This is a very difficult decision for any doctor and partly comes down to this or her own ideology and level of comfort.
Hospital doctors will almost always be better at outsourcing because of office-related expenses that they would not otherwise incur. As the owner of the medical billing service, you might think that I am naturally inclined to outsource. I can assure you that it is not.
Doctors who overly control, inconveniently or incorrectly trust the billing services are almost impossible to manage. I do not want to have anything in common with these types of doctors, but I fully respect and understand their point of view. Putting all ideology aside, I would like to delve into the pros and cons of this complex and complex decision.
I am a doctor who is very interested in the business aspect of medicine, and I don’t mind spending my precious time managing the medical billing aspect of my practice.
Obviously, the best way to do your calculation is to do it in person. Obviously, doing it yourself is probably not an option, but if you want to spend time and show interest, I would recommend that you do your own billing. Keep in mind that most billing service owners and, of course, our employees have limited medical experience. Doctors who study CPT, regularly attend billing seminars and are constantly updated on industry changes are, in my opinion, the latest medical gurus.
I am a doctor who has absolutely no time or interest in the medical billing aspect of my practice. I completely rely on my office manager and billing staff.
Unfortunately, most doctors are in this position. Even if they were interested in keeping up with all the changes and elements of medical billing, the practical reality is that there is absolutely no time. Let it stand; time is your most valuable asset. This is like mowing your own lawn. On Saturday morning, you’ll better receive financial assistance for patients for three hours. I believe that the following information will greatly help in deciding your question about outsourcing your billing or continue to do this independently and with future decisions in the ever-changing business aspect of medicine.
The advantages and disadvantages of outsourcing your medical billing services.
I would like a foreword to this article with a few obvious but important points. If you have a control system, do not forget about the competence of your office manager, you have an excellent computer system, the correct information systems and your office do an excellent job of collecting your money, and then by all means make no changes. Conversely, if you plan to outsource your billing, make sure you hire a quality company. I will spend some time at the end of this article, discussing this further.
Most leading experts agree that about 4.5% of net collections cost to perform the function of invoicing in the doctor’s office. By the way, this is close to my actual cost.
Theoretically, the billing service should collect more money than the doctor’s office, because it is our core competency. The question is, how much more? That is why I focus on how to choose a billing service at the end of this article.
Numbers
A. Let's just do the math in a theoretical model.
We will base our numbers in practice, the total amount of accounts receivable is $ 100,000 per month. Obviously, this is a too simplified model, designed to quantify the total costs and opportunity costs only for the medical billing component.
Current Total Billing Costs
Internal expenses
Total gross income $ 100,000
Current billing costs $ 4500
(4.5%) ---------------
Net income $ 95,500
Outsourcing Costs
Total gross income $ 100,000
Current billing service exp. 7,000 USD
(7.0% of net collection) ---------------
Net income of $ 93,000
Net value increase with outsourcing = $ 2,500.00
As you can see in this, the “all things are equal” theoretical model, your practice will lead to a decrease in net income by $ 2,500 when implementing an outsourcing billing strategy. Keep in mind that this model does not affect other less tangible problems, such as salary cuts, computer expenses, etc. In fact, the net worth may be significantly less than $ 2,500. Many doctors will take it as a small price to pay, while others consider it a costly price.
5% theoretical increase in gross income using outsourcing
Total gross income $ 105,000 (5%)
The expiration date of the payment order is USD 7,350
(7% of net collection) ----------------
Net income $ 97,650
$ 95,500 - $ 97,650 = $ 2,150, which means an increase in net income.
As you can see from this model with a 5% increase in fees, your net income will increase by 2,150.00 US dollars due to the additional costs of the billing service. Keep in mind that the increase in gross assemblies by 5% is actually quite conservative and should be easily obtained by a quality billing service.
intangible assets
B. The billing service should be able to provide you with a significant reduction in your daily aggravating circumstances, such as problems with practice management software, fewer employees, hiring competent employees, less medical insurance, less training, ECT, etc. And vice versa , you even lose control of your practice. If the billing service does not collect more money, your expenses will increase. It is up to you to determine whether the cost increase is offset by reducing the degree of exacerbation.
security
C. The billing service should be able to increase the level of security by creating a system of checks and balances. As a former police officer, I can assure you that crime statistics indicate that most of the theft / fraud / theft comes from within. During the investigation, Sears and Roebuck Co. Store Manager once told me: "Our customers take it in parts, but our employees take it in barrels." This logic also applies to the doctor’s office. The billing service can provide an additional level of protection since there is a system of independent checks and balances. Usually billing services are quite large enterprises with strict internal control. My organization Medi-Bill Inc. manages the internally similar banking institution in the way we handle funds. There is no doubt that the ownership of a reputable medical billing firm will put at risk the consequences of committing fraud with a client.
