Why Ophthalmology Practices Are Planning To Outsource Their Medical Billing

By Michael Carroll on September 14, 2016

For most small physician practices, medical billing expenses comprise a significant percentage of the overall expenses for the practice. Some small physician practices simply cannot afford to hire a dedicated billing clerk and assign billing responsibilities to office managers or another staff member. In these cases, physicians run an increased risk of losing hard earned money because office staff are overworked and often do not have time to pursue every penny earned. Also, in a smaller practice, your financial livelihood is based off of one biller.

  • What happens if that one person doesn’t show up for work?
  • How long would it take you to replace that biller?
  • Do you have protocols to ensure that the biller isn’t stealing from you?
  • Is the biller meeting all of benchmarks to make sure you are getting paid on a consistent and timely basis?

Medical Billing Outsourcing: A Growing Trend Among Small Physician Practices 

Medical billing issues are becoming increasingly complex and the cost to hire experienced billing clerks is on the rise. As a result of these factors, a growing number of solo physicians and small physician practices are planning to outsource their medical billing needs. Kareo’s Black Book (2014) indicates that 90% of these physicians who currently rely upon in-house billing plan to outsource their medical billing in the near future. Even practices with dedicated billing staff are exploring outsourcing, with 42 percent of small physician practices expressing the desire to outsource billing services.

The Benefits of Outsourced Medical Billing 

When some physicians initially consider outsourcing their medical billing responsibilities, they struggle with the prospect of relinquishing control of an important part of their practice. However, once these worries are considered in conjunction with the many advantages of outsourced medical billing, physicians are overwhelmingly likely to consider outsourcing billing. Below are the top ten benefits of outsourced medical billing.

1) A reduction in overall practice expenses. The amount of money saved annually by not employing a billing specialist is close to $40,000 USD. In addition to the money saved on salary-related expenses, a practice can save thousands of dollars by not having to invest in practice management software, computers, and training. The amount of money saved is enough to cover the cost of updating a surgical suite with a new surgical table, ophthalmic microscope, patient monitor and surgical light.

2) Ability to direct time and resources to new business development. Perhaps the single greatest benefit offered by billing outsourcing is the ability for physicians and support staff to devote more time to patient care as opposed to administrative tasks. This ultimately contributes to a better doctor-patient relationship and higher patient satisfaction.

3) Faster payments. Reimbursement delays tend to plague physician practices with in-house billing at a much higher rate than outsourced billing companies. Compared to in-house billing staff, the billing experts with outsourcing companies provide a higher average rate of claims acceptance with initial claims submissions. Some outsourcers strive to attain a 99% acceptance rate upon the first claim submission, which means that physicians are reimbursed faster.

4) The availability of sophisticated technology. Medical billing outsourcing specialists have access to the latest advanced workflow technology, reporting software, and phone systems. Additionally, physicians are able to view interactive billing reports through user-friendly web portals.

5) A higher level of billing expertise. The billing experts with outsourced medical billing companies have a proven track record of obtaining results through their industry experience. Small physician practices could add as much as $25,000 to their annual revenue simply by enlisting the expertise of an outsourced billing company. When the potential for compounding interest is considered, this additional revenue could potentially turn into $1 million over a 20 year span of time.

6) More office space for patient care. A key advantage of outsourced billing and collections is the availability of space that was once occupied by billing personnel, desks, files and office equipment. With in-house medical billing staff requiring an average of 150 square feet per employee, and physicians requiring an average of .75 administrative employees per physician, a small 4 physician practice will have an extra 450 square feet to devote to enhanced patient care by outsourcing billing. With an extra 450 square feet of space, a practice could open a new examination area or procedure room.

7) Access to financial and billing information at all times. Many physicians spend the majority of their days with patients and do not have time to review billing reports during the day. Outsourced billing companies offer full-time accessibility and transparency that are appreciated by physicians who may wish to access information at midnight or in the wee hours of the morning. Financial and billing reports are available 24 hours a day, 7 days a week.

8) Ability to provide a comprehensive array of billing-related services. Many outsourced medical billing companies offer a plethora of services in addition to handling your billing. Collections and cash payments are examples of optional services frequently offered by outsourcing companies. Notably, your practice can expect a 5% to 15% increase in the amount that they are able to collect by outsourcing billing.

9) Increased compliance with government and payor regulations. Payor and government billing regulations change with such frequency that it can be difficult for an in-house billing clerk to keep up with updates. The billing specialists with outsourced medical billing companies focus exclusively on billing practices. They receive the continuing education required to maintain a high level of proficiency with coding changes and current billing regulations.

10) Outsourcing doesn’t mean that it’s going overseas! Practices generally think that the word “outsourcing” means that the practice is sending its billing overseas. While this may be true for a lot of billing and medical management companies, there are companies like Agnite Health LLC who keep all operations right here in the USA. Quite simply, we believe that outsourcing your billing to experts in the USA will prove better than anything you can do in-house! According to the study, 99 percent of physicians prefer a U.S.-based vendor account manager to interact with practice staff and 94 percent of physicians prefer an onshore, U.S.-based call center for patients to reach out to.

How Outsourcing May Affect a Hypothetical Practice: A Look at the Numbers

While the benefits of outsourcing your billing seem attractive, it can be helpful to see a financial comparison of in-house versus outsourced billing before finalizing your decision. Physicians News Digest explores the question of whether your practice should outsource medical billing or stick to in-house billing. The article includes a comparison of in-house billing and outsourced billing using a hypothetical three-physician practice as a model. The comparison includes expenses related to billing, software, claims processing and collections costs. The results of the cost comparison strongly favors outsourcing, assuming that the outsourcing process will improve the billing collections process by at least 10%.

Seeking the Help of a Trusted Billing Business Partner 

The best way to determine whether your practice is ready for outsourced medical billing is to enlist the guidance of an industry expert. Agnite Health LLC offers a cost-effective, comprehensive solution that meets all of your billing and collection needs. Our trusted billing experts offer superb customer service and strive to attain a 99% acceptance rate during the first submission of your claim. Please contact us if you would like to learn more about the many benefits of outsourced medical billing. We look forward to hearing from you!