With rising costs worldwide, Cutting cost is priority for every organisation including the medical billing but without the expense of quality. Companies operating in US offering Medical billing services on various specialties to healthcare professionals related to different walks of life such as provider offices, hospitals, insurance companies, Vendors, Lawyers in Legal sector, Medical billing and Coding solution providers individuals or companies would want to decrease cost to stay competitive or to be more profitable. This article looks at Medical billing cost, the related services and how outsourcing of it can be beneficial for US companies.

Medical Billing Services And Outsourcing

Most of the Medical billing companies offer complete RCM (Revenue Cycle Management Services) starting from appointment booking to Patient statement and following up on outstanding claims/bills. These all, or some of the, services can be obtained by outsourcing located outside in third world countries. Companies offering RCM in third world countries not only have certified staff but also have trained and experienced workforce to offer on relatively lower cost and more efficiently due to their production of cost is lower in those countries. Few of the most outsourced services are as follows:

Clinical Auditing

Some of the companies outside US offer certain services free and Auditing is one of them. To find out how your Practice is performing against the targeted/established guidelines on various sectors such as financial health, the first thing the practice needs to consider is a Practice Audit. Audits help identify the financial health, The lagging processes and areas of improvement.

Clean Claim Rate

Another factor which plays critical role in Denial avoidance and management and one of the major sector which, if under performs, can drag the whole practice efficiency down and increases the cost is your first claim submission success rate. Normally this figure should be 95% or above If your practice is not to lose revenue and that also help reduce the cost as it eliminates the repetitive work in resubmission on claims and Clean submission can also reduce the A/R aging to less then 30 days which means less labor. With this service outsourced, practice one of the main cause of cost can significantly be dragged down, since this approach tries to be proactive, this lessen the cost of Denial management department.

Electronic Submission

Normally it depends upon the insurance company how they would like the claims to be submitted. But if you have the Electronic submission (Insurance has Payer ID and EDI is the method) option along with Paper submission, then practice should focus on outsourcing this part as this can help reduce cost of the practice. Electronic submission can reach the insurance company within 3-7 days. But if your major portion is paper based claim submission, you can still outsource them, since it will not only help save cost on stationeries, postage cost but also help save labor cost as quick response means quick job completion.

A/R Management

Account receivables is very important part of medical billing practice as it tells the claim status and money received against each claim is another major cost related services. Once the claim gets in aging bucket, the investigations start as to why we have not received the payment against the claim and this means physical intervention by labor, and a lot of calling. This whole practice of A/R management require a lot of resources and time and can drag the whole practice efficiency down. If this to be outsourced, one of the major cost of your service can be controlled.

Medical Billing Cost And Outsourcing
Labor Cost

One of the most cost heavy department is labor in every business let alone medical billing, the people who work for the practice. Now outsourcing beats this with hands down and can save upto 40% of the cost in general. Overall cost saving can depend upon the services you outsource but since labor can work on the fraction of the cost compared to labor working in US the saving can be high.

For example, Savings for 10 member of staff working at USD 30/Hour, the annual labour cost workouts to USD 63,600. If this is compared to labour working outside US in third world countries, they can work for USD 15/Hour or on Revenue collected basis (normally 5 to 10% of the total Revenue earned). And on top of that there is no Employee benefit plans to worry about. With this formula in mind, 40% saving on labour is inevitable.

Enhanced Efficiency

Since the companies sitting outside US can afford more people than the companies in US given the cost budget, which means they have more resources at their disposable to get the job done quicker which makes them more efficient than US companies. Also training of the staff is cheaper in third world countries, and staff is available on rather cheaper rates, this help provider become more efficient.

Cost-Effective Services with the Same Quality

The provider who normally get the billing done from other companies in US. The same services he is getting from US companies, he can get one or all of them from the companies working outside the US on affordable cost with no compromise on quality since good companies outside US employ experienced, skilled and certified professionals. The reason they can employee more professional people is because they can still afford them even with lesser rates offered compared to US. This is very important for new providers who just has started their services. Such an approach can help them grow faster by saving more.

Cost Structure

Companies offering services from outside US normally charge 5 to 10% of the total revenue they help earn through their billing. Their add on service charges may vary such as Coding (USD 10/patient), Credentialing (USD 180/Patient), Appointment Scheduling (USD 15/patient), Advance plan Benefit Verification (USD 5/patient) etc. This overall cost structure along with operation cost (Rent, utility bills etc) add upto saving of close to 30 to 40% depending on the deal you get.

Legal Aspect And HIPPA Compliance

This is very important when it comes to outsourcing. Practice offering medical billing services has to be HIPPA compliant and to be HIPPA compliant the companies offering services has to be registered in US. But if you are registered in US, how come you offer services from third world countries? Different companies have come up with different solution. One of them is that they register themselves in US with one of their representative staying in US permanently. The company is registered under the employee in US. Then these companies train their staff on Compliance with online certified tools available and test their compliance with Risk assessment tools developed by National Coordinator for Health Information Technology (ONC) and the HHS Office for Civil Rights (OCR). With these certifications, their services become compliant with HIPPA.

Outsourcing the Medical billing practice

One of the best solution to manage the cost of Medical billing is to outsource the whole medical billing process to companies in third world countries. This practice is perfectly legal with certified, well trained and experienced staff available there. This way the cost can of Medical billing can be reduced more then 40%. As staffing in USA is expensive along with their holidays and premises management. This all can be taken care of by the outsourcing companies with same or more efficient practice operations being more profitable.

How providers/Medical practice can be more profitable?

We at MTServices offer cost reduction on medical billing and coding solutions to companies operating in USA. Our team consist of certified coders, experienced and well-trained billers, having complete expertise on RCM (Revenue cycle management) with add on services, such as credentialing, Appointment booking, Auditing etc. With 50% cost reduction promised compared to other companies operating in US you can be rest assured that quality of services will not be compromised.

If you would like to know more about how you can save cost on your Practice, please contact us at info@mtservices.pro