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Caliber Healthsource is a niche Revenue cycle management company with 50 years of collective experience

Medical billing, Medical coding, Revenue cycle management, Claims, Accounts receivable

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Medical Billing Outsourcing:

The concept of medical billing outsourcing originated from the need to hire specialists to perform a secondary task related to the medical profession. Most medical professionals concentrate so much on their work and tend to neglect other essential support functions related with their work. However, they cannot just ignore this problem, as it is essential for the smooth running of their work. They can always hire someone to do this job in-house; but it is costly, as many different expenses would have to be incurred. So, it is cheaper and easier to outsource these kind of jobs to service providers. Outsourcing medical billing has become very popular, as it has enabled medical professionals in hospitals and clinics to concentrate on their primary objective.

With the rise in the population every year, the number of patients needing medical care has also risen. Medical professionals are facing problems, as there aren't enough doctors to tend to the ever increasing number of patients. Doctors are finding it increasingly difficult to cope with the problems that arise with the running of their practice, and simultaneously, having to manage its affairs.

Other than healing people, doctors also have to deal with the other aspects of their practice, which is their compensation. Doctors heal people and hence, to some degree do selfless work, often working long hours; which leaves less time to deal with money matters. They usually have to employ a secretary to run their medical practice and handle the billing. Doctors who choose to hire someone to look after the billing in-house (which can be expensive); instead, can outsource it to a service provider. These service providers are professionals who are involved in the business of medical billing.

Medical billing processing is the procedure, by which a medical professional can make a claim for payment of the service provided, from the insurance company or the government. This process starts with the visit of a patient to a doctor, where the patient is provided with the treatment for his medical problems. The clinic or the hospital maintain a history of the patient's medical records. These records also contain a copy of the insurance card and a copy of the super bill, or an encounter form which has all the information about the type of treatment provided along with the coding of the procedure followed and the diagnosis made.

After the treatment a claim is filed, either to the insurance company that has insured the patient or to the government, together with all the records to collect the payment for the service provided to the patient. The process involves a lot of paperwork and attention to detail, as instances of claims being rejected due to mistakes in the details are many. Doctors and other medical professionals tend to neglect this aspect of their practice due to a hectic schedule. As a result, forms are not submitted on time and the chances of claims being rejected are also high, as they don't pay attention to detail. This may hamper the billing process and can lead to financial losses. The need to improve the efficiency of the billing process can be fulfilled by outsourcing the process to a medical billing company.

Many outsourcing companies have come up recently to tap the potential in the business of medical billing. These companies are engaged in all types of services, which primarily involve maximizing and hastening the billing process by improving on the details. The outsourcing of medical billing is usually done to both, off shore and onshore companies. Onshore outsourcing companies usually comprise both, individuals and limited companies located within the political boundaries of the country. Offshore companies are those located in different areas of the world, other than the country that houses the service seeker. The benefits of medical billing outsourcing are as follows.
•Saves time: The billing is done by the hired, third party company, so that doctors can concentrate entirely on treating their patients.
•Saves resources: There is no need of hiring additional staff to look after the billing or burden the existing staff with the same, as the billing is taken care off by the hired firm.
•Less rejection of claims: The billing firms are completely focused on the details, so detail-oriented errors which are the common reason for rejection, are lessened.
•Extra security: There are lesser chances of fraud occurring when the billing is done by a third party, as there are independent checks conducted on accounts and balances.
•Faster billing: The speed of the claims submission is usually faster than before and a persistent follow-up is done, which ultimately results in faster billing.
•Positive business growth: A billing firm provides regular reports, keeps track of the financial position of the medical practice or hospital. It also provides advise on various areas of improvement, resulting in positive growth.
•Better relations with the insurance companies: A billing firm can provide detailed information that can help in better negotiations with insurance companies.

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