If you run a practice and are considering outsourcing your medical billing, you should look at the following factors to see if it's the best decision.

When you run a medical practice, you have a lot to occupy your mind, mainly when it comes to the ongoing health and wellness of your patients. The last thing you want to have to deal with after a long day of treating patients and filling out charts is billing.

Unfortunately, if you don’t deal with medical billing and coding, you’re not going to get paid. Don’t fret – there are professionals trained for this very purpose. You just have to decide if you want to hire a specialist for your staff or if outsourcing is a better option.

Here are a few factors you’ll need to consider before you make the decision to outsource this essential task.

1. Reputation

If you’re considering outsourcing medical billing and coding to a firm that specializes in such services, the first thing you need to do is narrow the playing field. In other words, you need to only consider partnering with a suitable company.

Research can start by asking trusted colleagues for referrals. Other doctors are sure to give you the unvarnished truth when it comes to medical billing services they’ve worked with. They’ll not only wax poetic about their favorites, but they’ll treat you to an earful concerning companies they’ve had problems with.

It’s best to take such accounts with a grain of salt and do some research on your own, but when a referral comes from a trusted source you’re more likely to follow advice than you would when reading anonymous consumer reviews online, for example.

Once you’ve narrowed your options you can then begin the process of consulting with different firms to compare services, pricing, and other important factors.

2. Services Offered

This is probably the most important aspect of choosing an appropriate resource for medical billing and coding. If the services you need aren’t offered, what the heck are you paying for?

At the very least, your billing service should provide guaranteed turnaround times for completing coding, submitting claims, and launching follow-up investigations for claims that have been delayed or denied. You should also seek out firms that have experience with your provider specialty so they are well aware of specifics for billing and coding for your practice.

You may also want to ascertain what kinds of extras they offer. Some firms are willing to provide additional advisory, monitoring, and management services related to medical billing and coding.

3. Cost

As a business owner you’re always concerned with the bottom line, so you need to carefully evaluate the financial benefits of outsourcing versus hiring in-house staff for the purposes of medical billing and coding. In most cases, outsourcing will end up being more economical for a variety of reasons.

First, there are known costs to consider. With in-house staff you’ll pay not only for salary and benefits (labor costs), but you’ll also be on the hook for hardware and software, including ongoing maintenance and upgrades. The company you outsource to will absorb the burden of these expenses and offer you access to a highly trained army of workers that you’d never be able to afford on your own.

Then there’s the return to consider. Many medical billing and coding firms have guaranteed turnaround for coding, submitting claims, making adjustments, and following up on claims that are delayed or have been denied. When you’re seeing a greater revenue stream and more timely returns as a result of outsourcing, the service is even more valuable.

Just don’t forget to make sure any firm you choose offers a payment plan that works for you, whether you pay a flat, monthly rate for services or you prefer to pay piecemeal for billing and coding.

4. Transparency

Even when you outsource to specialists, you still want to know what’s going on with your claims. A reputable and reliable firm should provide you with regular reports that show what they’ve been doing on your behalf and where you stand with claims. You don’t necessarily have to micromanage, but you do need to at least oversee billing to ensure that it is being handled in a timely and efficient manner.

5. Security

Patient privacy is of the utmost importance to your practice, not only because you’re running a business and your clients are trusting you with their sensitive data, but also because you have to comply with federal and state privacy laws, as well as HIPAA regulations. You must therefore make sure to find a trustworthy provider of medical billing services, one that takes security as seriously as you.

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