Sick of Medical Billing Mistakes? Outsourcing Provides the Answer.
When it comes to running an effective healthcare practice, priority number one is providing quality clinical care.
Priority number two?—providing accurate, timely billing services.
Any modern medical practice needs a consistent revenue stream to stay afloat, but billing effectively can be a measured struggle—insurers make money by delaying, denying, and rejecting claims which means even the smallest mistake in paperwork can impede your ability to get paid on-time. Yes, mistakes can be corrected, but resubmitting a claim consumes the valuable time and energy of your staff—time and energy that could be spent elsewhere.
That’s why more and more medical practices are turning to Business Process Outsourcing (BPO) to handle their medical billing. Faced with increasing red tape, never-ending paperwork, and rapidly changing insurer practices, outsourcing of billing services grew by more than 30% between 2011 and 2016.
So what are the benefits of outsourcing medical billing, and is it the right decision for your practice?
Keep reading to find out…
The Burden of Billing Mistakes
The American Medical Association estimates that medical practices spend up to 14% of their time and money on medical billing—primarily in the form of insurance error correction, which leads to supplemental paperwork and costly resubmissions fees. This is a WASTE. Keeping billing mistakes to an absolute minimum is one of the marquee reasons medical offices need to start partnering with BPOs.
Not verifying insurance
It’s sounds simple (and it is!) but in the chaotic environment of a bustling medical practice, confirming the validity—both expiration date and benefit details—of a patient’s insurance prior to submitting a claim is something that frequently slips through the cracks.
BPO providers have dedicated verification services that confirm patient insurance details long before the submission of a claim.
By moving the authentication process to the front-end of the submission process, BPO’s eliminate the common costs associated with claim rejection due to invalid insurance.
Inaccurate patient information
Typos befall everyone, and even the most talented medical office staffs will strike the wrong key every now and then. Unfortunately, these seemingly harmless mistakes create thousands of claim rejections every single year.
BPO providers employ teams of highly-trained professionals whose dedicated responsibility is data entry—that’s it. These workers don’t have other in-office duties to worry about in addition to billing, accurate billing is their one and only obligation.
Additionally, BPO’s employ highly-customized EHR (electronic health record) software to autofill and cross-check data across patient files—software many medical staffs don’t have proficiency in.
The depth of operational specialization practiced by BPOs keeps errors to a minimum, routinely improving medical office revenues by 5-15%.
Wrong procedure or diagnosis codes
Insurance claims must include the correct diagnostic and point-of-service codes—that much doesn’t surprise anyone.
But what might surprise you is this—new billing code books are issued every single year, and many doctors’ offices forget to make the necessary updates. When the new codes aren’t properly employed, claims are delayed, and when claims are delayed so is payment.
And that’s just insurers…the billing procedures for Medicare and Medicaid change annually too with the imposition (or repeal) of federally mandated regulations.
Busy medical offices have a difficult time keeping up with these rapid regulatory shifts which is why many find BPOs or Virtual Medical Offices so appealing. Because BPOs exclusively focus on medical billing, they heavily invest in staying up-to-date with insurer code books, and ahead of the curve on changes to federal medical programs—BPO staff are fully aware of new billing rules and regulations before they go into effect.
Someone else’s mistake
The American Medical Association estimates 12-17% of claims are rejected or delayed due to incorrect processing by the insurance provider.
Rejected claims need to be followed up quickly in order to ensure they’re properly paid out. BPO providers know how to contact insurers directly and resolve small issues before they become big ones, guaranteeing that medical practices get paid in a timely way, even when insurers make mistakes.
Best of all, working with a BPO means you and your staff can skip the nightmare of dealing directly with insurance company auto-attendants and call centers.
What do mistakes really cost?
The most obvious cost of any billing mistake is lost (or delayed) revenue, but there are plenty of other ways billing mistakes can cost your medical practice a pretty penny…
Time is money—cliché but true.
