Being a healthcare provider, one of the greatest problems that you encounter is the financial well being of your practice. Your billing system is also essential regardless of whether you are a small clinic or specialty practice such as thoracic surgery to ensure cash flow and profitability. However, it is a shame that in-house billing may sometimes result in errors, inefficiencies, and slow payments, which eventually impact on your bottom line.
This is where outsourced medical billing services come into play. Outsourcing your billing can help you get better results on your revenue cycle, reduce your denials, and improve the financial performance of your practice. Throughout this paper, we will discuss the ways outsourcing your billing management would assist your thoracic surgery practice to streamline its operations, enhance accuracy, and increase revenue.
What is Outsourced Billing Management?
Outsourced billing management can be defined as the activity through which you engage another company to undertake your medical billing operations. Such services are intended to deal with the coding and submitting claims, posting and managing payment, and denials. With the help of the talent of an outsourced billing partner, you will be able to outsource administrative tasks, minimize mistakes and make sure that payment is timely.
In the case of a thoracic surgery practice, the services of an outsourced billing would be able to perform a broad scope of activities:
- Coding and Charge Capture: Appropriate coding of thoracic surgery to make them in accordance with reimbursement rates.
- Claim Submission: Submission of claims to the insurance companies, where they are in adherence to the payer guidelines and ensure that they are submitted on time.
- Denial Management: Handling and appealing of claim denials to recoup revenue in a short period of time.
- Payment Posting and Reconciliation: To prepare payment and reconcile accounts to make sure they have gathered all the funds and recorded them.
- Accounts Receivable (AR) Follow-up: Handling the outstanding payments and shrinking the AR days to improve the cash flow.
Outsourced billing means that your practice will have access to a team of skilled billing experts and will be able to streamline their revenue cycle and ensure that they are being paid what they are worth to do the amount of work that they are performing.
Advantages of Outsourcing the Medical Billing of Thoracic Surgery Practices
When outsourcing your billing management, you are able to open several benefits that directly affect the financial status of your practice. The following are the most significant advantages of thoracic surgery practices:
Improved Cash Flow
The main objective of a billing system is to make claims fast and payments are received fast. Outsource medical billing services guarantee the practice an efficient system of submitting and following up claims. Claims are submitted promptly with a dedicated team of billing experts and follow-ups are undertaken immediately thus saving on time it will take you to realize a revenue out of the procedures.
In the case of a thoracic surgery practice, it will result in quicker reimbursement of complicated surgeries such as lobectomy or lung transplant operations, which are time-consuming and demand accurate coding. Outsourcing billing will also mean that all claims are turned in efficiently resulting in better cash flow and less delay in reimbursement.
Cost Savings
On-site billing departments are associated with a huge price: wages, bonuses, education, and technology. These costs can be cut down by a large margin by outsourcing. There is no longer any need to employ and retain a billing staff, install billing software, or train new staff. Rather, you have the advantages of having a team of professional billers at a fraction of the price.
In the case of a thoracic surgery practice, billing services may be particularly helpful to outsource as coding of complex operations such as thoracotomy or video-assisted thoracoscopic surgery (VATS) may be quite complex and time-consuming. Outsourced billing services help you save both time and money as you do not have to take the risk of spending money on hiring more employees to work with such specialized codes.
More Accurate and Less Denials
Among the major causes of payment delays and denials are billing errors. In case your practice is doing billing internally, then it is simple to make coding mistakes or err in claims submission. The mistakes may result in late payments, missed money, and accumulation of unpaid claims.
To reduce these problems, outsourcing the medical billing of your organization to a group of experts will assist you. The outsourced medical billing personnel will have the advantage of having specialists who are up-to-date with the most current coding systems and payer specifications. They are capable of coding thoracic surgery procedures correctly (e.g., pneumonectomy or bronchoscopy) that are both complicated and subject to coding errors. Outsourcing billing can also be able to minimize the rate of denials by providing accurate claims and enhancing the chances of receiving the full amount of reimbursements.
Increased Accuracy and Reduced Denials
The healthcare regulations and codes are evolving continuously. It is necessary to keep up with these updates in order to comply with them and not to be punished. In the context of thoracic surgery practice, it would be necessary to keep up with the latest ICD-10 codes, CPT codes, and Medicare reimbursement rates according to the surgical procedure.
