Most Physicians would undoubtedly agree that dealing with insurance carriers is extremely difficult. Insurance carriers are constantly changing their guidelines, their processes, policy coverages, etc. There are even some insurance carriers that will erroneously deny claims that should be covered. Then those claims need to be followed up on. An individual will easily spend more than 30 minutes on the phone with insurance carriers trying to get claims that should have been processed as paid, to be reprocessed. This is only one of the many benefits to contracting out your medical billing. Billing companies like AMB have tenured certified billing specialists that know exactly what needs to be done to get the claims paid. Often when practices hire less experienced billers, they will find themselves either in need of more personnel to handle the volume and complexity or their A/R or they will have large older balances that less experienced personnel just does not have the time to get to.
Coding claims based on the insurance carrier guidelines can make your head spin. It is my opinion that providers should not need to worry themselves with coding their services 100% to get claims paid. When coding claims, some insurance carriers will want specific CPT’s, specific ICD-10 and specific modifiers based on the services performed. Many insurance carriers have different guidelines for coding. This is yet another reason to outsource your billing. Just like certified billers, certified coders will have the training, education and experience needed to handle these challenges. If you are contracting with a good full-service billing/revenue cycle management company, then some of the financial benefits to outsourcing your medical billing are:
Saving the cost of billing overhead such as software and maintenance of that software, clearinghouse, employee benefits, etc.
Saving the cost of employee salaries. Note: Employing your own biller will most definitely make a dent in your payroll budget whether or not that employee is successful in collecting your due revenue. But when you outsource, you are only paying a percentage of collected revenue.
It is in not only the client’s best interest, but also the revenue cycle management (RCM) company’s best interest to increase revenue. You are considered a partner.
When using in house personnel, your cash flow will be interrupted if any of your billing staff are absent for any length of time. When outsourcing, there is a team that are cross trained and can step in for another should there be an absence. This ensures that the work flow is not interrupted which directly affects cash flow regularity.
Billing companies traditionally will assign their experts to more than one account depending on the size and volume of said accounts. Medical practices do not have that benefit to keep costs down.
One of the best reasons to outsource your medical billing is so that providers can do what they do best. Patient Care is their #1 priority as it should be. You went to school to take care of the health of your patients. Billing companies such as AMB went to school so we could take care of your revenue so you can continue to make a difference in your patient’s lives.
If after reading this article, you agree with any of these statements, please allow us an opportunity to speak with you further. Note: Allegiant Medical Billing does not outsource any of our services.
By: Shannon D. Russo-Leboff
Marketing Manager/Administrator
Allegiant Medical Billing
Allegiantmb.mgr@gmail.com
706-868-3200
Web: ambcares.com