Outsourcing Medical Billing

Medical Billing is an extremely important activity for healthcare service providers in the United States of America as they get paid by the insurance companies for the services they provided to the patient. With each and every activity or steps of diagnosis that the doctor does, a code is given which further builds itself into a patient record which is then sent to the insurance company. With the insurance company decoding the code and deciding to pass the claim, the healthcare providers get paid.

With the healthcare providers' major responsibility to treat patients and not get involved in administrative hassles, lot of the doctors, physicians and even reputed hospitals in the USA are outsourcing medical billing to countries like India, Philippines etc.

Some of the main reasons medical billing is outsourced to countries overseas is because:

  • Low salaries in overseas countries like India, Philippines etc allow the healthcare service providers to get medical billing done cost-effectively.

  • Healthcare service providers cut down their time spent on frugal, administrative yet critical practices. All that the service providers need to do is outsource this function to any 3rd party company in an overseas country and get the work done. Meanwhile, the service providers can focus on what they do best, provide treatment to the patients.

  • As the globe is 'shrinking' due to the internet revolution, lot of these 3rd party companies are building their medical knowledge-base by understanding medical terminologies, different drugs, various insurance plans available in the US market. This knowledge-base allows the 3rd party company to provide the medical billing function qualitatively to the healthcare service providers in a cost-effective manner.

  • A lot of these companies have realized the importance of infrastructure to get the medical billing process as error-proof as possible. These companies have started to build HIPAA compliant VPN systems which aids the healthcare provider with providing the service.

  • Speed of services - With repeat claims rate in some cases going as high as 50%, these 3rd party companies have, over the years brought that down to 25%. That is a big achievement considering, for a big hospital with about 1000 new visitors every day, thousand claims are filed and a reduction of about 250 reject claims (approximate) is a big saving for the hospital.

There are many companies overseas which allow Outsourcing medical billing from healthcare service providers in the United States of America. I would recommend that healthcare service providers to do a complete due diligence of business processes including risk management to ensure that they get quality service in a timely and a cost-effective manner.