8 Signs You May Need to Hire a Medical Billing and Coding Company

Ma. Yvette Quiwa • Mar 25, 2022

Medical billing and coding are a vital part of any healthcare practice. It is through medical billing that the practice receives payments for services rendered. The process begins with the patient's check-in, moves to the doctor's office, and concludes with the check-out of the patient. However, there are many steps in-between.

These steps take time, accuracy, and professional expertise to complete the process. There are several signs that your practice may be struggling in this area. This article will cover eight signs that you might need to hire a medical billing and coding company.

Red Flags That You Need to Outsource Medical Billing Experts

As a practice, you know that your revenue cycle is one of the most critical parts of your business. But when your team struggles to keep up with the healthcare industry's increasing volume, complexity, and regulations, it can become a problem.

Here are five signs that you should consider outsourcing medical billing and coding experts:

You Have Too Many Denied Claims

The first sign that you may need to consider outsourcing your medical billing is a high number of denied claims. A high number of denied claims indicates insufficient knowledge to code and submit claims properly. Many factors can contribute to this, including incorrect coding, incomplete forms, etc. Moreover, you are putting your practice at risk for penalties and fines for these billing errors.

Medical billers specialize in this area to help you file your claims correctly and completely the first time. They also remain abreast of any changes in rules and processes, reducing the chances of rejected claims.

Training an In-House Medical Billing Team Is a Challenge

Keeping up with insurance claims requires specialized training and knowledge. Coding claims correctly, handling appeals, and handling denials are vital skills for your staff. Otherwise, you may lose money on each claim. Medical billing technology also requires some skill development, and not everyone has the time or aptitude to become proficient.

Furthermore, hiring and training staff may take time, and mistakes can be expensive. When you outsource medical billing, you are already hiring experts who will work for you without the need for additional training. Due to their expertise, they can make sure your claims are filed correctly and bring in revenue to your practice. Billing services can also help you accelerate the revenue cycle and collect payment for services rendered more quickly.

You Don't Have a Medical Billing Specialist on Staff

Although you are not required to have a billing expert on staff, it is a good idea to have one. Hiring a certified medical biller can do everything from coding patient records to handling insurance claims — but they aren't cheap. It's costly, especially if you have to train them yourself. If you don't feel like your office can afford the additional expense of hiring an in-house local biller, then consider outsourcing remote medical billers and encoders. You can hire a biller by the hour or hire someone who can assist on just one step in the RCM process.

You and Your Employees Are Burnt Out

Taking care of patients leaves little time for the myriad paperwork tasks that need to be done each day. The average doctor's office has hundreds of patients each day. With just a few doctors on staff, it can be easy for your billing department to become overwhelmed with all the paperwork that needs to be processed each day. In turn, this can lead to errors and missed deadlines.

If you have more patients than you can comfortably see in a day, hiring someone else to handle your billing and coding can free up some of your time so that you can take on more patients. With the help of a medical billing company, you'll be able to improve your efficiency without sacrificing patient satisfaction.

A medical billing firm can reduce the amount of paperwork you have to maintain and ensure your bills are submitted on time. In addition, they can help you track down payments for outstanding invoices and follow up on claims that take too long to process.

Your Account Receivables Are Too High!

It's normal for accounts receivable to increase as your business grows. However, if the amount continues to grow at an alarming rate or if you aren't receiving payment from insurance companies within 30 to 45 days of submission, it could be a sign that there is a problem with how claims are being filed. When your AR is too high, your practice is losing money. The longer a claim sits in your AR, the less chance you have of collecting payment.

Your Revenues Have Declined

If your revenue has declined dramatically over the last several months, it could indicate some problems with your accounts receivable systems or your billing department. Medical offices with inconsistent billing often struggle to collect payments from patients, resulting in lost revenue. A medical biller can help ensure all payments are collected, so there's no money left on the table. They also keep track of patient balances, so you don't have financial problems due to unpaid bills.

Your Patients Are Unhappy

When patients aren't happy with their experience at your practice, they're unlikely to return or recommend you to others. This can damage your reputation in the community and cause your revenue stream to suffer over the long run. Your current billing system could lead to bad customer service, so consider reviewing your practices if you hear complaints from patients more than you'd like.

You're Not Getting Paid on Time

Insurance companies have a deadline for paying medical claims, and if you're not getting paid on time, it means your billing department isn't following deadlines, either. Incomplete documentation could result in your practice not receiving payments from insurance companies or patients.

It is possible that your office staff does not know how to navigate complicated insurance regulations, which could lead to payment delays or rejections. If claims take longer than 45 days on average to process and get paid for, this is a sign of inefficiency in the billing process and untimely cash flow.

A medical billing and coding company will help expedite the payment process by ensuring all documentation is complete. This reduces claim denials and other issues that can cause delays in reimbursement.

Partner with DrCatalyst!

You may find that hiring a medical billing and coding company can help you avoid these issues and speed up your collections process to get faster payments. Outsourcing your medical billing and coding can be a great way to free up time for patient care, reduce stress and help ensure that you receive prompt payment for your services.

Partner with us! DrCatalyst will handle all your RCM and Medical Billing Needs, whether you're looking for: