The billing outsourcing market size was $12.2 billion in 2022. But the issue is that almost 80% of the US medical bills contain errors. The reason for this error is that the healthcare resources do not have enough knowledge of all the billing guidelines, which leads to billing inaccuracies. So that is why many healthcare providers outsource medical billing services company to streamline their business operations. There are several features of the medical billers, but the essential 5 features that one can't overlook are:
Advantages of choosing a Medical Billing Services Company
• Compliance with all the updated regulations: The HIPAA, CPT, and HCPCS regulations are very complex to adhere to, which is why the billing inaccuracies occur as the healthcare staff do not have proper knowledge of all the complex regulations. Apart from that, as the billing regulations continuously change, so the healthcare staff do not have enough time to learn all the updated regulations as they have other important tasks to do. That is where a medical biller comes in with their experienced experts who adhere to all the billing regulations and double-check each claim so that no billing error occurs, thereby leading to smoother claim submission.
• Managing prior authorization complications: There are numerous complex procedures of prior authorization which becomes extremely difficult to manage for the providers. However, it has been observed that the medical services have experience of managing all the complex nuances of prior authorization. Hence, it leads to faster claim submission which ensures better ROI for the providers.
• Dedicated resource: Do you know what is one of the main reasons for claim denials? It's that the providers do not have enough time to thoroughly check all the nuanced billing intricacies, which leads to claim denials. It is no longer a secret that billing is a very complicated affair and claim submission can be highly costly for the providers. However, the in-house billing department is very expensive for the providers. On the other hand, outsourcing medical billing services company is highly cost-effective as they provide dedicated resources that will only focus on solving billing issues, thereby streamlining the claim process and reducing claim denials.
• They utilize advanced technology: Manual billing is very labor-intensive and also it takes a lot of time for the providers. Though it takes a lot of time, still numerous billing error exists which leads to claim denials because it's not possible to manually correct all the billing errors. So, that is where the medical billers use advanced billing software which not only automates the claim submission process but also saves a lot of time for the providers.
• Surprise billing professional management: Surprise billing is one of the biggest issues that providers face. It occurs when a patient receives a bill from an out-of-network provider which was not expected, thereby leading to an increase in healthcare costs. However, the outsourced medical billers are experts at handling intricate issues by strictly following the No Surprise Act law so that the patients do not get a surprise medical bill, which leads to quicker claim submission and increased revenue growth.
Hence, managing all the intricacies of billing is highly challenging for the providers to manage. Moreover, using an in-house billing team is also very costly for the providers, which can reduce their cash flow. So that is why it can be a feasible option to outsource a medical billing services company that stays updated with all the healthcare regulations and takes less cost compared to an in-house billing team. Moreover, their experienced experts double-check all the complex nuances of billing to make a streamlined claim submission which leads to an increase in revenue.
References - https://www.grandviewresearch.com/industry-analysis/medical-billing-outsourcing-market