“The billing and especially chasing side of private practice is not something medical secretaries enjoy, and they are often happy to relinquish responsibility for this task”
Outsourcing private practice medical billing and collection has become an increasingly common option for consultants. Simon Brignall discusses some of the most common reasons why this is the case
OVER THE past decade, there has been three distinct trends in private healthcare:
1 The rise and rise of the selfpay patient;
2 An increase in the number of consultants working in groups;
3 A growth in outsourcing the medical billing and collection side of the practice
As I have covered the first two trends in previous articles this year (August and April), I turn to the third, highlighting the main reasons why consultants, groups and clinics are choosing to outsource this key role
Splitting the practice into clinical care and finance
Probably the most important, and often overlooked, benefit from outsourcing is that your medical secretary can maintain a clinical relationship with the patient that is not hampered by the business side of the practice.
Remember that your medical secretary is the first point of contact for your practice and is a vital part in the patient journey.
Outsourcing allows this relationship to remain warm and engaging by compartmentalising the two sides of the practice, leaving the billing company to focus on the business side and those difficult conversations about money.
This improves the patient experience and benefits the practice, as the secretary can focus on responding to new and existing patient inquiries.
Experts in their field
Consultants spend years in education and training to become experts in their specialty, but when they start out in private practice, running a business often presents challenges that they are not prepared for.
Even busy practices that have been running for many years still can find this difficult. Procedures often are not as robust as they should be or, more importantly, seldom routinely followed.
I still come across consultants that do their own billing – not a valuable use of their time or experience.
If you are going spend time billing, surely it is better to use that time more productively by seeing patients and leaving the billing to experts.
Most billing companies’ fees are calculated against received income, so their business model means that they are incentivised to ensure that they always bill the optimal amount on your behalf and that these invoices are settled as soon as possible.
“If you are going spend time billing, surely it is better to use that time more productively by seeing patients and leaving the billing to experts”
Cash flow/bad debts
The most common inquiry we receive are from practices that have problems with their cash flow due to issues with outstanding debt. This can be the result of a range of issues such as:
- Delays in raising invoices;
- Delays in the reconciliation of payments;
- Outstanding invoices not being chased effectively;
- Poor practice financial data – no visibility of the scale of the problem;
- Limited payment options for the patient.
I often meet with practices that are writing off 5-10% in bad debts a year because they find it difficult to stay on top of this side of the practice. A professional medical billing company that specialises only on this role will have robust procedures in place to resolve these issues and provide you with a range of payment pathways. This will all help to keep your bad debts to a minimum.
At MBC, our bad debt level is less than 0.5% across the firm.
Medical billing is a complex process and some countries require you to have medical billing qualifications to carry out this task. There are over 2,000+ Clinical Coding and Schedule Development codes as well as diagnostic codes to consider and each insurance company has its own price list and rules in relation to how these codes can be billed.
These are updated monthly, so keeping on top of this can be challenging. Failure to do so can mean the practice loses out on income or, worse, result in issues with the insurers from incorrect billing. I still come across practices that are not billing what they could be due to errors in this key role.
Chasing outstanding debt requires a specific skill set and, for many medical secretaries, this is a task they do not relish, which can often mean that it gets put off. A medical billing company provides a wealth of experience in this task as it is core to what they do.
Outsourcing often provides a simple yet effective solution to a range of staffing issues. We often get inquiries from consultants where a long-valued medical secretary has retired and their replacement is not as proficient on the billing and collection side.
A well-resourced billing company means that the financial side of the practice is no longer impacted when the secretary is on holiday, as they will continue to provide continuity in service.
This can be beneficial with growing practices or groups where sometimes binary decisions about staffing need to be made when workload increases or decreases. Outsourcing means you have the capacity of the billing firm available to meet your requirements.
The Coronavirus pandemic has highlighted the need to have adequate disaster-recovery planning, which can be difficult to manage.
At MBC, all our systems, including our phones, are web-based, which meant we adapted a remote working model swiftly with no drop in our service levels. Our staff have now been back in the office since July and we are prepared to react to events accordingly.
Practice financial data
A common complaint I receive from consultants is that they do not have easy access to up-to-date and accurate financial data on their practice. All practices rely on this information as the first step in the chase process, otherwise the whole process is flawed.
At MBC we provide our clients with access to a full array of reporting tools to review their practice data via our software. Clients can access this information 24/7 allowing them to view reports detailing:
- How much they have invoiced and collected based on a range of criteria including patient type, payment company and location;
- What codes they are billing;
- Aged debt.
Access to a range of practice data allows consultants to make informed decisions about their practice. Billing companies can also provide end-of-year reports that can be sent directly to their accountant.
Outsourcing can provide a range of payment pathways that were previously unavailable to the practice or difficult to implement.
Many of these not only improve the patient journey but benefit the cash flow to the practice. Here are some examples of what billing companies can offer:
- E-billing of private medical insurers and patients;
- Ability to collect 24/7 card payments via our card portal linked to each invoice;
- Collection up front of monies when required;
- Collection on the day via our client self-pay platform.
Billing companies’ costs
Most billing companies work on a cost structure that is calculated against received income, not on what you invoice.
It is always good business practice to have a cost structure that is correlated to the monies you receive. This has been highlighted this year when income has been less predictable.
As I have presented an in-depth examination of why outsourcing has been proved to be a popular choice for many practices, I think it would be useful to discuss some of the concerns that are raised.
The most common concern is around a perception that the practice is giving up control. This is best addressed through transparency. It is important that you know what the billing company is doing for you, therefore access to practice data is key so you can review its performance. Only then will you be able to establish trust and allow the partnership to flourish.
Another concern I hear from consultants is that they do not want to upset their secretary. In my experience, the billing and especially chasing side of private practice is not something medical secretaries enjoy, and they are often happy to relinquish responsibility for this task.
Building a partnership
It is important to make sure that you understand how the billing company operates, its workflow and who will be responsible for your practice, as this will ensure a smooth transition.
Establishing a good foundation to build a partnership with the practice is key. Our onboarding process, which is called ‘intensive care’, is managed by a senior dedicated personal account manager who establishes a good working relationship with the secretary so that this takes place.
By removing the billing and chasing side of the practice, this leaves the secretary to focus on the higher-value side such as patient engagement and can often lead to increases in revenue.
In summary, the outsourcing of the medical billing and collection role to billing companies is a trend that is well established and I expect will continue. Should you feel that is something that may benefit your practice, then why not contact a professional medical billing and collection company.
At MBC, we have over 28 years of experience in this sector and, as such, have a wealth of knowledge, making us ideally positioned to offer advice and guidance.
Simon Brignall is director of business development at Medical Billing and Collection