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outsourcing billing-pros/cons
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outsourcing billing-pros/cons - July 25, 2006 3:39:00 PM
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Soleman
Posts: 55
Joined: March 12, 2000
From: USA
Status: offline
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I am a single practitioner practice open for about a year. We are growing and I find my office manager is no longer able to keep up with the billing and sending out pt. statements and so forth. There is a lot of time involved tracking down insurance companies, why they didnt pay for xyz, etc and it just takes a lot of time. We are getting busier so I am considering outsourcing billing to a billing company and paying 7% of collections to them, VS. contracting with a woman who will come in at night and provide the same service using our existing software at an hourly rate. The woman would be cheaper.
Questions:
1) can anyone give me pros/cons of the above scenarios
2) if anyone recommends outsourcing to a billing company, can you recommend a quality, ethical company to me?
3) any suggestions or comments?
Thanks!
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Re: outsourcing billing-pros/cons - July 27, 2006 11:09:00 PM
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goodlooks58
Posts: 417
Joined: October 21, 2002
From: CA
Status: offline
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Where are you located? In my 21 years of experience in private practise...inhouse billing is the only way to go, however, depending upon where the billing agency is located makes a big difference.
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Re: outsourcing billing-pros/cons - July 28, 2006 3:22:00 AM
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SJBird55
Posts: 2286
Joined: May 10, 2004
From: Michigan
Status: offline
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I pay 8% of collections to a billing company. I am of the belief that the billing company has an incentive to send out a clean claim each and every time because the sooner the money comes to me, the sooner they receive payment for their services. They also deal with posting the charges and posting what was received... resubmitting... sending on to secondary payers. I personally just didn't want to deal with all that kind of stuff. Claims are electronically submitted and they deal with all the computer glitches - theirs, the clearinghouses' and the payers'
I do my fair share of trying to have a clean claim also. My office manager communicates to me on every patient - I provide her with an ICD-9 code and she references BCBS and Medicare to see if it is a payable code for whatever procedural codes I think I'll use. She also spends a good chunk of time up front reviewing the patient's benefits to understand limits in services and copays/deductibles. I just got burned by an auto insurance company and am fighting a claim... so, I just implemented another process that incoporates not just receiving a fax that the patient has an open claim, their claim number and the address to send claims and documentation - but that is now followed up with a second fax that needs to be received before the patient attends therapy that is signed by someone at the auto insurance agency indicating that my charges will not be contended. I also personally review every EOB and denial and write my comments on it prior to sending it off to my biller.
So, even though I do outsource, I do spend a small chunk of time (hopefully less and less with things I've implemented this year) dealing with reimbursement issues.
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