Practices of any size could potentially be viable candidates to outsource their billing. Whether you choose to outsource medical billing
or keep it in-house is a matter of comfort and understanding your revenue. Certain checkpoints and metrics indicate a practice should consider outsourcing billing.
The first thing to determine is whether or not your practice can afford the service. If you can afford it, and your patient and billing
volume is becoming unmanageable for your staff, you should consider an outside solution to help.
Moreover, when reviewing your revenue collections, look at the number of days in AR, clean claims rate, and denials rate. These are strong indicators of the strength or weakness of your internal revenue cycle management.
Typically, things should only be in AR for 30 to 35 days. If your practice is above that towards 50 days, then something is seriously wrong with your billing process. You should also have a clean claims rate above 85% and a denials rate below 10%. However, even if your revenue process is going smoothly, it may be worth considering outsourcing billing to provide extra bandwidth to your staff and improve your overall numbers.
One reason to keep billing in-house is the amount of control and clarity you get into your revenue. It can be difficult to trust an outside vendor with something critical to your business. That’s why you have to make transparency a high priority when looking at RCM vendors. A clear look into every step of the revenue process by a team of experienced billers and coders will make it easier to know you’re in good hands.