If you ask private healthcare consultants which part of their job they enjoy the most, few, if any, would point to billing administration as their highlight.
Nonetheless, collating and submitting claims is an essential part of life for any consultant who steps into the world of private work.
No longer able to depend on their hospital’s admin or finance team to drive the process forward, consultants frequently find the administrative time associated is considerable.
As their practice grows, so does the level of time dedicated to billing, often at the expense of other administrative tasks or, in some cases, time spent with patients. As such, any consultant undertaking a significant amount of private work will find themselves considering how best to reduce the time spent on the process.
While a number of options are available to consultants seeking to minimise the billing burden, the choice will likely boil down to whether or not to outsource the billing process to an external billing specialist, or to keep a greater degree of control over the process by doing it yourself.
What are the benefits of outsourcing my billing?
If you are a consultant looking to take a more arm's-length approach to managing your finances, outsourcing certainly presents an attractive option.
On the face of it, external providers present a solution to many of the most problematic aspects of medical billing. As experienced actors, they understand the billing process and can ensure that the minimum requirements for a claim are met. Understanding what is and isn’t necessary for a claim to be approved should enable them to flag where further information is required prior to submission, reducing the likelihood of a claim being rejected or delayed.
The use of external providers may also relieve you of the need to directly submit and follow up on claims that have been submitted, freeing up valuable administrative time that can be redirected to other tasks.
Finally, because external providers deliver work at scale, they are typically able to manage your practice’s billing on your behalf at a lower cost than if you employed a dedicated staff member to do the same job.
Why outsourcing may not be a ‘silver bullet’ for your billing needs
You can never fully delegate the billing process
While the prospect of delegating the end-to-end management of your billing may sound appealing, doing so may not necessarily be the right move for your practice.
Although third-party providers may have a better understanding of the billing process itself, it is unlikely they understand your practice or your work as well as either you or your medical secretary do. As a result, they may miss crucial details of a claim that you would not have missed had you been submitting the claim personally.
As the business owner, you retain overall responsibility for claims and for supplying missing information. When insurers require more information, your involvement will still be required to supply extra detail or clarification. Ultimately, therefore, the hope that by outsourcing your billing you pass on overall responsibility from the process is unlikely to be fully realised.
Being at arm's length can be frustrating
Billing is a critical aspect of your business. If claims are not submitted and approved, then your business may experience delays in being paid for completed work or may even stand to lose money. The ability to track and follow up on delayed claims or late payments is critical.
By delegating this process, consultants yield a degree of oversight to a third party that, had they chosen to manage billing in-house, would have meant that the process of tracking and chasing claims was more straightforward.
This can be frustrating, particularly where there is a significant amount of income coming from private work and the consultant must follow up with the third-party billing specialist to track the status of their claims.
By addressing the most common concerns, in-house billing can be a better choice
Keeping billing in-house offers consultants greater control and oversight over the process, but as we explored earlier, can add a significant burden without the necessary tools needed to streamline and simplify the process for your team.
When it comes to the collation, review, and submission of claims information to an insurer, many practices continue to rely on manual processes, which can be time-consuming and prone to error – potentially causing delays further down the line.
Similarly, the typical process for tracking claims and following up on payments may take the form of a spreadsheet detailing when a claim was submitted, with a reminder to follow up if payment is not received by a certain date.
At MedoSync, we’re digitising the claims process with the aim of minimising challenges like these experienced by healthcare admin teams.
We built MedoSync Navigator as a structured claims submission process that ensures all required information – signatures, procedure codes, or other required information which might affect whether a claim is approved – is present prior to the claim being submitted.
In doing so, we’re reducing the likelihood of errors and, as a result, minimising the time providers and consultants will spend waiting for payment.
By digitising the process, Navigator also enables providers and consultants to track their claims, with an online portal displaying the current status of a claim and any action required on their part – bringing a greater level of transparency to the process.
The person who cares most about you being paid is you.
When it comes to managing your billing, both outsourcing and 'insourcing' each have their merits, and it is important to weigh up the pros and cons of each before making a decision on which is best for you.
Ultimately, however, nobody will place the same importance on ensuring you are paid for your work as you will.
At MedoSync, we're committed to providing you with the tools you need to take control of your billing and ensure you’re paid accurately and promptly for the care and services you provide.
If you’d like to find out more about how MedoSync Navigator can help you with billing, speak to our team.