may wonder just how many revenue opportunities they’ve missed each year — or over the course of their careers. The reality is that gaps can occur between the services you perform, the documentation that supports performance and the actual amount of reimbursement you receive.

There are a number of factors at play, and ModMed BOOST RCM services can help.

One factor may be value-based care, which replaces fee-for-service reimbursement and requires physicians to deliver data that show the value of their patient outcomes, quality of care, cost efficiencies and conformation with interoperability. Failing to provide a complete, compliant submission can affect your reimbursement.

Additionally, medical coding guidelines may change, leaving you with inaccurate documentation. Time limitations can impact how long you have to claim payment. Lingering unposted and unbilled charges risk revenue opportunities. Sometimes, you may not even realize you’ve performed services that are part of your allowable reimbursements.

When you outsource medical billing to specialists who have experience in the claim submission process, you’re less likely to be affected by these factors.

2. Stabilize costs

Physician’s offices can have a lot of variable overhead. If you can fix certain costs, you can bring greater predictability to your overall financial outlook. Even if you choose revenue cycle management services that determine cost based on percentages or tiers, you can still bring stability to your expenses and plan several months ahead.

When you handle billing in house, it can be more challenging to predict the costs associated with ongoing work efforts, training and management.

By comparison, cost consolidation is one of the major benefits of outsourcing medical billing. When you know what to expect, you can improve your practice’s financial health.

3. Reduce capital investment

Along with stabilizing costs, you can reduce the amount of capital outlay required to perform billing in house. Here are just a few of the bigger capital investments you may be able to eliminate:

  • Hardware, like computers, drives and device accessories
  • Software for coding, accounting, billing and more
  • Furniture, like workstations and hardware cabinets

By turning capital investments into operating expenses, you can gain flexibility, scalability and control over your costs.

4. Optimize workflows

When you take care of billing within your practice, you may find that everyday office matters can disrupt your billing workflows. It could be as simple as someone calling out and causing havoc for the day. Other impacts might include a rush of patients, an urgent patient care scenario or technical difficulties with your local internet.

When these matters arise, it’s up to physicians and practice managers to prioritize what occurs next, and billing can be one of those things that gets pushed to the back burner for another day. And another. And another.

By dedicating an external team to perform your medical billing, you can remove in-house obstacles from the process and create a reliable billing cadence that optimizes your time and energy. With ModMed BOOST RCM, you work with a team of billing specialists to help you keep your billing workflow on track.

5. Maintain compliance

Compliance is important to obtain the full reimbursement requested. If you fail to comply with laws, regulations and rules, you may find payments are denied. Even if you’re able to correct your submissions, the costs attached to resubmission can add up.

Some common compliance risks include:

  • ICD and CPT codes may be removed or added each year.
  • Required fields may be submitted blank.
  • Services as presented may not be covered by payers.
  • Claims or services may appear to be duplicate.
  • Time limits for filing claims may have expired.

It can be time consuming to keep up with every single detail required for complete and accurate billing. A team with the experience to deliver accuracy and thoroughness can help resolve or prevent compliance gaps.

6. Extend staff capabilities

Staffing shortages are constraining capabilities for practices everywhere. It’s not a challenge limited to any particular size practice or geography. Outsourcing is one of the ways you can circumvent the challenges of hiring right now. External billing teams are able to scale their efforts to take care of your needs, so you can avoid investments in a staff search and onboarding process.

Your current staff may appreciate the decision to outsource medical billing. Reliable cadences and lower stress created by reducing in-house billing tasks contribute to a positive work culture for everyone, which in turn, can lead to greater productivity. You may find that attrition is less of a threat when people are productive and engaging in a positive work culture.

7. Increase focus on care

It can feel like a paradox, but running your practice can take away from the actual act of practicing medicine. For many doctors, patient care is the reason they chose the profession. One of the reasons to outsource medical billing is a return to focusing on patient care.

Physician burnout can put pressure on individuals and practices, too, threatening the ability to provide excellent care. Outsourcing medical billing can help reduce the risk of burnout by reducing the amount of work for which you feel responsible. One result can be that lessened pressure can also contribute to better patient care.

8. Improve patient satisfaction

As you continue your relationship with ModMed BOOST RCM teams, you may find that you begin to realize positive knock-on effects. Increased focus on care is one of them, and it can lead to increased patient satisfaction. As your ModMed team brings greater accuracy to your billing, you may be able to avoid snafus that may leave patients feeling financially blindsided or mistreated. Developing trust also has a cyclical effect that can improve rapport and communication for stronger care.

9. Discover growth opportunities

In addition to revenue opportunities for services performed, your practice may be missing out on opportunities for growth. With a billing partner to help you optimize workflows, including reporting and analytics, you may discover that you have capital to invest in expansion or other forms of growth, like education, training, new hires and equipment that can attract new patients.

With so many reasons to outsource your medical billing, it makes sense to explore some of the opportunities available to you. Discover how ModMed BOOST revenue cycle management can help your practice now.

* “Medical Billing.” Hospital Billing Errors | Medical Billing Services, Healthcare Business & Technology, 21 Apr. 2011.

This blog is intended for informational purposes only and does not constitute legal or medical advice. Please consult with your legal counsel and other qualified advisors to ensure compliance with applicable laws, regulations, and standards.