Why Doctors Need to Contract Out Their Medical Billing and Coding

Medical billing

Every medical office relies on the same system of medical billing and coding to get paid by insurers and government payers. That system is extremely complex, with an alphanumeric code for every kind of diagnosis and treatment. Many of the codes have several layers of modifiers, making them even more complicated.

Traditionally, each medical office had its own billing staff, but with the standardized codes and the number of constantly changing rules and regulations, it has become more effective for doctors to contract out, or outsource, their medical billing and coding to companies that specialize only in those services.

Outsourcing Medical Billing Increases Revenue

When in-house staff is responsible for billing and coding, there are often claims that get abandoned, particularly if they have been denied by the insurer. Finding the issues with claim payment and getting them corrected can be very time consuming, so many office staff decide it just isn’t worth the effort to fight with the insurer when a denial is received.

A good medical billing and coding service will have a system for efficiently sorting out the issue with the claim and handling the appeal. Keeping track of claims so that each one gets paid is a large part of our success as a medical billing and coding company.

Hiring a Professional Medical Billing and Coding Company Saves money

One of the biggest hurdles to getting doctors to outsource their medical billing is concern about taking on more expenses when their budgets are already tight. That really does not need to be a concern. The way medical billing is usually set up is that the billing company gets a small percentage of the money collected.

If the doctor never gets reimbursement for a claim, the billing company never gets paid for processing it. By only collecting a percentage of collections, medical billing and coding services have a good incentive to make sure they collect payment for each claim. The doctor pays more when they receive more payments, but if payments drop off, then so does the amount that gets paid for medical billing.

Turning Over Billing Frees Up Staff and Increases Job Satisfaction

There is another, non-monetary advantage to hiring a medical billing company, and that is that when doctors and other medical staff don’t have to worry about managing the billing and coding, they are free to devote their attention to patient care. This results in less stress and distraction for the staff. Coding and billing stress has even been the reason for physicians taking early retirement. By giving those tasks to specialists who can devote all their time and attention to them, medical professionals have experienced much more job satisfaction.

Outsourcing Reduces Office Space and HR Needs

When medical billing is handled by an outside firm, the medical practice no longer needs to provide office space for it, so they can either reduce the space they rent, or use that space for something else. Outsourcing also reduces the number of people requiring HR support and saves the expense and time investment of hiring and training new coding and billing staff every time someone quits their job.

In addition to medical billing and coding, businesses like Medicare MSO offer a full suite of revenue cycle management (RCM) services, including payer credentialing, charting compliance reviews, end of year assessments, payback, etc. Having one company handling all these tasks makes it easier for administrators to coordinate with them and saves the effort of finding a new consultant for each service that is needed.