When a pandemic arrives, the repercussions are felt across the economy. The continued presence of COVID-19 in the world cannot be denied, nor can its effects be ignored any longer. In many ways, the economic aspects of the healthcare system have been the most affected, directly as well as indirectly. Healthcare facilities are taking the brunt of the COVID-19 cases while also serving the non-COVID related cases at the same time.
The additional burden that is put on the healthcare providers has made their jobs all the more demanding. In an attempt to relieve some of this burden, many services are now being shifted to the virtual space. This tactic has been employed to keep patient care unblocked while minimizing contact between individuals at large. Opting for solutions outside of the workplace is therefore the better choice in these times.
Bearing in mind that healthcare providers need to be freed from repetitive, tedious, and non-core related functions such as medical billing and coding, these services can wisely be outsourced to external billing and coding companies to benefit the global community.
What do Medical Billing and Coding Entail?
The functions of the healthcare system can be broadly divided into core jobs such as being hands-on caregivers to patients, and non-core-oriented functions such as administrative jobs. The latter includes arduous services that do not require the skill set that physicians and other staff members trained in medicine bring to the table. Nevertheless, these tasks are important as they keep the business from sagging in any manner. In the case of medical billing and coding, the process involved can become an additional demand on the already overloaded medical practitioners.
Some of the ways in which medical billing and coding have been draining resources and manpower are elucidated below:
- Patient record management – Among the responsibilities that billing and coding duties include, management of patient records is a primary one. This is a repetitive process that involves collecting patient information by filling out relevant forms and then transcribing these details onto online systems. Medical records are full of case histories of patients, their insurance policy details, and the mode of payment that will be opted for once the services have been billed. Going over these details repetitively for the huge number of cases that arrive in hospitals, especially with a minimal staff force in place, is hard to manage.
- Converting treatment plans to codes – Medical coding also involves the generation of specific codes that have been outlined by the regulatory bodies against the different services so that there arises no confusion in the treatment plans and billing process. The nature of this task is also tedious as it requires several hours of manpower for correctly assigning codes and then cross-verifying the same. This too can be a drain on the limited resources that care facilities have at the moment.
- Error-free code to invoice generation – Accumulation of errors while performing repetitive tasks is somewhat unavoidable when the individual is performing under pressure. With the increasing number of cases, both related and non-related to COVID-19, it is becoming increasingly difficult for medical practitioners to avoid errors in bill generation. This can hamper their overall revenue collection and impede the operational flow of the organization. Hence, avoiding erroneous bill generation is also a key point in the manifesto for keeping the healthcare system functioning.
- Submitting claims, follow-ups – Another major responsibility of the billing and coding task force is to file insurance claims and follow-up subsequently with the insurance companies. Precious time and effort are spent in this process as claims require continuous follow-ups. Managing a vast number of claims can become taxing on the time of a healthcare professional. These tasks can pile up to prevent providers from performing their true roles in the healthcare system.
- Close interaction with doctors and patients– Generating bills and codes requires relaying information to and fro between patients, doctors, and insurance companies. Information flow between these points of contact cannot be treated with laxity, as the slightest slip can cost patients dearly. The time and effort that this interaction demands must not be carved out of the healthcare provider’s schedule, as this may hamper their performance in both spheres.
How external medical billing and coding companies can be utilized during the ongoing COVID-19 crisis
Outsourcing these repetitive tasks to medical billing and coding companies is the natural and most efficient course of action, particularly during testing times. The decision to outsource medical billing has been proven to be beneficial time and again. Listed below are some of the key benefits that reiterate the wisdom of choosing to outsource:
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Cost-benefit
At a time when the economy is reeling from the impact of the COVID-19 outbreak, keeping the cash flowing into the practices is the topmost priority. When organizations outsource medical billing tasks, revenue collection typically increases. This is owing to the fact that competent medical billing and coding companies are better equipped to handle the flow of a large number of cases and process their information accurately.
The cost of operations for the client is also significantly reduced as a bulk of the redundant tasks are taken over by more efficient and goal-oriented billing professionals. Keeping in mind that the pandemic is putting so much strain on other operational areas as well, offloading billing and coding is the most logical option.
Another benefit is the reduction in logistics costs since the maintenance of office space, computers, and software for billing staff need not be maintained in-house by the client. The cost-benefit to practices is one of the most obvious benefits but there are many other advantages that should also be considered.
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Manpower optimization
Owing to this unprecedented health and economic crisis, the majority of the population is staying in and working from home to reduce the burden of incoming cases on the healthcare system. Individuals whose services are not essential to controlling the pandemic are being advised to stay away from the workplace.
For healthcare facilities, this translates to minimizing the management of non-essential staff and instead, directing the manpower towards patient care. Core responsibilities of physicians thus get the center stage they deserve.
It is reasonable to outsource medical billing services as they can be executed satisfactorily by seasoned medical billing companies with their trained staff. Significant cost-saving can be achieved by cutting down on the investments in the training of billing and coding-related staff. Thus, providers can direct the savings to better utilize the manpower in a more value-adding aspect of the practice.