Conversely, the problem again comes down to control. For obvious reasons, many doctors are not at all concerned that their checks and correspondence were delivered directly to the billing service. A further aggravation of this dilemma is “what happens to the checks and correspondence after the termination of the billing agreement?” (Again, we will discuss alternatives at the end of the article)
Technologies
D. Modern practice management software is an extremely expensive investment. If you’ve already invested in a high-end computer system, I don’t think that outsourcing your billing will be financially important if your computer provider does not charge excessive support fees. If you are planning to purchase a computer system or a medical record management system, my favorite provider, with whom we have been working for more than 15 years, is Office Management Solutions (OMS), based in Tampa Florida. The owner’s name is John Piquet, and he is by far the most honest and authoritative computer supplier I've ever worked with. OMS can be obtained by calling 813-963-5582 or at http://www.oms-online.com.
If you need to upgrade your system, purchase a new system, or your support fees will be out of control, this may be the right time to consider your billing outsourcing services.
Financial security
F. Many doctors for obvious reasons do not want their office managers / employees to have any in-depth knowledge of how much money this practice makes. Reputational and correctly executed billing service can create such a level of financial security. The best scenario is for your employees to only see your expenses and have a limited understanding of the income generated. This can also be done internally by making and recording your own deposits. If you are going to do your own billing, I must stress the importance of financial security. You must create a financial security system. If you do not have time to personally open your mail and make deposits, you are definitely a candidate for outsourcing. Many banks offer a “lock” where you can send your checks and correspondence. Banking booth services are usually quite expensive. Usually they charge about 0.25 per copy. You can also choose your own mailbox located next to your billing company. Thus, you still control your checks and correspondence.
Collection Agencies
G. Many billing services are owned or affiliated with collection agencies. You definitely want to avoid this situation. Make sure your billing service provides you with a monthly report containing the correct delinquent account information, allowing your office manager to send the information to the agency of your choice. In my opinion, billing services owned by collection agencies or establishing close partnerships with them are unethical and should be avoided at all costs. Although it is almost impossible to find a collection agency that has no relationship with medical billing services, the point I'm trying to do is to make sure your billing service is independent and you have the freedom to choose a collection agency payments of your choice. This relationship is a scenario where the billing service can simply go after a simple collection of bills and allow more difficult, but still collectable, to fall into the hands of a collection agency, which obviously charges a much higher percentage of collections. Again, it’s easy to see how the billing service can ease or undermine your sense of control. The most authoritative collection agency I considered was a company called the Bureau of Information Collection (CIB). I have been doing business with them for many years, and they have never tried to establish partnerships with my company. CIB can be reached at 1-800-231-3514, contact sandy Lopez.
Different types of billing services
There are three different types of billing services.
* Application fee
* 50/50
* Full range of services
The fee for billing services for the application charges a flat rate for each claim. Fees typically range from $ 1.25 to $ 5.00 per application, depending on the services provided.
Benefits:
· May be useful for a completely new practice that has not fully implemented a computer system or is still trying to decide whether to outsource.
· Practice with old or outdated computer systems.
· Relatively inexpensive cost per bid
· Great for a practice that has a problem with only one specific payer group, such as Medicare or payers that require electronic filing
· Doctors plan to resign within one year
· High flexibility
· Practice with a small amount
· Less staff
Disadvantages:
* Expensive to practice large volume
* Poor integrity of receivables
* Lack of information systems
* Lack of control
50/50
50/50 billing services install a computer terminal / terminals in your office. The billing service performs part of the billing process, and your office performs another. As you can probably tell from my list of flaws, this is, in my opinion, the least desirable type of billing service.
Benefits:
· Less expensive than full service
· Avoid buying practice management software.
· Creates a system of checks and balances
· Less staff
Disadvantages:
* High commission for installation
* Low responsibility from the billing service
* Lack of control
* Communication problems (all collection problems will depend on your office)
* Your staff will probably finish most of the work anyway.
