Medical Billing Outsource

What is Medical billing outsourcing

Provider or hospital giving their job to third party to do the work behalf of them . This process is called as Medical billing outsourcing. The primary job of the provider is treating patient but apart from that their primary task is submitting the claim to insurance and get paid for their service. Most of the time they can't do the both work at a time. Hence they outsource their work to others for easier their life.

Advantage of Medical billing outsourcing.

1.Medical billing outsource save their money.
2.Save their time so provider can concentrate on treating more patient with quality healthcare.
3. Reduce the equipment usage
4. Dealing with insurance billing rules are very difficult process. Now Billing company will do this.
5. Faster transaction, Most of the billing company submit the claim within 48 hours.
6. No need to handle more human resource in their practice.
7. Better quality.
8. Maximum reimbursement
9. Dedicated professional resources.
10.Better Denial management.
11. Better follow up with old claims.
12. Better financial control - medical billing companies will provide more monthly report.
13. Better customer support
14. Outsource allows to staff to concentrate on other works.

We wont say, its all because of Medical billing outsource. All the above points can be achieved in in-house billing also but it the success rate is high in outsourcing than compare to in-house billing. We are saying this from our clients.

Usually Medical billing company working based on their collection hence they will work harder to collect more money than in-house billing staff who are getting flat salary.

The price of outsourcing

Usually Medical billing charges 4% - 8% depends upon type of claim and nature of work and many more criteria. If the single claim has bigger value then the charge is low.

Factors of fixing price.

1. Level of work - Is it include AR process or not.
2. Single claim value - High value claim means less work so lower charge.
3. Is it include other charges such as clearing house, paper claim
4. Number of patients. Less patient will lead to higher charge.
5. Patient statement.


How will you determine outsource or not?

Medical billing services are useful for many different types of health care providers. On the small end, solo practitioners often don't have the time or the expertise to handle billing in‐house: just keeping up with demands of building a successful practice is enough of a challenge. Larger practices, clinics, and hospitals may also see significant results from even a small percentage increase in collections, making a billing service worthwhile for them, too.

Not every health care professional is a good candidate for a billing service, though. If your volume of patients is low, it may be hard to reach a deal that makes sense for you and the billing service. For example, psychologists and chiropractors may only see 5 to 10 patients a day, and have relatively low reimbursement rates. For most billing services to cover their costs, they would have to charge a high percentage that would be unacceptable to these types of practices.

If you are not familiar with computer and Medical billing rules then you should consider the outsourcing.

How outsourced medical billing works

While each service may have slight variations, the general process of working with an outsourced medical billing service is fairly straightforward:

* You send patient information, insurance data, and diagnosis and procedure codes to the billing service

*  The service checks the data, completes the appropriate claim forms, and submits them to a claims clearinghouse.

*  As claims are approved, explanation of benefits forms (EOBs) and checks are sent to you. Claims that are denied or rejected are returned to the billing company, which then corrects any errors and either resubmits  them, or returns them to you.

*  The outsourced medical billing provider delivers regular reports on your claims and payments.