Medical billing involves submitting and following up on claims with health insurance companies for reimbursement. The efficiency of this process directly impacts the financial stability of a healthcare business, as any delays or denials in claims can disrupt cash flow. Many healthcare providers outsource to medical billing companies. Here are the pros and cons of using a medical billing company:
Pros of Using a Healthcare Billing Company
Outsourcing to a medical billing company brings trained professionals with a comprehensive understanding of medical billing and proficiency that can speed up the claim submission process and follow-ups. They are consistent with the up-to-date process and evolving landscape of healthcare regulations. Keeping pace with changes in the industry mitigates the risk of claim denials due to outdated practices. This helps prepare your business for future regulation shifts and remain current with changes.
Cost Savings
Utilizing a medical billing company can result in significant cost savings for your healthcare business. By outsourcing, you can drastically cut overhead costs that would otherwise be spent on maintaining an in-house billing department. This includes expenses related to workspace, equipment, specific training for regulations, and state-of-the-art software for medical billing. It also eliminates the need to hire or seek certified employees.
A specialized billing company provides trained professionals already well-versed in coding, rules and regulations of medical billing, and comprehensive performance of reports and data extracts. This saves your business from the cost and time associated with training. The healthcare business can now focus on allocating resources more efficiently and focus more on patient care.
Improved Revenue Cycle Management
Your healthcare business can improve its revenue cycle management by engaging a healthcare billing company. A facet of this enhancement is the ability to process claims consistently and quickly. The experts at a professional billing company can swiftly navigate the complexities of claim submission, which helps claims to be filed accurately and promptly. This expeditious filing reduces turnaround times, leading to quickly processed reimbursements. Their expertise helps minimize claim denials and rejections. They have a thorough understanding of the common objections or reasons for denials and rejections. They can implement strategies to prevent such issues and meet the stringent requirements of your claims with insurance companies.
Cons of Using a Medical Billing Company
One disadvantage of outsourcing to a billing company is the potential loss of control over your billing processes. By outsourcing, your business will have less direct oversight and influence over the daily operations of your billing process. This shift in management makes it difficult for accessibility or control functions. It puts a significant amount of trust in the hands of the external company to accurately and effectively manage your billing processes.
The maintenance and oversight of the contract need to be addressed. This helps to make sure both parties’ needs are being met. If a billing company’s practices do not align well with your healthcare business’s values, it could lead to conflicts and misunderstandings. This could impact the effectiveness and efficiency of your billing processes. This misalignment may also negatively affect your business’s reputation if the billing company’s practices do not meet your patients’ expectations.
Privacy and Security Concerns
Outsourcing medical billing responsibilities can introduce privacy and security concerns, such as sharing sensitive patient information with a third party. When you place your billing processes to an external company, you inherently will trust them with confidential patient information. This data is invaluable, and its mishandling can lead to significant repercussions, both legally and regarding your business’s reputation.
The billing company must adhere to stringent data protection protocols to safeguard this information. They must comply with the Health Insurance Portability and Accountability Act (HIPAA) by law. HIPAA sets the standard for protecting sensitive patient data, and any non-compliance with its regulations can result in severe penalties.
Deciding to Hire a Medical Billing Company
Using a medical billing company can be advantageous for saved expenses, up-to-date software, and quick turnaround reimbursements. A third-party company can offer expert knowledge, cost savings, and improved revenue cycle management. They can also increase collections, investigate income stream opportunities, and monitor under or over-payments. Consider hiring a third party, so your healthcare service can be focused on the patient while the business brings in consistent revenue.