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Should Health Care Providers Outsource Billing Services?
Whether or not to outsource is a very difficult decision for any provider to make. This decision is most heavily influenced by personal ideology and comfort level. It is our opinion that providers who can dedicate time to study CPT® codes, attend continuing education courses on billing, and maintain current competency should do their own billing. With their vast medical knowledge, providers who dedicate time to personally perform their own billing tasks are exceptional billers for their own practice. Although providers make the best billers, efficiency and efficacy of netting dollars is severely compromised in this scenario. It can be related to painting your house. Perhaps you can paint your house over a period of three hours per week for four weeks, saving the cost of hiring painters. What was gained in savings was lost by multiples by not seeing twelve hours worth of patient visits. A billing company should be able to collect more money than a physician’s office because it is a billing company’s core competency to maximize cash flow while minimizing turnaround time. In addition, using a billing company can ensure continued cash flow whereas this may not be the case with in-house billing due to staff time off and/or turnover.
Most providers who are considering hiring a billing company have questions shared by many:
I want to “keep my finger on the pulse” of the business end of my practice. How do I do that if my billing is being done at an outside location?
We recommend that, if you decide to outsource, that you do business with a billing company that provides frequent activity statements along with a virtual portal network (VPN) which allows providers to view work in progress in addition to work that has been done. You should also be able to view the billing company’s follow up on denials.
When payments are made from third party payers, where does the money go? Does it go straight to me or straight to the billing company?
Payments from third party payers should go directly to the provider, in most cases through electronic fund transfer. These payments can be matched to claims. Payments made on claims should, in turn, match your billing company’s invoice for services provided.
How do I know if my billing company is invoicing my practice accurately?
Whether you prefer to be charged based on number of claims or by a percentage of dollars collected, the billing company should provide you with a concise and easily readable statement that, when matched to payments made directly to you by third party payers, outlines what claim items were billed, what was received, what was denied (and why), status of follow up on denials, and what monies are expected to come in. We believe that it is essential that all providers continuously have a bird’s eye view of their business. With a good billing company, this will not be time consuming for you or your staff.
What is the billing company’s incentive to maximize my income and to decrease turnaround time between billing and receiving payment?
Most companies, including ours, operate on a percentage fee system based on receivables. Ensure that your billing company is not charging anticipated fees on prospective receipts. Fees should be charged in “real time,” charged only when the provider receives payment.
The most important factor is trust. First establish contact with a billing company and meet with the owners. When you find a billing company that you are willing to establish a business relationship with, start with the basics. First, finalize a contract – a contract will outline specific services to be provided, the mechanics of such services, and fees. A contract also serves to provide mutual protections and stability, thoroughly organizing both parties’ intentions into a united mission from the outset. Many billing companies, including ours, work hard to eliminate risk.
For more information, Atlantic Billing and Coding, LLC may be contacted by calling (315) 379-9659 or by visiting www.atlanticabc.com.
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