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Saturday, October 4, 2008

Outsource Medical Billing - Deciding If It Is Right For You

Over the next several articles I plan to discuss a framework for thinking through whether outsourced medical billing is the right decision for you. The decision is a critical one, so it is imperative that it be based in facts and not in urban legends and myths. Although I am focusing on medical insurance billing services, the basic concepts apply to any outsourcing decision. Today I will outline the main benefits to consider when making the decision about medical insurance billing outsourcing and the most typical concerns and risks associated with the decision to outsource medical billing. Over the following days I will discuss each element in more detail.
The fundamental principal behind outsourcing is the focus on core competencies. The idea is that you and your practice are geared towards treating patients, not fighting insurance companies and pursuing personal balances. On the other hand, medical insurance billing services focus on billing and should have the scale, focus and employees to do a better job than most medical practices or medical facilities. The primary benefits that a medical practice should see from the right medical billing service are:

1. They have more scale to purchase and deploy the technologies required to properly submit claims, battle with insurance companies and collect personal balances.
2. They are able to attract a higher caliber of billing specialists and retain these individuals.
3. They have a deeper bench of employees and this provides a layer of protection for your practice by decoupling you from the risk associated with losing a key (if not the key) billing employee.
4. They are better positioned to properly utilize the technology they have.
5. They have a broader scope than any single medical practice or facility. This allows them to see patterns across practices, specialties, states and payers that can add money to your medical practice's bottom line.

The typical concerns that physicians and practice managers have when deciding whether they want to outsource medical billing are:

1. Will billing services fight as hard for me with insurance companies as my own employees?
2. Can outsourced billing companies handle the unique elements of my practice?
3. Will I lose control and visibility into how my accounts are being worked?
4. Will an outsourced billing company alienate my patients through heavy handed collection practices?
5. Will medical insurance billing services only go after the low hanging fruit, and leave the more difficult money uncollected?

Over the upcoming articles I will go into more depth on each of the benefits and concerns outlined above. I will go ahead and give you a peek at the final chapter. The trick is finding the right insurance billing company. Once you have a company with a proven track record you will be able to see substantial improvements in your practice's revenues have a more attractive bottom line and have more time and energy for your patients, growing your practice and - heaven forbid - a life outside the office.


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