Outsource Medical Billing?

Medical Billing has become increasingly complex. As a result, many providers evaluate outsourcing. New law, HIPAA, requires the same standards and rules for outsourcing companies as it does for the providers.

Other factors to consider about billing companies are:

  • Do they have the best systems in place for billing and coding
  • Since the billing company is an extension of the provider, will they be represented in a professional manner with patients and payers?
  • What is the track record for receivables management
  • Do they have certified coders on staff
  • What kind of references do they provide

With the advent of ICD-10 coding (2015), it is anticipated that more coders will be needed since it is likely both the old and the new codes will have to be used for some period of time so that the coder will actually be doing redundant coding, doubling the work. Experts say that many institutions will be seriously looking at outsourcing some or all of their coding.

If a billing company does the job well, they have incentives to collect more revenue than the provider since they are most often paid on a percentage basis. It is their business to stay current with changes in government or private insurance policies, rules, and law. All things considered, it is often a better alternative than keeping the coding and billing in-house.