WIXLIB

TO HIREkareo.comor Not to Hirea Billing Service

Table of ContentsFIRST, ASSESS YOUR PRACTICE05OUTSOURCING YOUR BILLING OPERATIONS06KEEPING YOUR BILLING OPERATIONS IN-HOUSE07STILL UNDECIDED?082 To Hire or Not to Hire a Billing Service – How to Make the Right Choice for Your Practice

At some point, every practice has to ask Do we continue doing what we have always done?Or is it time to make a change in the way we operate?The business of medicine is growing more complicated every dayMost, if not all, practicing healthcare providers believeas insurance reimbursement rates decline, operating costs rise, andthat medical billing is one of the most complex and crucialadministrative challenges increase. From elaborate and confusingcomponents of their business. As the management of medicalpayment systems and intricate compliance requirements topractices evolves with the introduction of new technologies,IT-related issues like security and reliability, it is becominggovernment requirements, quality assurance measures andincreasingly difficult to manage the business of your practice withoutfinancial limitations, practitioners and practice managers findlosing focus on the quality of care your patients receive.themselves having to decide which operations methods will bothsave expenses and generate revenue. And of course, medicalThe consequences of neglecting your business operations arebilling is one of those operations.great. In addition to decreased cash flow and increased operatingcosts, missing the opportunity to improve operational efficiencyMany practices ask, “Should we hire an outsidecan result in too much time and attention spent on administrativebilling service?”matters, reducing revenue and diminishing profitability.3 To Hire or Not to Hire a Billing Service – How to Make the Right Choice for Your Practice

Whether you keep your billing operationsin-house or you choose to outsource, yourfirst concern should be that yourproviders are documentingtheir services based oncoding standards.The overall effectivenessof your billing operationsbegins and ends with billingand coding knowledge—if youdon’t learn how to bill and code forprofit, not much else matters. Oncethat’s covered, you’re ready to assess yourpractice and explore which of the two mostcommon billing scenarios benefits you the most.4 To Hire or Not to Hire a Billing Service – How to Make the Right Choice for Your Practice

First, Assess Your PracticeTo find out what the best choice is for your business, ask yourself these questions about your billing process,staff, physical space, and plans for the future:Is your accounts receivable too high (more than 45 days)?YESNOAre you experiencing an increased number of denied claims?YESNOIs your net collection rate declining?YESNOAre some of your charges and claims not making it to the appropriate payers?YESNOIs coding and billing for your specialty especially complex?YESNOAre you spending too much time on the business aspect of medicine?YESNODo you want to focus more time on patient care?YESNOAre you generally frustrated with the effectiveness of the billing/business office?YESNOAre you concerned that your staff or office manager has knowledge of your income?YESNODo you feel too reliant upon your office manager?YESNODo you have several employees performing tasks that could be handled by one,more experienced biller or manager?YESNOAre you having a difficult time hiring or keeping experienced billing staff?YESNODoes your staff lack a certified professional coder?YESNODo you struggle to find time to check patient insurance eligibility and benefits?YESNOAre you planning to expand your practice?YESNOAre you facing a major capital investment in new hardware or software?YESNOAre your computer support fees too high?YESNOIs your computer system obsolete?YESNOAre hardware, software, and IT issues disrupting the operation of your practice?YESNOAre you short on space and locked in to a long-term lease agreement?YESNODo you believe that your practice’s cost structure is too high?YESNONow, let’s look at the options.5 To Hire or Not to Hire a Billing Service – How to Make the Right Choice for Your Practice

OutsourcingYour Billing OperationsIf you answered yes to most of these questions, using a billingfirm is probably a good fit for your practice and will most likelyOutsourced billing is typically a good fit for start-upincrease your bottom line. There are many benefits to hiring apractices that have unpredictable patient volumes andbilling service to manage your billing operations, as well as a fewmust keep costs low, delivering quality service withoutpotential drawbacks.the help (or expense) of an administrative team.When you outsource your medical billing, you can:All of the day-to-day billing functions are handled offsite when your Focus more energy on what you do best:practicing medicine and taking care of patientsbilling is outsourced. Plus, a reputable medical billing company Stop hiring, managing, and training billing staffnuances of medical billing, from coding to patient collections. Avoid delays due to vacation, sick time, or staff turnover Reduce costs associated with personnel, such assalaries and benefits, computer hardware and software,office supplies, office space and trainingwill provide a team of well-trained, certified billers versed in theMedical billing companies are often the best option for smallerpractices simply because of the prohibitive cost of specializedmedical billing tools and technologies. Eliminate expenses such as annual coding andcompliance educationAlthough outsourced billing companies enable practices to be Reallocate space that would be used for billing togenerate additional revenue streamsyou’ll need to get used to working with people outside of your Dedicate more resources to making an efficienttransition to electronic health recordsprocesses will be critical to your success. In the beginning it may Lock in a portion of operating expenses at a setpercentage of revenueto a billing question, or make a process change. But, as the Avoid purchasing an expensive billing systemkind of real-time exchange of information that you would if youless concerned with the claims process and record retention,practice. Establishing good communication channels andtake a little longer to find a problem, track down the answerpartnership evolves, you should be able to experience the samewere in the same building.6 To Hire or Not to Hire a Billing Service – How to Make the Right Choice for Your Practice

