Healthcare organizations rely on the accuracy of their medical billing and coding operations to maximize revenue. Errors in billing and coding cause millions in lost revenue and waste valuable resources every year.
Medical billing and coding is complicated. Constantly changing payer rules, government regulations, and coding procedures make it very difficult for management and staff to keep up to date with all of these changes.
When is outsourcing your billing and coding operations the right choice?
There are several common symptoms healthcare organizations experience when in-house billing and coding operations breakdown, which leads to the decision to outsource.
- Lack of qualified staff and/or small talent pool
- No formal training programs
- A/R is growing or needs to stabilize
- Don't want the headache of managing people
- Employees wear multiple hats in smaller facilities leading to multiple conflicting priorities
- Poor cash flow
If you feel something isn't working (A/R is too high, staff can't keep up, missing revenue goals, etc.), outsourcing your billing and coding might be the right choice to get your finances back on track. For most healthcare organizations, the benefits of outsourcing outweigh the costs.
Benefits of Outsourcing:
- Budget neutral – spend stay the same but your revenue increases
- Fills gaps in staff (ex: maternity leave)
- Shortened revenue cycle – get paid faster
- Not one-size-fits-all, it's completely customizable (ex: project based, only a portion of billing, etc.)
- Mitigate risks of penalties and audits
Many healthcare CFOs face the decision to outsource (all or part of) their billing and coding operations — more open to in-house management alternatives than ever before — a viable option for hospitals, clinics, and healthcare systems. However, this decision shouldn't be made lightly, there are financial and legal implications to consider. When choosing a partner, make sure to set clear goals and expectations. Open lines of communication are also a very important for a long-lasting partnership.
If your healthcare organization is experiencing any of the common symptoms listed above, please contact our revenue cycle experts. Waiting too long can lead to cash flow paralysis and a diagnosis of long-term revenue cycle deficiency.