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Updated on: June 14, 2021

Revealing Information About Offshoring

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Original story posted on: June 7, 2021

Outsourcing versus offshoring – do you know who is working for you?

Should you outsource the medical billing, coding, and/or administrative needs of your practice? Also, if the answer is yes, make sure you know the difference between outsourcing and offshoring, as some think this is the same thing, and it is not. It’s important for a facility and an independent practice to consider  budget and preferences when deciding whether to outsource their medical billing processes.

Questions to consider before you outsource:

  • Is your billing process inefficient? If your collections are dropping every day, your in-house billing department may be having issues. Outsourcing to a third-party provider could significantly reduce the number of rejected claims and the time taken to receive payments. The focus of such a provider is only on claims processing and appealing rejections.
  • Do you have high staff turnover in-house? Staff turnover in a small or independent medical practice, especially in the billing department, can be damaging. Claims processing is the lifeblood of any medical practice. Any additions or replacements in the billing team will inevitably slow down claims processing.
  • Are you and your staff tech-savvy? Keeping your billing in-house will require investing in good practice management software. So many practices focus only on electronic medical records software and forget to invest in a practice management system. You’ll also need to frequently train your staff, which adds to the costs. If you don’t want to deal with software upgrades and frequent technical issues, outsourcing your billing is probably the right move.
  • Are you a new medical practice? New medical practices have their hands full managing patient care, making it tough to manage billing as well. Outsourcing your billing right in the beginning can give you much-needed relief from the day-to-day stress of launching and managing a new practice.

Many solo physicians and small medical practices aren’t too savvy with the business side of things. Some just want to help patients, and not undertake administrative tasks. Outsourcing the billing process eliminates this daily hassle and allows you to focus on providing patient care.

After you ask yourself these questions and speak to your administration or management team about what your needs, if you decide to outsource, there are some things you can expect:

    1. All outsourced billing companies use offshore companies to assist with billing tasks, in one form or another. The reason? Because it is not only cheaper, but consider this: when your in-house staff has been calling payors like Aetna, UnitedHealthcare, or Blue Cross and Blue Shield, have they been telling you that they feel like they are speaking to someone overseas? Well, it is because they often are. Insurance companies make no apologies for offshoring their day-to-day work.
    2. If your billing practices and workflow were not efficient when you kept them in-house, you cannot expect things to be magically instantly fixed when you outsource. Make sure that you clean up your workflow processes before outsourcing. Remember that the old saying, “garbage in, garbage out,” also holds true for billing.
    3. Unless you research the company, you are going with, know that not all billing companies have certified coders in your specialty. It is important that if you are going to trust someone to handle your revenue, they understand the specialty on which they are reporting and collecting.

Lastly, make sure you have a liaison within your practice who is the point person who communicates with the supervisor of the billing company: someone who can respond to questions, run any report you request, and be available for provider questions when they arise.

This communication and understanding what the accessibility rules are (working hours) will be the key to not only successful billing processes, but appropriate revenues you have earned.

Program Note: Listen to Terry Fletcher report this story live today during Talk Ten Tuesdays, 10 a.m. Eastern.

Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS,  ACS-CA, SCP-CA, QMGC, QMCRC

Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, QMGC, QMCRC, is a healthcare coding consultant, educator, and auditor with more than 30 years of experience. Terry is a past member of the national advisory board for AAPC, past chair of the AAPCCA, and an AAPC national and regional conference educator. Terry is the author of several coding and reimbursement publications, as well as a practice auditor for multiple specialty practices around the country. Her coding and reimbursement specialties include cardiology, peripheral cardiology, gastroenterology, E&M auditing, orthopedics, general surgery, neurology, interventional radiology, and telehealth/telemedicine. Terry is a member of the ICD10monitor editorial board and a popular panelist on Talk Ten Tuesdays.

Latest from Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, QMGC, QMCRC

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