By outsourcing the billing, you would be able to utilize the knowledge of experts who are committed to ensuring that they are abreast of such changes. They make sure that each of the claims is made according to the most recent regulations, which will minimize the chances of audits or sanctions. Through outsourcing, you also have them with their experience of dealing with Medicare billing of complicated thoracic procedures, which makes everything commendable in the process.
Focus on Patient Care
The best benefit of outsourcing billing management is that it saves the time of your staff to do what is important the most; patient care. Having an in-house team that is not overburdened with billing processes will allow them to spend more time on patient appointments, treatment, and patient outcomes.
In the case of thoracic surgery practices, it translates to more time under critical care and less time under administration such as checking of insurance or reconciliation of claims. Through outsourcing, your staff is able to concentrate on quality care to patients undergoing complex surgeries which results in improved outcomes and patient satisfaction.
Regulatory Expertise and Compliance
Rules and regulations on healthcare are ever evolving. It is important to keep abreast with these updates to guarantee it does not face penalties. In the case of thoracic surgery practices, this requires being updated on the new codes of ICD-10-CM, CPT codes, and the current Medicare payment rates applicable in surgical procedures.
Your outsourcing billing would enable you to utilize the experience of specialists who are committed to meet such changes. They make sure that every claim is presented according to the current rules minimizing the threat of audit or fines. Also, when you outsource, you are also enjoying the experience they have in dealing with Medicare billing of complex thoracic surgical operations hence compliance at all levels of the procedure.
Focus on Patient Care
Benefits of outsourcing billing management include the fact that it saves the time of your staff to attend to the most important: patient care. The in-house staff would be able to spend additional time on administering and providing treatment to patients, and enhancing patient outcomes once they are no longer bogged down by billing duties.
In the case of thoracic surgery practices, it translates to a greater amount of time in critical care and a reduced amount of time in administration such as insurance checks or claims balancing. Outsourcing will enable your employees to work on quality care to patients during complex surgery with the ultimate results in quality services and increased patient satisfaction.
How Outsourcing Billing Management is Good in Helping Your Practice Financially
Medical billing management is a good tool to trim down the financial status of your practice. Here’s how it works:
- AR Management: In case your practice hires the services of a third party billing, the third party service handles the whole accounts receivable process. This involves chasing unpaid claims, patient balances as well as addressing billing problems. In order to decrease days in AR and maximize collections, you should have a committed team on AR.
- Revenue Cycle Optimization: Outsourcing improves the whole process of the revenue cycle by making sure that the claims are correctly coded and submitted in time. In the case of thoracic surgery, where the reimbursements are often complex, outsourcing of the same will make sure that the procedure is correctly coded and sent to the relevant payer. This reduces reimbursement time and mistakes.
- More Profitable: Your practice can experience a rise in profitability due to the optimization of billing processes and the decrease in overhead expenses. Outsourcing enables you to channel resources in other areas that bring a direct influence on patient care and growth, whereas the billing department makes sure that the financial aspect of operations is working well.
Selecting the Proper Outsourced Billing Partner
The selection of a third-party billing company to your thoracic surgery practice is critical, whereby the company must be one that appreciates the specialty needs. Here’s what to look for:
- Surgical Billing Specialization: The outsourced company needs to have experience with complex surgeries and coding. In case of thoracic surgery, they should understand such procedures as lung resections, surgeries of chest walls, and thoracic endovascular surgery.
- Knowledge of Medicare and Private Payers: Most of the thoracic surgery operations can be paid out of Medicare and private insurance companies. Your billing partner must be highly familiar with these payer conditions and must have a successful history of negotiating their features and complexities.
- Transparency and Reporting: Find a provider that has transparent reporting on the financial performance of the practice. Easy access to such metrics as the days in AR, clean claim rates, and denial rates will be available to you.
Conclusion
One of the best options you can have in order to maximize your practice financial health is to outsource your billing management. Collaborating with a professional billing service, you will be able to increase cash flow, decrease denials, and remain abreast of all the changes in regulations and release your staff to practice. In the case of thoracic surgery practices, billing is one aspect that should be outsourced, as the procedure is complex and specialized in terms of coding
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