Medical Billing Trends: 6 Undeniable Signs You Need a Medical Billing Expert

Irfan ahmed
By Irfan Ahmad Jul 26, 2021
Medical Billing Trends: 6 Undeniable Signs You Need a Medical Billing Expert

When it comes to medical revenue service collections, every medical practitioner needs an expert on their side to make things happen. After all, healthcare facilities are rarely dull. Everyone is busy most of the times, as employees wear multiple hats. Right from dealing with patients and their families to verifying insurance eligibility & deductibles and reviewing & documenting medical records, all hands are on deck.

However, as capable as your in-house team might be, the ever-changing policies and medical billing trends within the industry are bound to overwhelm them at some point in time. The outcome? You might not just lose out on significant revenues, but also cause your team members to lose focus on patient care and well-being – the reason why your healthcare facility was established in the first place.

The billing and collections procedures in a medical practice are time-consuming and bound by stringent statutes. In fact, medical billing and coding requirements can often cause business disruptions leading to poor management and high account receivables. To be done right, medical revenue cycle management requires utmost expertise, experience, and focus – and that is why countless healthcare leaders believe in hiring medical billing experts from India – the hub of medical billing outsourcing.

But how do you know that your healthcare practice needs a billing expert? More importantly, why should you outsource your medical revenue service collections process?

Here are 6 signs that prove you need to outsource your medical billing requirements:

Sign 1: Your team does not have enough time for patients in your facility.

How will you and your team be able to provide optimal care and attention to patients when all their time is hogged up in monitoring collections, taking care of denial management in medical billing, and scrubbing claims? The right way to go about it is to delegate your medical billing services to an experienced team. This will allow your team to spend more time with patients and give them the quality, specialized care that they deserve.

Sign 2: Your Account Receivables (ARs) are skyrocketing.

Account receivables mean the money that is owed to you. Defective and outdated software as well as an inexperienced biller, both are the primary causes why ARs go from being under control to embarrassingly high in a short window. But how does this happen?

It might be the case that the entire billing and collections procedures in a medical practice need revamping. Redundant software with obsolete medical billing trends causes this problem. Another reason could be the shortage of staff at your medical practice. Short-staffed offices usually fall short in following up on denials and claims. Any of these causes, or a combination of both of these, contribute to shockingly high account receivables.

Sign 3: Your overhead costs are way too high.

Did you know that a qualified medical billing outsourcing company could bring down your overhead costs drastically? By changing the expense structure from fixed departmental costs to a variable price that’s exponential to the net revenue collected, your medical billing partner can save you thousands of dollars.

Billing fees vary in conjunction with how well a healthcare practice is doing with respect to the number of patient visits and net receipts collection. This is why the expenses of your billing department should be tied to the net collections – a rule of thumb that experienced billing experts know.

Sign 4: Your claims and medical revenue service collections lack vision and control.

The main focus of any healthcare facility – big or small – is the safety and well-being of patients. So, unless you have dedicated personnel in-house who carefully monitor the insurance billing and front office payments, revenue can get off track very quickly.

As a practice, healthcare businesses only resubmit about 40% of denied claims. Now, determining why claims were rejected and following up with payers is a time and resource-intensive process, and most facilities owners don’t have the time or the budget to go through with denial management in medical billing. Your billing partner is a Godsent boon in this situation, going the extra mile in rebilling and ensuring that all claims get settled.

Sign 5: You find in-house hiring expensive and time-consuming.

Maintaining an in-house team for billings and collections procedures in a medical practice is not just expensive, but can also be resource-intensive. First, you need to allocate a budget to onboard them, then you need to invest both money and time to train them, and then you need to bear their salaries and benefits – this list is endless.

On the other hand, outsourcing your services to a medical billing company means you don’t have to worry about infrastructure, onboarding, licenses, system setup, and training. With outsourcing, you’re setting up your practice for short- and long-term accomplishments.

Sign 6: Your revenues are dipping.

Let’s say you charge about $200 per patient. You might get about 20 patients every day but only net about $100 per patient. Where’s the remaining amount?

