Should I Outsource My Billing, Collections and Credentialing?

Mar 29, 2024 | Coding & Billing

When Does It Make Sense to Consider a Strategic Partner?

A magnifying glass iconRunning a practice can feel like three jobs.

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 a certain point, it makes more sense to seek out and invest in a strategic partner that can remove — or support — some of that weight.


Insurance Billing & Collections

A document with a shield iconWhy should you consider outsourcing?

If you had a trusted support partner submitting claims, confirming receipt, following up, handling appeals, verifying payments, and ensuring payers follow through on their promises, what does that leave you?

The energy and time to focus on revenue-generating activities and increasing patient flow.

Plus, you’d enjoy quick, correct payment posting, so you’d collect what you earned. And your patients would 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


A shield with checkmark iconWhy 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.

If you had a trusted support partner handling the health-insurance enrollment and credentialing process, providing ongoing credentialing service, and tracking deadlines, expirations, and renewal dates, you’d enjoy faster application turnaround, reduce busywork, and devote more time to priorities.

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

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

Training them in creating HCFA and submitting claims through your OMS, reviewing rejected claims in the clearinghouse, and billing processes such as verification of benefits and EOB payment posting would go a long way toward lightening your load.

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.

Make your practice even more efficient, profitable, and responsive.