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Health care providers should periodically review their financials and revenue cycle, so that they can take corrective measures at the earliest if required. A great deal of medical offices / health care providers find that medical billing is one area which could be drastically improved. Using the latest billing techniques, a provider’s efficiency and efficacy rates will increase. Data shows, there’s been an exponential increase in medical costs over the last few years. Hence, patients expect health care providers to be more transparent while calculating payment(s). Additionally, patients want more options for making payment(s). Therefore, the medical service provider has to consider multiple factors while billing. Fortunately, there are some new medical billing trends which simplify the process of collecting patient payments.

Automation

Many healthcare providers prefer automation, since it helps reduce costs and it’s more convenient for the patient. Using an automated billing system reduces effort, saves time and eliminates many human errors. Additionally, it’s easier for the patient to understand the billing. While some patients may require more information about how they are being billed, data suggests most health care provider staffs and their patients are quite satisfied when medical billing protocol(s) are streamlined and automated.

Using Registry or EHR for Payment Incentive under MIPS

Under the medicare system of payment adjustment, eligible clinicians may get a payment bonus, payment penalty or no adjustment of payment under the Merit-based Incentive Payment System (MIPS) program. Healthcare providers can choose from different methods for reporting to MIPS, with Electronic Health Records (EHR) and registries being the most popular methods. EHR has the patients medical information in digital format, while the registry has more comprehensive analytics information and is designed for submission to MIPS. Each of these options have their own disadvantages and advantages. Hence, the health care provider should compare each option carefully before finding the most suitable option based on the requirements of their organization.

Using Improved AI

Worldwide, Artificial Intelligence (AI) technology is being extensively developed and the number of applications using the technology are increasing rapidly. In the medical sector, professionals have found this technology to be extremely useful and can be used holistically. Some health care companies and providers have started using AI for coding and billing applications, since AI can be used for extracting specific data patterns and sets. Other organizations have found that AI to be useful in collecting patient payments.

Comparing Outsourcing and In-House Billing

Although many large medical providers perform their own medical billing (in-house), it makes more sense for new or small to mid-sized medical practices to outsource. Small to mid-sized providers realize that billing is extremely labor intensive, yet a very crucial part of their business model and revenue cycle. It’s been our vast experience that medical practices should focus on providing health care services to their patients and leave the billing to experts. Qualified medical billing groups ensure billing accuracy and speed and are well trained, with experience.

Healthcare in a digital environment is complicated, particularly with the numerous regulations that seem to be constantly rolling out additional layers. Healthcare providers are spending more time and resources as they organize patient care, and this time could be put to better use. Using a qualified, outsourced behavioral health billing company can provide better service as your workload reduces, you experience fewer disruptions and your profitability increases.

10 Advantages of Outsourcing Your Behavioral Health Billing

Decreased Employee Expenses. You will not be liable for employee healthcare, acquisition costs, PTO, and other employee load expenses when you are outsourcing your behavioral health billing. The amount of resources expected to manage the behavioral health insurance process is high. Another point of using an outsourced behavioral billing solution is the cost-share model. This enables billing expenses to be based on your volume and earnings. This is an advantage if you have a low-income month; you will not have a fixed cost associated with your billing.
Improvement of Revenue Cycle. As the legal and administrative terms for behavioral health providers constantly keeps growing in complexity, and as claims process grows more challenging, working with a skilled, qualified billing company trained in behavioral health can provide big relief. RCM software or Behavioral Health Revenue Cycle Management is a specific application specially designed for practices that treat patients with behavioral concerns. It helps practices process payments, handles claims, and creates revenue better than using a generic billing application. This will drastically improve the management of your revenue cycle.
Keep Patient Data Secure. One of the major concerns that prevent physicians from outsourcing their medical billing is internet security. Protecting patient and practice data is critical. All professional outsource medical billing company has the responsibility to protect all patient information (HIPAA compliant).
Reduce Staff Errors. Even the smallest blunder can cause an insurance company to deny a medical billing claim, with someone on your staff to correct the mistake, resubmitting the request and waiting for the revised application to be accepted and processed. Working with a specialty provider reduces staff blunders, since they have more experience working with billing and have undergone a lengthy training process, much greater than your in-house team.
Greater Consistency. Due to unplanned staff changes or employee absence, billing in-house puts your practice at higher risk for revenue interruption. An outsourced medical billing service provides an entire team of experienced people ensuring that your claims get prepared efficiently, leaving your practice less exposed to interruptions in cash-flow.
Better Claim Processing. Every insurance claim must be paid promptly and accurately in order to optimize a medical office’s cash flow. Time is valuable, generally healthcare staff do not have the luxury of reviewing and following-up on each claim. Let’s face it, healthcare professionals and their support staff are often pulled in various directions. But these claims should be presented as soon as possible and accurately the first time. Otherwise, unpaid claims can quickly rob an office of resources that could be applied elsewhere. Being forced to make tons of phone calls to insurance providers only wastes more time and adds frustrations. Healthcare providers should greatly consider outsourcing this function to reduce the administrative load placed on their support staff. Good medical billing companies are quick, consistent, and accurate with the submission and processing of any insurance claim.
Transparency. Others believe that outsourcing your billing means giving up control and the power of your practice, but this is entirely incorrect. When you outsource your billing, you obtain greater control and transparency. You can review compiled data or monitor the process at any time, according to your discretion. This gives you up-to-the-minute evaluations of how your practice’s billing is being processed and whenever you decide.
Profitability Increase. Due to incompetent, inadequate, or inaccurate claims, medical providers lose revenue. However, that’s not the case if you outsource billing to a qualified behavioral health billing group. Why? Simple! These outsourced behavioral health billing specialists are just that, experts, much more skilled than your in-house staff. They’re skilled at handling appeals and reversing denials. They hold the insight and expertise to pinpoint specific areas of vulnerability, limiting repetitive errors in claims, and assuring more claims are met (paid out) on the first attempt.
Knowledgebase. Outsourced billing solutions for behavioral health come with a wealth of knowledge. They understand the various complexities of billing insurance and hold the knowledge to examine trends and recognize industry transitions on the spot. Longevity in this niche area is not common; however, necessary. The results that stems from longevity and experience is priceless. Being able to understand each insurance carriers’ historical trends, paid amount(s), fine print of policies, etc., can have a massive impact on your behavioral health organization’s capacity to collect on insurance.
Faster Procedure. Automating routine administrative duties makes your work more productive and valuable. Automating same-day claim submissions will increase your cash flow. A standard paper-based claim may take at least two months to move through all the channels before you receive payment. Advancing a clean claim, appropriately coded for maximum benefit, supported with the assistance of the EHR can result in full compensation in a short period of time.
Conclusion

These are plenty of great reasons to outsource your behavioral health billing to a professional group. It makes sense to outsource revenue cycle management services to a third party, putting less strain on your internal resources.