The efficiency of a healthcare organization’s medical billing is a key player in their financial stability and success. With the advent of massive changes facing today’s medical practices, the demand for streamlined third-party billing solutions is strong, and the numbers agree – outsourcing may be the answer.

Drivers of the outsourcing boom

Outsourcing medical billing to specialized companies can help healthcare providers reduce administrative costs, automate their billing processes, stay compliant, and receive timely payments. Providers are paying attention and as a result, the global medical billing outsourcing market continues to expand (expected to reach 30.2 billion USD by 2030). This market growth is being driven primarily by factors including an uptick in regulatory changes, risk management concerns, and the need to streamline workflow while reducing internal processing costs.

As healthcare groups regularly consolidate and implement EHR integration, the result is an increase in large healthcare networks that recognize the need to utilize outsourced billing and is another factor fueling market growth. Providers have learned that outsourcing medical billing tasks to specialized companies reduces administrative costs, prevents staff burnout, and ensures timely payments.

Other movers behind the projected growth can be attributed to COVID-19 revenue chokeholds causing the need to trim budgets and increase cash flow. The healthcare industry was blindsided when the ability to see patients in person became nearly impossible, and fear of the virus had patients skipping visits. The drop in physicians’ revenue was significant with an average of 30% (as high as 50% in some fields). Physicians are now looking to reduce overhead and take back some of their lost revenue by outsourcing medical billing.

An enormous task of healthcare organizations is adapting to this rapid change. Prior to the pandemic the healthcare industry was reticent in buying into digital and innovative technologies to improve healthcare but that is no longer the case. The need for action and the construction of a scalable, digital healthcare infrastructure is at the forefront of the change as organizations continue to regroup. This includes outsourced billing with its resultant market growth.

Healthcare worker shortages, coupled with the increase in the need for medical care, and mental health services also increases the demand for automating and outsourcing medical billing. In some states the healthcare labor force is projected to shrink throughout 2026. Patient visits are estimated to increase by 10% over the same period. Outsourcing is a part of a solution to fill the gap created by the staffing shortage and keep the revenue cycle moving.

Demand for error-free electronic accounting and faster claim processing is expected to become standard. The healthcare systems’ movement to outsourcing of clinical billing is fueled by the mandatory implementation of complex ICD-11 coding systems, rising healthcare costs, and the federal mandate to deploy EMR.

Top benefits of outsourcing

Healthcare practices know outsourcing revenue management avoids the need for an administrative team to process and manage in-house billing functions. Hiring an outside company that focuses solely on medical billing saves a practice money with the overall reduction of office payroll. Automating reduces billing errors, increases compliance rates, and improves both the patient and employee experience.

Reduces billing errors and denials

A medical billing company’s sole responsibility is to ensure they provide superior medical billing services. This involves a comprehensive knowledge of current medical codes and payer guidelines to avoid denials. Medical billing service companies help streamline a practice’s medical claims to ensure maximum reimbursement for patient care. Processing properly coded, clean claims on time results in an increase in revenue due to fewer delays and unpaid claims caused by billing errors and denials.

Improves cash flow

Most practices have a small staff that handles medical billing. Should the biller require time away from work, the medical claims are on hold, and cash flow slows. Outsourcing to a medical billing services company eliminates the worry of employee absences as claims can continue to be processed and paid on time without interrupting workflow.

Outsourcing billing is a cost-efficient alternative to expensive in-house processes and eliminates high initial costs for setup, reduces training and education, direct claim processing, departmental costs, and software and hardware expenditures.

Ensures billing compliance

Changes and updates to regulations, codes, and procedures for Medicaid, Medicare, and private payers are endless. This makes billing complex and overwhelming for many practices. The increasing rate of claims denials is adding to an already arduous task. Medical billing outsourcing handles the updates to coding and billing. Relying on a third-party’s expertise to process claims and manage reimbursement lifts the billing burden.

Patient satisfaction perks

Practices that outsource medical billing services are more effective in both billing and patient care. Organizations with streamlined, outsourced billing continually report greater patient satisfaction than those without. Handling both billing and patient interaction can be an overwhelming endeavor, but the sole focus of medical billing companies is the billing cycle. A successful medical billing company is current with the latest in government regulations and private payer guidelines and maintains compliance to submit clean claims that are followed through to payment. Reducing staff stress by removing medical billing tasks frees time to prioritize customer service and allows staff the ability to focus on what healthcare workers do best – care for patients. 

Bottom line boost

Increasing denials and crushing staffing shortages have providers looking for solutions to resolve unpaid claims, reduce errors, increase compliance, and mitigate financial loss. The efficiency of a third-party billing company results in faster claims processing and payment, leading to a more reliable revenue flow.

Virtual OfficeWare Healthcare Solutions – your medical billing services partner

Is your organization looking for an expert medical billing partner? Virtual OfficeWare Healthcare Solutions works with your practice during initial onboarding and beyond to ensure your staff is properly trained and equipped to ensure a seamless, outsourced billing transition.

Our dedicated account team of experts are devoted to your practice’s success and remain with you through each stage of implementation with athenaOne®.  Through our  extended billing services, including end-to-end billing solutions, practices can reduce administrative overhead, limit complexity, and build efficiency. We’re trusted by top healthcare organizations nationwide as a top line solution for all specialties and are up to date with billing regulations and federal guidelines, and we’re ready to meet the changing needs of any healthcare organization.

We understand billing hot buttons and know how to remove them from your workflow. We know claim profitability, navigation of complex payer rules, and the everchanging reimbursement methodologies and denial trends impacting your practice. With sophisticated technology designed in athenaOne’s athenaCollector®, you’ll be able to utilize automated rules engine helping to catch claims errors before they are submitted to insurance, saving you valuable time and money. Receive claims management and monitoring, patient scheduling solutions, and an online revenue cycle dashboard with real-time performance reports. Contact the experts at Virtual OfficeWare today and find the best solutions for your medical billing needs.