The number one reason practices outsource their billing is the promise of higher collections. But there are a few misconceptions floating around the healthcare world about medical billing companies. Some are more harmful than others, so we decided to demystify the three that could put your practice into a compromised situation.
Myth 1: You Don’t Need Service Guarantees
Any billing service worth its salt will share freely share its key statistics with you. For example, how many days (on average) claims stay in AR for your specialty and what percentage of charges are turned over to a collection agency. The latter is especially important because some billing companies transfer charges to collection after one or two bills to make their days in AR look better. Be sure to ask about the maximum time between encounter sent /charges entered and the number of claims guaranteed to be processed daily.
Make sure you have a detailed discussion with any billing service you’re considering about the service guarantees they offer. Examine these carefully to make sure (1) the levels will work for your practice and (2) the items they guarantee are the most important ones to achieving positive cash flow.
Myth 2: Specialty Doesn’t Matter
It’s common sense to assume that coders who understand your specialty will be more productive and generate fewer errors—the longer they’ve been working with practices like yours, the better. Understanding the codes, jargon, anatomy, and internal workings of a practice like yours is invaluable when it comes to accuracy, payer expectations, and productivity.
If billing companies will try to tell you otherwise; don’t listen to them. Look for a billing company that is fully up to speed on the nuances of your specialty for maximum revenue boost.
Myth 3: You Won’t Have to Learn ICD-10
This would be fantastic if it were true, but it’s not that simple. Because ICD-10 codes are so numerous compared to ICD-9, many old codes don’t have an equivalent in the new coding system. So, even if you outsource your billing, it’s the physician that diagnoses, meaning your practice will still need to prepare comprehensively for the fall of 2015. When they document, clinicians will have to specify the level of detail within ICD-10 if coders are to be successful billing ICD-10, whether the coders are in your office or not.
On the plus side, if you use an outsourced billing company, they’re responsible for educating their coders and billers on the new diagnosis system, considerably reducing your practice’s training expenses.
Last Updated on May 13, 2014