21 Mar Should Medical Coding and Billing be Outsourced?
Medical billing and coding can be handled in one of two ways. The first, which is in-house, has been standard for years. The second, outsourced, was at first a rarity, but today is becoming more and more common. The fact is there is no absolute right or wrong when it comes to who performs your medical coding and billing tasks. But many practitioners, hospitals, and others find that one, either in-house or outsourcing, fits them better than the other.
There are some key points to consider when deciding what route you should take in medical coding and billing. Here’s a consideration of the positives and negatives associated with both, and some recommendations when considering outsourcing.
In-House Pros and Cons
There are two major positives when it comes to performing medical coding and billing chores in-house. The first is that you have total control of all aspects of the process and your billing staff is readily accessible. Often this aids in the free flow of information between medical staff and those in charge of coding and billing. This can help to facilitate an effective and efficient billing cycle.
In addition, when billing in-house you are in control of and able to maintain the security of all information. There’s less chance of violating patient confidentiality and of breaking HIPPA laws. Both of which can be costly to any healthcare entity.
The two negatives most commonly associated with in-house medical coding and billing are cost and administrative challenges. It is more costly to hire and pay an in-house staff, as you’re responsible for salaries, benefits and other associated costs. Also, in some way or another, the practice, hospital, or other healthcare entity must deal with administrative issues, including employee relations and complaints, disciplinary and behavior problems, and performance evaluations and associated actions. These can become complicated, eat up time, money, and resources, and become a major distraction from what a healthcare practitioner, group, or organization should be doing, which is providing services.
Outsourcing Pros and Cons
There are various benefits that you can enjoy when you outsource your medical coding and billing. The first is cost effectiveness. Most medical billing companies are only paid when the person or organization for whom they are working is paid. The billing company receives an agreed upon percentage of each claim they successfully process.
Also, by utilizing a separate company to focus on coding and billing, you have more credibility with health insurance companies. This is due to the fact that with another party charged with handling your billing there’s less likelihood of fraudulent or negligent practices. With this being the case, there’s more transparency in the entire process and, thus, you’re practice is afforded more credibility. Plus, you’ll have access to all billing records, claims, and correspondence associated with your practice, group, or organization. That means you can always be up-to-date on the state of your invoicing and payments without having to administer it.
One negative associated with outsourcing is a loss of control in terms of managing personnel, coordinating invoicing, and maintaining security. In making your load a little lighter, the medical billing and coding company must also be given a certain amount of power as well as access to a wide range of confidential company and patient information.
The other factor that can be is con concerns hidden costs associated with the company that you hire. Make sure that you and your legal representative reviews all aspects of the agreement that you are about to enter into with the billing company. Look for, amongst other things, additional charges for generating reports, key services that may not be part of your standard agreement, which you may be billed separately for, and fees associated with your cancelling your contract.
When it comes to going with either in-house or outsourced medical coding and billing take the time to weigh all of the pros and cons. In the end, what you decide to do should be totally dependent on what works best for your particular situation.
MPMR offers the top outsourced medical billing nationwide to both physician practices and ambulatory facilities. Call us today to see how we can non only increase your revenue, but also help with operations management consulting too!