With all of the changes that occur in medical billing every year, one of the most important questions that physicians with private practices need to ask themselves is whether or not it is time to outsource their medical billing. With this blog, I want to shed some light on the topic by talking about recent AMA changes, and the many benefits of outsourcing.
The American Medical Association (AMA) publishes the CPT coding manuals on an annual basis. In this year (2016) release, the AMA has released a total of 542 CPT code changes. 505 of these changes have been in effect as of January 01, 2016.
Here is how the above code changes are broken down – 266 new codes, revised 129 codes and also deleted 147 codes. The CPT code changes are mostly in pathology / laboratory services, surgical services, and radiology.The AMA has created 107 new codes for the Pathology and Laboratory section, revised 27 codes and has deleted 49 codes. For the Surgery section, it has added 84 new codes, deleted 42 and revised 62 codes. Radiology has 15 new codes in and 23 codes have been removed, and 4 have been revised.
With all of those changes you can see how it is hard to keep on top of your medical billing, it takes a lot of time and resources to make sure that you are doing things properly and aren’t making any mistakes.
Here are a few factors you should consider before making a decision on whether to outsource medical billing or train your current staff.
Outsourcing allows you to keep up with code updates.
Outsourced billers keep themselves up-to-date diligently with the changing regulations and insurance requirements. They keep up with the latest industry regulations, procedures, and the annual updates on ICD and CPT codes. They are trained on the 2015 CPT code updates which ensure smooth transition to new codes.
Outsourcing provides effective use of electronic health record (EHR).
Outsourcing medical billing means effective use of EHR. This can help your practice avoid down-coding as the health record system will recommend certain CPT codes based on what occurred during the patient visit. Did you know that most physicians lose more than $10,000 per year due to undercoding? Don’t let your practice be one of them.
Outsourcing provides accurate capture of critical information.
Your in-house billing staff may not be competent enough to capture critical patients and procedure-related details perfectly, which could lead to claims denials. Professional billers submit accurate medical bills and file the claims on time to make sure that denials do not happen.
Outsourcing reduces cost.
Outsourcing medical billing results in a dip in the operating cost for medical service providers. By outsourcing billing, they just have to pay for the basic operations and the medical billing company takes care of the coding and claims filing procedure. They also do the needful for updating all the billing-related software or infrastructural maintenance demands.
Outsourcing reduces claims denials.
As I just said – professional billing providers submit accurate medical bills and file claims on time. Billing accurately report the information, which results in a considerable drop in processing time – plus, with expert billers there are minimal coding errors that, leading to reduced claims denials.
Outsourcing increases revenue.
Given all of the previous points, this one should come as no surprise. Think about the potential loss (with in-house staff), and then compare it to the increased revenue and cost of the outsourcing company. By outsourcing billing, you are allowing the expert to look after the accounts receivables (AR). They ensure continuous business operations, which leads to a steady flow of claim submissions. By outsourcing their billing you can save thousands of dollars in the form of annual salaries and benefits that an in-house billing team requires from their employer
That being said I will end with some shameless self-promotion. Companies like Park Medical Billing have a team of certified coders who are well-trained in switching to these coding changes and revisions. The talented coding specialists at PMB have been helping physicians overcome revenue challenges caused by the CPT code changes every year. We provide affordable billing and coding services to ensure maximum revenue returns for providers.