When your office is forced to resolve its own billing mistakes, employees will waste hours on the phone with insurers trying to not only identify why a claim was rejected, but how the matter can be resolved. Then there’s the matter of actually re-submitting a claim which takes more time. This is all time and energy your employees could put to better use.
Healthcare BPO providers do a better job of ensuring claims are properly submitted the first time and, if there is a problem, they pursue it until the matter is resolved in its entirety.
When medical offices are force to wait weeks on end to resolve denied and delayed claims, it’s hard to get a clear picture on the fiscal health of the practice.
Repeated billing errors create a domino effect that leads to under-budgeting and understaffing. When revenues are in constant question, it’s nearly impossible to understand the needs of your office and state of your cash flow.
Outsourced medical billing services give practices better insight into the reality of their financial health, giving decision makers the clarity they need to make better operational decisions about their business. This helps maximize revenues and reduce time taken to process bills.
And because BPOs are a hired service, it’s far easier to account and budget for their expense—there are no overtime fees, sick days, or vacation days to worry about. All you and your staff need to do is give the BPO provider access to the necessary information, everything else, from insurance verification to collections on unpaid claims, is done for you.
Focus on what you do best
Another perk to outsourcing medical billing?—it lets practices focus on what they do best: help people get healthy.
Getting medical billing practices nailed-down is critical to the survival of any practice, but it takes time, effort, and specialist knowledge. Handing it off to a high-quality medical BPO, physicians can reap the benefits of a top-quality billing team, without having to sweat over whether their staff can “handle it.” It gives doctors the headspace and peace of mind to fully focus on providing the best possible level of care for their patients.
When practices and their staff are mired in the mess of insurance verification, claim submission and resubmission, and regulation maintenance, they can’t devote adequate time or attention to patient care—phone calls go unanswered, wait times increase, and patient happiness (a key component of health) decreases.
Using a dedicated healthcare BPO gives your practice the freedom to avoid the day-to-day frustrations of dealing with medical insurers and billing processes. They eliminate the need for medical office staff to stay abreast of changes Medicare, Medicaid, diagnosis codes, insurer billing protocols, and new patient information verification.
Outsourcing also means having a cleaner understanding and expectation of what annual budgets should look like—there’s no need to buy the latest EHR software or spend valuable time and money training staff on how to use it. And when your practice experiences back-office turnover, having a BPO in-place will eliminate the risk of interruptions to billing and mitigate the costs of new hire ramp-up.
Trust the Experts
As one of the leading BPOs in the United States, TrueShore knows how important accurate, efficient medical billing is to the vitality of the modern medical practice. That’s why we invest so heavily in the training of our staff. Our employees are not only familiar with the latest EHR applications, but are veritable experts on changes to Medicare, Medicaid, and 3rd party insurer practices. For those not in the healthcare industry, we can still provide specialized outsourced billing services for your organization.
By making medical outsourcing services the cornerstone of our business, we help doctors’ offices get paid far more quickly, effectively, and accurately than they could on their own. Trusting us to handle your billing needs will free up your staff, and the great service we provide will increase your revenue and stabilize your income stream.
The reality is this—the medical world is changing faster than ever making accuracy and flexibility in billing a necessity. Reducing costs and elevating client experience are a requirement not only to stay in business, but to keep growing.
Ensuring your patients have insurance – and understanding the limits of those insurance policies – is the first step toward greatly reducing billing errors and non-payments. TrueShore knows the codes, regulations, HIPPA laws, and other details necessary to avoid the types of common mistakes front desk personnel make.
Outsourcing is the most cost-effective way to handle the non-medical aspects of your practice. TrueShore gives you access to a highly-trained professional workforce without having to worry about training, sick days, staff costs, or investing in equipment. We’ll reduces your overhead and provide smarter, more effective service than any in-office staff ever could.
Start looking at TrueShore’s Healthcare Outsourcing Services today and start creating a more helpful, profitable medical practice for tomorrow.