Four Benefits Of Outsourcing Medical Insurance & Billing

Running a medical practice takes a lot of work, whether in a big city or a small town. Medical offices are homes to primary care providers, specialists, surgeon consultants, therapists, and other healthcare professionals. These offices must balance many daily tasks as they seek to provide the best quality care to the patients who walk through the door. Staff often have their hands complete when handling patient calls, messages, faxes, medication refill requests, prior authorizations, and other clinical matters. Even with a great staff of PSRs, medical assistants, supervisors, and a manager, you may need help dealing with billing issues. Below is our guide that explains the four benefits of outsourcing medical insurance and billing matters to a third party.

1. Successfully Start A New Practice

When starting a new business, especially in the healthcare industry, you must pay close attention to your finances. While the money you spend on office supplies, medical equipment, and staff salaries is essential, ABA billing claims are a far more critical factor in whether your business survives the first few years.

You submit a claim every time your practice sees a patient with an insurance plan. Ensuring these claims are processed correctly and without hiccups means your business receives money promptly. Entrusting this work to the one or two billing professionals you hire is risky and unnecessary in 2023.

There are countless reputable third parties you can contact for ABA billing services. Such companies have many current billing and insurance claims professionals on the latest standards and laws. They will ensure that every claim related to your practice is filed correctly and accurately.

Using such a service for ABA billing is more accurate and cost-effective. The fee to a third party is much less than the full-time salaries you would have to pay to billing professionals.

2. Avoid Costly Errors

The average healthcare practice has a five to ten percent denial rate for medical insurance claims. Such a standard may be acceptable for larger organizations, as those hospital networks have other revenue streams that make up for the loss. You will want to keep those denials to under five percent when running a small to mid-sized clinic.

Such a figure is tough to achieve if you plan to keep your billing and insurance claims department in-house. Those professionals would have a significant burden on their shoulders, as any errors they make would cost your clinic a lot of money.

Hiring third-party professionals to handle ABA billing is a much more sensible option. They have the experience and staffing to provide you with the prompt and accurate billing and insurance claims services you seek.

3. Too Many Employee Absences

Most healthcare practices with three to four providers will not budget for more than one or two billing professionals. You can keep up with the ABA billing workload when those employees work their regular shifts.

The problem arises when one or more of those employees is absent. One employee may have a scheduled holiday while the other is unwell and has to take unscheduled PTO or sick days during the same period. Now you need billing professionals, which can cause your office to lag significantly behind billing and insurance claims.

Obtaining replacement personnel is expensive and often ineffective, as you must go through a temp agency and can only sometimes get qualified replacements on short notice.

4. Lack Of Staff Experience

Another issue for medical facilities is that staff members may sometimes have the requisite experience to handle medical billing and insurance claims. Your staff may not receive periodic training on ABA therapy, which can result in them falling behind the most recent standards.

While such a lack of training may not be apparent in every claim they file, mistakes will add up over time. Getting staff the appropriate training costs money, and it also requires them to spend several workdays receiving training and going through the relevant competency testing.

Rather than constantly worrying about your staff being up to date on the latest ABA billing standards, you can outsource the work to a third party.

Handling ABA billing in-house in 2023 is a significant mistake for nearly all medical facilities and healthcare practices. Unless you are under a considerable hospital network umbrella, you should not attempt to handle billing and insurance issues in-house. The desire to keep all aspects of your practice in-house is tempting but will likely cause stress and other cases if you embark on this without external assistance. Rather than maintaining a streamlined operation, trying to handle billing and insurance claims will only cause you problems and cause losses in the long term. Third-party professionals are there to make this aspect of your business run smoothly. Hard work is essential in business, but so is working smartly by conserving your precious energy for the areas of your business where it is most effective.

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