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Regulatory Compliance
All reliable medical billing companies keep themselves up-to-date with the frequently changing regulatory guidelines. They do so by making sure their employees undergo training related to the relevant fields and become well-versed with the guidelines. With respect to the pandemic, regulatory bodies such as AMA and FDA have been issuing new guidelines to accelerate the billing and coding process.
Insurance claims related to both COVID-19 and non-COVID-19 cases at this time must be cross-verified in detail. This will reduce claim denials and rejections and in turn, boost the revenue flow. Experienced medical billing companies always prioritize compliance in all of their operational services, thus ensuring their workflows have the desired accuracy for a successful medical billing process.
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Technological Advantage
Another advantage of partnering with a billing and coding company is the security that comes with using its established technical tools. The software and web applications that outsourcing agents use come with certifications that ensure data security. Critical information related to the payment of medical bills receives the required protection when data is exchanged with experienced billing companies.
Moreover, patient information is stored on cloud platforms to make data easily accessible to insurance companies for verification and processing of claims. Cloud storage establishes a fine balance between security and accessibility of data, making sure only data that is intentionally shared becomes available. The traceability of sharing and receiving data adds another layer of protection to the activity.
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Faster and Accurate Claims
Among the many services offered by medical billing companies, verification of patient eligibility for insurance claims is critical. The importance of performing this task prior to rendering services to patients is that it clarifies which services can be billed to insurance companies. This helps to accelerate payment clearance and prevents unnecessary hold-ups.
Fewer claim rejections and lesser time spent in managing rejected claims imply better utilization of that time in collecting more revenue. When practitioners outsource medical billing tasks, they also get access to the services of certified coding specialists without having to hire one. Such billing specialists can generate cleaner claims which are less likely to run into denials.
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Impact on the revenue cycle by outsourcing billing and coding
With healthcare practices struggling to stock up on resources owing to the demands of the pandemic-related cases, utilizing existing resources to the best of their ability is desirable. Outsourcing of billing and coding streamlines the revenue collection process and thereby makes it easier for practices to stay operational. The revenue cycle experiences improvements as outsourcing companies are incentivized to increase their commissions arising out of the total revenue collected.
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Improving patient satisfaction
The bottom line is that when physicians and medical staff are freed from handling the hassles of accounts management, they can devote the bulk of their attention to patients. Scaling up the healthcare practitioners’ outreach depends on building trustworthy relations with patients who feel comfortable returning to the same practice because they feel that they have received the right amount of care and attention from the caregivers.
Thus, opting for external services helps practices build strong and long-term relations with patients. The whole process can thus be summarized as a cycle of service providers taking care of one another and, in turn, helping build a steady economy.
Beyond the Pandemic
The uncertainties and challenges the healthcare system faces would not end with the pandemic. New threats always keep appearing for practitioners to jump through. Indeed, it would be reckless to assume that the current extraneous circumstances are a one-time occurrence that the healthcare sector will manage in the coming days. It’s better to keep practices prepared for all kinds of unforeseen circumstances by reinventing the benefits of outsourcing to suit the industry needs.
Anticipating that the work never gets easier, nor do health-related problems ever disappear, practices will keep encountering the same billing and coding procedures over and over as long as they are in business. It is, therefore, a better option to keep the medical services outsourcing companies enlisted with all their arsenal of medical billing services on hand.
- A sudden transition from existing systems to new ones can be difficult to manage, especially if practices are in the middle of managing outbreaks as well. There is no reasonable explanation as to why healthcare practices should wait till they are overwhelmed beyond their capabilities to finally opt for external help. It is always better to be prepared instead of stretching out resources until they are too thinly distributed to serve any real purpose.
- Irrespective of whether or not the world wakes up to a pandemic, the essential services of physicians and support medical staff should remain uninhibited. Ensuring this will require foresight and an ability to make the right decisions, which will also guarantee positive outcomes. Hospitals, clinics, as well as small practices can realize optimum outcomes by hiring a trusty and experienced medical billing service provider.
The sudden arrival of the pandemic has created a dire scenario for the healthcare sector across the world. The management strategies which had worked so far, no longer hold much sway. To keep practices from being swamped with administrative tasks, outsourcing medical billing and coding works is the most efficient and accessible solution.
The ever-increasing need for outsourcing is not likely to dissipate once we are in the clear. Outsourcing has transformed into a commonplace solution to the multiple operational hurdles and is being embraced by most care providers. As the benefits of outsourcing far outweigh the initial concerns or doubts, teaming up with an outsourcing partner will reap fruitful benefits for practices and will continue to do so in the long run.
Who We Are and Why We Are an Industry Authority?
This article is brought to you by OutsourceRCM, a leading healthcare solutions provider with over 10 years of experience in healthcare BPO.
We provide enterprise-grade medical billing services to our clients to manage a range of billing services such as aging AR, denial management, and appeals processes. Our streamlined services have assisted our clients earn greater revenue through improved collections and accelerated reimbursements.