Keeping Your BillingOperations In-HouseIf you answered no to most of these questions, your practiceDepending on the size of your practice, the averagemight benefit more from keeping billing operations in-house.in-house billing department consists of one or two trainedIn the same way that hiring a billing service has its own uniquebillers per one to three providers. Payroll expenses aside, theadvantages, so does maintaining an in-house billing staff. Somestart-up costs of an in-house billing department will include:of the advantages include:equipment (such as computers and software), registration Having more day-to-day control of the billing andcollections process Utilizing the full capabilities of your existing staff Recouping your practice’s investment in abilling systemwith a clearinghouse, additional space for records storage, andreference materials (such as annual coding books or courses).Other ongoing costs include photocopying when needed forpaper submissions/resubmissions, stationery, postage, patientstatement processing, and software and hardware support.An in-house billing team may seem like an administrative burdenand an increase in overhead, but the advantages of having yourbillers in-house may outweigh those factors. With an in-housebilling department you can keep a close watch on your day-to-daybilling operations, questions can be addressed in real time, andchanges can be implemented immediately.7 To Hire or Not to Hire a Billing Service – How to Make the Right Choice for Your Practice

Still Undecided?How you manage your billing isn’t always a black-and-whitedecision. Here are five other factors to consider if you are stillstruggling to find the right answer for your practice:1. Control3. PerformanceHaving control over the billing cycle is important to manyPerformance of your billing service can be best gauged by anphysicians and practice managers, whether billing is managedincrease in your revenue and the speed at which you receive it.in-house or by an outside billing service. If you use an outsideCompare the performance of the billing service by measuringsource for billing, will the physicians or office manager work withthese three indicators of best-in-practice industry standards:a designated billing specialist? Open communication and a quickresponse to any concerns will help the practice maintain greatercontrol over the billing and revenue process.With cloud-based systems, the office manager and/or physiciancan view the real-time status of patient accounts by simplylogging on to the system in the same way they would if thesystem was being used by a biller onsite.2. CommunicationBilling and financial matters require consistent, effectivecommunication. Choose a billing company that will respond toyour needs at a moment’s notice and keep you abreast of theirperformance by supplying you with timely and accurate reportson a consistent basis. You’ll feel more in control of your revenuecycle and their full-time billing staff will get the information andanswers they need to help maximize your revenue.8 To Hire or Not to Hire a Billing Service – How to Make the Right Choice for Your Practice Days in A/R Net collection rate Percentage of A/R over 120 days

4. CostThe cost of the product or service does not necessarily have toIt’s often more cost effective to outsource billing. Make sure thatbe less than the cost of managing the product or service in-whatever service you choose charges between four and eighthouse. The most important factor to consider is whether or notpercent of claims paid and that the percentage charged goesyour billing service is increasing your revenue and shorteningdown as the rate of claims paid increases.your days in A/R, thereby helping you earn more money, faster.Because of the amount of money involved in the averagemedical claim, even a five percent improvement in collectionsmeans exponentially more to the bottom line than a five percentreduction in billing fees. For the average provider:5. Management styleYour management style is one of the most important factors toconsider when deciding between in-house or outsourced billing.If you like to have your hands in the heart of your practice, thenin-house billing is probably the best option for you. If you prefer5% improvement in collections 24,000 in additional annual revenueto let go and focus solely on patient care, be sure that your billingservice offers you access to the information you need to make thequality decisions that affect the profitability of your business.No matter the direction you choose —in-house billing or billing servicepartnership — your medicalpractice can be a great businessand an exceptional place to providehealthcare services to your patients.As your business needs change,the decisions you make today mayneed to change as well. Always stayopen to the possibilities and makechoices that allow for flexibilityin the future.9 To Hire or Not to Hire a Billing Service – How to Make the Right Choice for Your Practice