Outsourcing Your Ophthalmology Billing to Enhance Collections

Outsourcing Your Ophthalmology Billing to Enhance Collections

In a perfect world, companies would send out invoices, file insurance claims and be paid the full amount – on time – without any hassles.

Unfortunately, we do not live in a perfect world.

As a result, your billing clerk, office manager or other staff members who have been assigned medical billing responsibilities (in addition to their other duties), have to work very hard to make sure every penny owed is paid to your practice. In a perfect world, your staff would be able to handle every billing hiccup that occurs without missing a beat.

Again, this is not a perfect world.

Medical billing issues are extremely complex. It is becoming increasingly difficult for in-house billing staff to recoup payments on every service. As a result, more practices are moving toward outsourcing their medical billing responsibilities in an effort to make the process more profitable. In fact, Kareo’s Black Book 2014 report stated that 90% of singular, small physician practices plan to outsource their medical billing in the future. Practices are learning that the investment in outsourcing medical billing will actually grow their revenues.

It is important to note that outsourcing medical billing does not mean moving this process overseas. There are U.S. based companies that have the experience you need – not only with billing but also to effectively communicate with patients, if necessary.

11 Ways Outsourcing Improves Your Practice

  1. Overall expenses are reduced. Consider how much annual salary and benefits you pay your in-house billing expert. Consider how much money you spend on training that person to continually learn the new rules surrounding medical billing. Consider the amount of practice management software and computers that person needs to do the job. All of these costs could be eliminated by outsourcing your medical billing.
  2. Faster, more complete payments. It’s one thing to file a claim; but it’s a much more difficult process to follow-up on the claim, work claim denials and more. One person may not be able to effectively and efficiently move all of the claims through the system which will slow down your payments. When you have a team of billing experts on your side, you generally get a higher average rate of initial claims acceptance which translates into faster payments.
  3. Increase of clean claims: Get it done right the first time to save time and money. In-house billing staff may be overworked and not have time to spend on the nitty-gritty details of claim submission. This just results in more time spent down the line correcting rejected or denied claims due to inaccurate information. If your clean claim acceptance rate is below 95%, outsourcing this task may be your best move.
  4. Reduction in rejected claims. Often, claims will be rejected because of errors in coding, patient information or insurance identification information. Sadly, these can fall through the cracks if they are not closely followed, verified, corrected and resubmitted. This should be done within 24 hours of denial. If your in-house billing staff is not able to watch for these every day, you could be losing revenue.
  5. Appeal of denied claims: Not every denied claim should be appealed – your billing staff should have the expertise to know when to spend precious time submitting an appeal.
  6. Constantly updated technology. Your practice should be focusing your efforts on obtaining the latest medical technology to make your procedures more effective…not software and workflow technology. Outsourcing medical billing moves this responsibility to outside your office so you can gain the benefits of the changing technologies without the added expense and training needed to implement them.
  7. Expansive billing experience. Two heads…three heads…more…are better than one when it comes to medical billing. When you partner with a medical billing company that employs certified employees, you will have a team of experts on your side. For example, if you have an ophthalmic practice, there are medical billing companies that specialize in ophthalmology billing and have staff who are Ophthalmic Certified Specialists certified by the American Academy of Ophthalmology. You won’t feel as if you are turning your accounts payable over to people who have no idea about the intricacies of your field of expertise.
  8. Information and reports. Most physicians just assume that they are getting paid for the work they do every day. Unfortunately, with their days being full of patient care, staying on top of financial records can be difficult. Providing accurate, transparent and easily-accessible reports is one of the main responsibilities of outsourced billing companies. Your doctor will not have to request the information and wait for it to be assembled; it will be readily available at any time, day or night. This allows your doctor to have a more comprehensive view of the practice.
  9. Sticky situations. No practice likes to deal with collections, but these situations often arise. The more you are able to collect from overdue payments, the more your revenue will grow. Consider how many outstanding payments you have in your system right now – and what type of lost revenue that represents. An outsourced billing company will have the experience and training to make this process as seamless and effective as possible.
  10. Changing regulations. Just when your staff thinks they have the government billing regulations down, they change. There are continual updates to coding rules and regulations; if your in-house staff does not receive regular training, this could slow down your payments (due to red tape). Alternatively, medical billing companies are completely focused on this field (and HIPAA compliance) and they stand ready to quickly learn and implement changes. This is just one more hassle for which your practice will not have to pay for special training or spend time worrying about mistakes.
  11. More free space. By eliminating in-house personnel for medical billing, you may be able to free up office space for other usage. With the need for office equipment and desks removed, you could transform the once-occupied space for a consultation room, exam space or even a patient/family lounge.

If you would like to learn more about your options to help manage and grow your ophthalmology practice through outsourced medical billing, contact Advantage Healthcare Consulting, a Division of Advantage Administration, today. We have teamed up with Agnite Health LLC to offer this service in our Managed Service Organization (MSO). Agnite Health LLC is a U.S. based ophthalmic billing company with over 50 years of experience in this ever-changing field. Your practice can gain group purchasing power through our MSO on this service as well as many other benefits to increase your bottom line.