8 Reasons to Outsource Offshore Medical Billing

Outsource Offshore Medical Billing

Healthcare providers outsource offshore medical billing because of their need to minimize errors. By transferring billing functions to outside experts they also reduce costs and increase collections. 

In addition, the ICD-11 implementation and the Accountable Care Organizations (ACO) have put pressure on healthcare companies to seek innovative ways to stay profitable while providing exceptional patient care. This has positioned outsourced medical billing as an attractive solution for both small and large practices. According to a 2022 report made by The Business Research Company, medical billing outsourcing is expected to grow at a compound annual growth rate (CAGR) of 11.5%. This will outperform the $2.17 billion made in 2021 to an outstanding $13.56 billion in 2022.

Despite its popularity, outsourced medical billing is not for everyone. Keeping billing functions in-house remains strong for practices that are financially stable.  Outsourcing can be beneficial for your company if you’re in the dire need of increasing net collections and revenue. It becomes an even wiser business decision if your company is just a few steps away from financial disaster. There are, however, other reasons why outsourcing medical billing makes sense.

Below are 8 good reasons to outsource offshore medical billing:

1. Outsourced medical billing can help improve collections and revenue.

According to the Medical Group Management Association (MGMA), rejected claims can reach as high as 50 percent for some practices. More than half of these claims —at $25 per claim on average — go unworked. Claims over 120 days can add up to thousands of uncollected dollars. If not corrected, this can lead to a massive loss of revenue every month. Collections can drop due to several reasons: coding errors that lead to high denials and write-offs, high A/R, inefficient RCM processes, inexperienced billers, old systems, difficult claims, etc.

Identifying the exact cause of poor revenues within an organization can be challenging. A medical billing provider has the tools to quickly determine what is causing the problem. Aside from delivering an objective view, it implements immediate solutions to stabilize collections and slowly improve revenue cycles. Hospitals on the verge of bankruptcy outsource medical billing because of this reason. Even practices that are doing well financially can benefit from outsourcing, as there may be overlooked areas of improvement that a service provider can identify and exploit.

For instance, if errors are causing high denials and poor collections, a billing provider can scrub claims before they are submitted to the insurance carrier. The billing company can then provide individual coaching if the issue is caused by untrained billing staff.

2. Outsourced medical billing gives you access to skilled medical billers and coders.

High employee turnover and lack of skilled talent are issues in any industry, but they can be particularly debilitating to healthcare organizations that rely on experienced billers for their revenue. Billers specializing in complex or difficult claims such as motor vehicle accidents, mental health billing, and complicated surgery, are in demand and hard to find. It can also be difficult and expensive to hire the right people in certain locations. As such, some practices hire inexperienced billers. This can interfere with your revenue cycle, which can consequently have an impact on your revenue.

On the other hand, outsourcing medical billing to a third party means immediate access to the best billers, coders, and claims specialists. Whether local or offshore, experienced billing staff can perform high-quality work for their clients.

3. Outsourced medical billing provides you with better resources.

New practices need all the help they can get. Like any startup, new practice owners often do everything themselves due to limited resources. A medical billing provider can help control costs at the early stages of your business and customize billing solutions as your business grows.

By outsourcing, you can gain access to experienced medical billers and coders, the latest technology, and best-in-class RCM processes. You can also receive consulting services without the need to invest in recruitment and infrastructure.

4. Outsourced medical billing can help you improve patient care.

Physicians that perform admin duties and use legacy or paper-based systems are unable to fully focus on their patient’s health. More admin and paperwork means spending less time with patients, who can easily switch to another healthcare provider.

Patients today are more demanding and have higher expectations. They want access to their own information, and they want to be able to connect in multiple ways with their medical providers. For the practice, this often means digital transformation, which is a trait medical billing providers excel at. Offloading admin tasks to a medical billing company and switching to new systems can greatly improve patient satisfaction. It gives you more time to improve your medical services.

Sourcefit Philippines Outsourcing Blog: Reasons to Offshore Outsource Medical Billing

5. Outsourced medical billing provides better performance measurement.

Another advantage of outsourced medical billing is improved transparency and performance monitoring. 

Your billing partner will send you weekly, monthly and annual reports detailing billing and collections data and highlighting areas for improvement. They will also identify important patterns and will provide you with valuable revenue cycle insights. Some billing companies even go further by recommending solutions to improve their services and add value for their clients. It’s like receiving a report card that shows how outsourcing is impacting the bottom line, and how the service provider is living up to the service level agreement.

6. Outsourced medical billing helps you keep up with changing regulations.

Regulations in the healthcare industry are constantly changing, and keeping up with them can tax your resources. The ICD-11 transition alone, which increases the number of medical codes, is one of the biggest changes to hit the industry in years. Analysts expect increased claim denials and longer revenue cycles during the transition period, leading to low collections. Many healthcare organizations worked with third parties to navigate effectively through the ICD-11 changes. Billing companies are prepared for rollouts. They have systems and processes in place to help practices stay profitable during challenging times. Billing companies also ensure that your technology and processes comply with HIPAA and other healthcare laws.

7. Outsourced medical billing helps you save office space.

Paper documents can be a major problem for a growing practice. Patient registration forms, EOBs, insurance cards and medical charts can pile up. Storing them in the closet or basement is an option, but this practice is not aligned with the regulations established by the Health Insurance Portability Act (HIPAA). It also makes it difficult to access the right forms when you need them. Because practices are required to keep these legal documents for up to 10 years, boxes of paper can accumulate over time. If your practice is in the process of transitioning to EMR/EHR, a medical billing provider can scan the paper documents and store them electronically.

Some providers offer secure cloud storage with 24/7 access. Scanned records can be indexed in such a way that physicians and office staff can easily retrieve them. You can scan and archive these documents yourself, of course, but investing in a high-speed scanner and other equipment can be expensive. A service provider can provide scanning and storage services at very low rates.

8. Outsourced medical billing can provide you with better analytics.

Reputable medical billing providers understand the role of data in organizational transformation. They also know how to perform valuable insights for your company. The billing provider can help you identify strong and weak process areas by using analytics software and other sophisticated tools. This can help you maximize reimbursements by:

  • Detecting bottlenecks that slow down claims processing.
  • Identifying specific claims or insurance carriers that increase A/R days.
  • Training or coaching staff that are underperforming.

At the very least, clients enjoy the benefits of knowing exactly where they stand in terms of collections and profitability.

To learn more about outsourcing, you can read our Top 8 Qualities of an Outsourcing Company in the Philippines article. We invite you to follow us on social media and to visit our website to learn more about our services..

banner-finalAbout Us: Sourcefit is a widely recognized US-managed business process outsourcing company based in Manila, Philippines. We proudly serve over 100 clients with a workforce of more than 1,300 employees. Our global centers can serve multiple markets, and our staff is highly proficient in English, Spanish, French, and Portuguese. Whether you need a few or many employees, we can help you achieve your business goals and build high-quality offshore teams.

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