Outsourcing of medical billing is on the rise
The COVID-19 pandemic and the difficulty of hiring staff have led to an increase in the outsourcing of medical billing, according to some industry experts. While using the services of outside companies can be an attractive option, there are some important considerations that firms should be aware of.
“Staff shortages, closures, quarantine and workforce virtualization have all led to many practices outsourcing billing services to a company that can handle the administrative and human resource burden,” said Matt Seefeld, revenue cycle manager at MedEvolve in Little Rock, Arkansas. , which offers specialized practice and revenue cycle management software. “Often, outsourced billing companies charge a fraction of the revenue they collect, which can cost less than keeping billing staff in-house. “
Amy Raymond, head of revenue cycle operations at AKASA, a company that uses artificial intelligence and machine learning to provide healthcare systems with revenue cycle automation operations, also believes that outsourcing the medical billing may be a prudent option in today’s environment. “Outsourcing can help you avoid the added cost of staff turnover. In terms of investments, the average employer spends $ 4,000 and 24 days on a new hire and the average cost of replacing an employee is between 16% and 20% of that employee’s salary, ”said Raymond.
She also observed: “Outsourcing can potentially provide a more flexible workforce capable of scaling up and down at no additional cost and without undue burden on the organization.
Raymond advised firms to be selective in the billing tasks they outsource to ensure that they can be handled efficiently and in a way that improves results.
More direct collections from patients
In recent years, Seefeld said, medical billing companies have had to change their collection practices in light of an increase in high-deductible health plans that have increased health care costs for patients. So in addition to submitting claims to insurance companies, companies often have to request payment directly from patients. “Raising money from patients is a whole different situation that requires soft skills and proactive communication as well as innovative technology,” Seefeld said. “The old billing and collection methods no longer work. Much of the medical billing work took place after the appointment. Now what happens before the date can be even more important in avoiding problems later.
Outsourcing medical billing can limit the ability of practices to enter into payment agreements with cash-strapped patients. For example, internist David Prelutsky, MD, medical director of Southampton Healthcare in St. Louis, Missouri, noted that with an external billing company that handles collections, he loses flexibility in setting up schedules. payment with the patients and the possibility of not continuing the payment of the indigent. the patients. “I don’t like to outsource billing because I know the history and financial situation of patients and we don’t sue them if we know they are poor,” Dr Prelutsky said. “If they’re not scammers and they’re late, they visit the billing person and we put them on a billing system. They can pay as little as $ 5 per month.
Areas of concern
Jacqueline Washington-Todd, executive vice president of revenue cycle management (RCM) at Alta Medical Management in Salt Lake City, Utah, said practices should consider some important factors when outsourcing billing. medical. For example, they could be held responsible for errors from a billing company. “With any relationship with a supplier, there are risks,” Washington-Todd said. “Although rare, there can be security holes and violations of HIPAA law. “
While HIPAA privacy breaches can occur with internal billing, the risk is potentially greater and more difficult to manage when it is outsourced, she said.
Seefeld has advised on practices for obtaining real-time reports from medical billing companies. “Monthly reports are no longer acceptable, but unfortunately most RCM companies cannot produce real-time actionable metrics that allow the vendor to hold them accountable,” Seefeld said. “Some billing companies outsource services to India and other countries, resulting in delays, problems filing claims on time, and communication barriers.”