5 Factors to Consider Before Outsourcing Your Billing Functions

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By Melissa Romanelli

Providers and practice managers often debate on the benefits of outsourcing their billing functions to independent firms or keeping those functions in house.   From a process management standpoint, if the practice processes are solid, any support function should be easily “lifted out” of the office and outsourced to a specialized group.  The location of where support services are provided should not affect the quality of the work product.

However,  there are a number of considerations that should be weighed before deciding to outsource, and then before selecting an outside billing service:

  • Cost:  There should be a definite cost benefit to outsourcing any function of any business organization.  But you must consider total cost which would include such factors as labor, benefits, taxes, office rent and utilities, technology, training, postage, clearinghouse fees and materials.  The office manager should know how many claims are generated monthly, quarterly, and annually; and a total cost per claim should be very easy to accurately calculate.
  • Full time staff:  A billing company should employ full time employees who are assigned to deal with your account.  This will provide you with a support team that has intimate knowledge of your patient’s accounts.  There should be one primary point of contact for your staff to ensure solid communication between the office and the outside agency.  A billing company should be a full time business and not a casual source of secondary income for a family.

  • Active Collection Actions:  A billing company should be actively working on your accounts receivable to address any issues and ensure your cash is flowing.   A routine review of outstanding accounts should be part of their normal work processes.   And your office should receive regular feedback regarding any issues that are preventing you from collecting on claims.
  • Full service, one fee:  A billing company should provide you with all the services necessary to help your practice maximize collections.  Once you have made the decision to outsource, there should be no surprise additional fees to ensure that the entire function of billing for the practice is properly handled.  Credentialing, patient billing, and responding to outside inquiries should be part of the service.
  • Varied Client base:  A billing company should have experience in a wide range of provider specialties.   The skills required to submit a claim do not vary too much by specialty and having a broad based client base demonstrates and understanding of the entire revenue cycle.

There are many benefits to outsourcing your billing functions to a professional agency.  Before you make the leap, be sure to consider all of the factors that will be involved.  Be sure that your office processes are going to compliment the information necessary  for an outside agency to submit your claims.

Melissa Romanelli is the founder of Medical Practice Management Services, a full service billing company specializing in the medical industry. For more information, visit www.mpms.info.