In-house vs. Outsourced Billing
In-House Medical Billing • Pros – Maintaining Control (long-time, trusted, hands-on employees) – Capitalizing on Investment (trained medical billers and PM system) – Proximity to Staff (when problems arise, walk across the office) • Cons – Increased Costs (labor, technology, office expenses) – Liability Issues (staff neglect of encounters, superbills, denials, theft) – Staffing Issues (finding qualified help, vacations, sick-time, turnover)
Outsourced Medical Billing • Pros – Lower Costs (lower employee costs/expenses, no turnover issues) – Accountability (billing company offers reporting and accountability) – Consistency (contractual obligation for services) • Cons – Loss of Control (giving up control to a third party) – Variable costs (collection % results in charges based on volume)
Additional Challenges for Consideration • Declining Reimbursement • Increase patient workload to stay even financially • Affordable Care Act (aka Obamacare) • • Electronic Health Record deployment Changing regulatory environment Claims follow and denials management Staff turnover, sick time, vacation time, etc.
How much can you outsource? • • • • EOB Management Primary & Secondary Billing / Rebilling Electronic Claims Submission Medical Billing Forms (HCFA and UB-92 forms) Line-item Payment Posting Electronic Eligibility Verification Patient Statement Cycling Professional & Institutional Claims Clean Claims Rules Engine Workers Comp and No-Fault Financial Reporting (Account, claim and lineitem level) Electronic Remittance Advice (EOB) Electronic Superbill Payment Plans and Collections Patient Account Management
Other Benefits of Outsourcing • • Focus on patients and service quality Reduced errors and improved accuracy Decreased labor cost and overheads Increase % of paid claims, reduced write-offs • • Maximize reimbursement, revenue, cash-flow Less employee stress and HR issues Better compliance with regulations 20% software cost saving with RCM services
Thank you! Cure. MD Corporation 55 Broad Street, New York, NY 10004 Tel: (212) 509 -6200 www. curemd. com
Скачать презентацию In-house vs Outsourced Billing In-House Medical Billing
62dddae01a4b5150ad3a4dd11649e4d3.ppt