* Fully dependent on the Internet
* Data loss
* HIPPA Questions
Full range of services
Benefits:
· Completely remove the billing process from your office
· Symbiotic relationship
· Avoid expensive computer systems.
· Checks and balances
· Less staff
Disadvantages:
· Expensive
· Loss of control
· Patient relationships
· Collection agencies
Should I redirect my billing checklist: if you answer yes to most of the following questions, then you should probably consider outsourcing?
· Is your total collection declining?
· Too high receivables?
· Do you experience an increased number of denied claims?
· Is there a high level of frustration with your billing / office?
· Are you facing a major investment in new hardware or software?
· High fees for supporting your computer?
· Do you have a hard time storing or hiring experienced billing staff?
· Do you spend too much time on the business aspect of medicine?
· Are you concerned that your staff or office manager knows your earnings?
Are you completely dependent on your office manager?
· Do you plan to expand your practice?
· Do you think that the cost structure of your business is too high?
· Do you have several employees performing tasks that can be handled by one more experienced manager?
· Is your computer system out of date?
· Do hardware, software, and information technology disable your practice?
How to choose a billing service?
1. The service must match or complement the size of your actual practice. Try to get a general idea of the size of the firm. Solo practice is likely to be more successful in a small and medium billing company. It is obvious that a practicing solo family probably will not be very well served by a publicly traded company.
2. Avoid long-term contracts. You must be entitled to terminate your agreement at any time within 30 days with written notice. The agreement should clearly state what each side will do for the other. Ensure that the agreement ensures that you will receive a detailed account receivable upon completion. [listed by individual patient],
3. Request links and call other providers!
4. Inquire / investigate the actual owner of the company. Ask to speak with the owner directly.
5. Avoid firms that offer too many different types of services. Medical billing is a very specialized area. Companies offering collection services, payroll, financial consulting, tax consulting, negligence insurance, marketing services, etc., etc. In my opinion, they are not focused enough on what they need to do. Collect your money!
6. Ask other doctors. Do not forget about this, because doctors who are satisfied with their billing company do not need to grow and usually like to keep a low profile on this issue.
7. Is billing service for sale? Try to find out whether or not the firm was recently sold. In your contract / agreement, you must request a notification within 30 days from the date of sale. In my experience, billing sales are constantly being bought and sold. Sometimes the acquisition is a positive thing, but quite often a merger / acquisition can be very harmful. You must at least be informed and give enough time to make the right decision about whether you will stay with a new company or choose another one.
8. Where will your checks and correspondence be delivered? This delicate and important issue should not be as difficult as it seems. Многие врачи по очевидным причинам связаны с тем, чтобы проверки и переписка были отправлены непосредственно в их биллинговую службу. Некоторые авторитетные, высококачественные биллинговые услуги даже не предоставляют услуги клиентам, которые настаивают на том, чтобы их проверки и переписка были переданы им напрямую. Я хотел бы потратить несколько минут на эту важную проблему и объяснить последствия именно того, где будут проводиться ваши проверки и корреспонденция. Поддержание целостности вашей дебиторской задолженности имеет решающее значение! Если ваш офис регулярно не может правильно отправлять копии чеков и корреспонденции вашей биллинговой компании, ваша практика может быть подвергнута серьезной опасности потерять контроль над дебиторской задолженностью. Если ваша дебиторская задолженность должна поддерживать любое подобие финансовой целостности, критически важно, чтобы работники биллингового обслуживания не тратили драгоценное время и силы на последующие выплаты, которые уже были оплачены и не были должным образом направлены им. Понятно, что ваш сервис может даже рассматривать это как намеренную попытку сократить свои обязанности. Опять же, банковские блоки блокировки являются альтернативой этой дилемме. Некоторые методы разрешают эту проблему, направляя все проверки и корреспонденцию в PO Box, сохраняя EOB отдельно от другой корпоративной почты. Проверки и переписка подаются в биллинговую службу «нераспечатанной» раз в две недели. Это отличный компромисс и создает систему контроля. Существует много других возможных вариантов, но важно помнить, что один объект должен нести полную ответственность за достоверность и целостность вашего EOB.
9. Удостоверьтесь, что все чеки и корреспонденции выданы под вашим идентификационным номером налога и выплачены вам! Убедитесь, что в вашем договоре / соглашении указано, что биллинговая служба не будет подписывать или пытаться списать ваши чеки и корреспонденцию.