In such a scenario, your billing department is working without well-defined processes and automation in place. You need someone to be on top of every aspect of your medical revenue cycle management. You need an expert to look into:

  1. Benefits verification
  2. Calculate and collect payments
  3. Manage contracts
  4. Rectify incorrect superbill reconciliation

With the right billing company, you can expect benefits in not just better revenues but also better management of the collections and claims.


Top 3 medical billing trends for 2021

Any change, no matter how big or small, affects the medical revenue cycle management process. Below are the top three trends of 2021:

  1. Outsourcing billing and collections procedures in a medical practice

While some healthcare practices swear by outsourcing billing services, others feel that outsourcing will relinquish their control over cash flow. Interestingly, 2019 saw a record number of healthcare practices outsourcing their medical billing requirements. Experts predict that the numbers will grow throughout 2021.

  1. Cloud-based medical billing services

Cloud services have transformed nearly every industry in the country and medical billing has not remained unimpacted. Cloud makes data storage, maintenance, and access very easy and simple. Moreover, it is quite secure and offers greater privacy than non-cloud systems, thanks to encrypted software. Easier access, higher efficiency, and cost amortization make cloud medical billing systems a robust and fail-proof option for the near future.

  1. Automation of billing, collections, and denial management

With the penetration of artificial intelligence (AI) in the healthcare billing industry, it has become possible to automate many recurring processes such as claims submission, insurance verification, and follow-ups on receivables. AI not just automates these time-consuming processes but also reduces the risk of errors in filing claims, payment delays, and denials.

How to choose a company for outsourcing medical billing services?

Below are some of the key pointers that will help you pick a company that is the right fit for your billing requirements. Look for a company that offers a healthy mix of most of these qualities along with affordable pricing and quick turnaround times.

  1. Excellent communication tools

Remember, your outsourcing partner will be at least a few thousand miles away from your office. Without the right communication tools, you might as well flush your money down the drain. Most aspects of being a medical billing specialist involve communicating with other people. Your partner company should be ready to spend a lot of time on the phone, touching base with patients and insurance representatives about their bills and accounts. They should also have the right tools to quickly get on an audio or video call with you to keep you up to date on the events.

  1. Effective time management

If you’re going to hire medical billing expert from India, chances are, you and your billing partner company are in two different time zones. This is where the ability to manage time effectively comes into play. Every moment a resource from the outsourced company spends on your project should be put to good use. Medical billing experts have a lot of responsibilities and these can quickly pile up, if not managed properly. The right billing services provider will be upfront about the amount of work their resources will be able to deliver in a day and will be able to upscale or downsize their deliverables to accommodate your requirements.

  1. An eye for detail

The billing and collections procedures in medical practice are more than just collecting receipts and keeping a tab on payments. The responsibilities also include an in-depth understanding of policy and compliance changes, identifying the discrepancies in payments, and a sound understanding of the up-and-coming medical billing trends. Your billing services provider must have attention to detail.

  1. Ability to multitask

Every day, the billing specialist will have to undertake several different tasks. There’s no telling how each day is going to be, and an adept billing specialist should be comfortable in juggling multiple tasks simultaneously. In addition, they should also be able to attend phone calls and emails from insurance agents and patients and must be able to go back to what they were doing before the call or the email.

  1. Being a team player

While the job of a billing services expert is independent and solitary, teamwork is something that should come to your outsourced partner as a natural skill. Why?

Because there will be times when they will have to coordinate with other department heads in the team for Knowledge Transfer and requesting access to files and data. Additionally, they will often need to follow up with doctors, nurses, and receptionists regarding patients’ documents and procedures. In addition, they might have to occasionally speak with patients to resolve their queries. In all these scenarios, teamwork is an indispensable asset.

I hope that you now have a better understanding of why medical revenue service collections need outsourcing. If you want to hire a medical billing expert from India, Virtual Employee can help you save over 70% of your overhead costs and in-house hiring expenses. Get in touch with our experts for more details.

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