Should I Outsource My Billing, Collections and Credentialing?

When Does It Make Sense to Consider a Strategic Partner?

Running a practice can feel like three jobs, not just one. In fact, some days, patient care seems like another duty just tacked on to everything else. But anything not related to your core competency — in this case, patient care — runs the risk of draining your time and energy. For example, how much time does your team devote to insurance billing, collections, and credentialing? At some point, it makes more sense to seek out and invest in a strategic partner who can remove some of that weight.

Insurance Billing & Collections

Why should you consider outsourcing?

Your team can focus on revenue-generating activities and increasing patient flow while we submit your claims, confirm receipt, handle follow-ups and appeals, verify payment, and ensure payers follow through on their promises. You’ll enjoy quick, correct payment posting, so you collect what you earn. Your patients will appreciate timely statements and online-payment capabilities.

When should you consider outsourcing?

It might come as a surprise, but there are tangible indicators that it might be time to consider outsourcing your insurance billing.

• Your diagnostic and contract-fee revenue is greater than 20% of your total revenue
• Your third-party appointments are more than 20% of your total appointment volume
• Your 90-days-overdue accounts receivable is greater than 20% of your total accounts receivable
• No one on your team has experience in medical insurance billing

Credentialing

Why should you consider outsourcing?

Credentialing is no longer optional for building a practice. Today it’s more necessary than ever for you and your providers to be in network. But credentialing is also a complex and time-consuming distraction. Enjoy faster application turnaround, reduce busywork, and devote more time to priorities while we handle the health insurance enrollment and credentialing process; provide ongoing credentialing service; and track deadlines, expirations, and renewal dates.

When should you consider outsourcing?

When the following happens, consider seeking out a strategic partner for credentialing:

• A provider’s demographics change (name, address, contact information, etc.)
• You hire a new provider
• Your practice changes addresses or adds a location
• Any change in ownership or employer identification number (EIN)
• Any new contract the practice has reviewed and would like to participate with

Insurance Billing and Collections Training

If your staff isn’t experienced in insurance billing and a strategic partner isn’t a viable option, it might make sense to have them trained in the general principles and processes of insurance billing.

Training topics include creating HCFA and submitting claims through your OMS (Sycle and CounselEar), reviewing rejected claims in the clearinghouse, and billing processes such as verification of benefits and EOB payment posting.

When is a good time to seek training in insurance billing? When your 90-days-overdue accounts receivable is growing or claim submission is falling behind. Remember, claims not filed in a timely manner can be denied, and the practice will never be paid.