The Importance of Medical Billing Solution

Updated: Apr 7, 2021

Medical billing companies know the importance of deadlines on claims and when to follow-up. They provide a detailed report and records on time and date when a claim should be made, and when it is sent. In case of denied claims, they can help you file for an appeal. The best thing is, you no longer have to deal with medical billing errors because of their accuracy.

Okay, let’s be honest. Medical billing is one of the most complicated and trickiest parts when it comes to running a practice. I’m pretty much sure that many healthcare providers would agree with this statement. Oftentimes, this time-consuming task sidetracks providers from their main goal—taking care of patients. Although this may be the case, however, medical billing also stays as one of the most important processes that help medical practices stay afloat. The stability of your practice depends on the effectiveness of how you handle your medical billing. This is the reason why many medical practices have switched from in-house medical billing to outsourced medical billing. And here’s why:

Patient volume has increased

More patients now have health insurance than before. According to a report published by the United States Census Bureau in 2017, the percentage of people with health insurance coverage was 91.2%. Furthermore, between 2016 and 2017, the number of people with health insurance coverage increased by 2.3 million, up to 294.6 million. It is evident that people are now paying more attention to their health by making sure that they are insured. Because of this, healthcare providers should brace themselves for an increase in patient volume.

Because of this change, the staff at medical practices may not be equipped to deal with the influx alone. This will be more challenging in small practices where one staff needs to do other tasks as well. Aside from taking care of patients, they also have other tasks they should attend to in order to provide better patient experience. With what’s already happening, it would be more advantageous if medical practices will just use medical billing software or outsource their billing processes. This would increase the staff’s productivity and improve the way they treat patients.

Patients demand a better experience

Nowadays, patients have more power than ever. This is why the healthcare industry continues to embrace a more patient-centric business model. Patients want healthcare providers to focus on providing them the best quality of care. Because of administrative tasks, it feels like physicians are part-time doctors and part-time medical billers which should not be the case. This will be avoided if all your medical processes will be handled by a third party agency that has an experienced team of medical billers. This way, you’re sure that your claims are processed effectively and efficiently and you also get to spend more time on providing quality care to your patients.

Switch to ICD-10 coding

The switch to ICD-10 may have happened a few years ago but many in-house billers still aren’t well-versed on all the codes. This would likely result in medical billing errors or mistakes. Did you know that $262 billion in medical claims are initially denied? An analysis conducted by Change Healthcare in 2017 revealed some compelling statistics about claim denials and its financial impact on medical practices. The findings showed that out of $3 trillion medical claims submitted by hospitals in the United States in 2016, $262 billion of those charges were initially denied. This is the true cost of denied claims. What’s more troubling is the fact that it increases every year.

Medical claim rejection and denials can be the most significant challenge for a medical practice. Even the smallest medical billing and coding errors could be the reason for denials or rejections. And of course, you don’t want any claims being denied, lost, or ignored. However, the likelihood of claims being denied or rejected is actually lower when you partner with an experienced medical billing agency. They are up-to-date with the latest changes in medical coding which means that they process claims faster, more efficient when it comes to handling claims. Should there be lacking information or inaccurate documentation, the medical billing company will also be the one who will fix the issue. As a result, the whole process of medical billing becomes hassle-free and efficient for healthcare providers.

Compliant requirement changes

Medical practices always prioritize patients’ health and wellness more than anything. Next to patient care, medical practices should also be mindful of such as protecting patient personal information, charging honestly for the services provided, and auditing their compliance to healthcare requirements. It is normal for providers to worry about healthcare compliance. Just a quick overview, healthcare compliance is a general term describing the observance of conventions, guidelines, and state and federal laws. This is according to the American Academy of Professional Coders. Medical practices and other healthcare organizations usually appoint someone dedicated to ensuring that healthcare regulations are being followed. While this has presented new challenges to providers and healthcare facilities alike, it has helped standardize how patients are treated.

Compliance adds a certain level of complexity when it comes to medical coding. And it would take a large portion of your staff’s time keeping up with healthcare compliant changes. However, this is not something medical billers in medical billing agencies worry about. One of their responsibilities is to make sure that they are up-to-date with recent changes in healthcare compliance that might affect processes in medical billing. This enables the process of processing claims faster and more efficient.

Medical billing has become very challenging throughout the years. This caused physicians to spend more time on administrative tasks than on patient care. This is why it would be beneficial and advantageous if you will partner with a medical billing agency. You will not feel like a part-time doctor and a part-time biller. If you ever need help with your billing processes, X-Factor can help. We are an end-to-end RCM and medical marketing services company. We provide over two dozen different medical billing services (plus administrative, marketing & more) that will give you back time several hours each workday and have you feeling like a full-time doctor again! Give us a call and let’s discuss how we can help you.


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