The US healthcare industry is constantly undergoing reform, especially since the implementation of ICD-10 in 2015 and the shift towards value-based payments. These changes have caused many solo physicians to consider selling their practices or merging into group practices in order to cope with the workload and expected revenue loss. Outsourcing medical billing services has emerged as a solution to help solo practices navigate these challenges and improve their financial performance.
Challenges Faced by Small Practices in 2023
ICD-10 and Compliance Reform Issues
The implementation of the new coding standard is causing apprehensions among physicians, but more so among individual practitioners. The reason behind this is the increase in workload that consists of administrative tasks, billing routine, paperwork, and so on, as cited in multiple reports. The transition from ICD-9 to ICD-10 has significantly increased the number of codes, which can be overwhelming for healthcare providers. This can lead to errors, rejections, and denials, resulting in delayed payments and revenue loss.
Less Individual Patient Time
The quality of service is expected to take a beating because physicians are going to remain busy with administrative tasks, and as a result, they will have less time for each patient. Statistics reveal that usually, physicians spend around only eight minutes with each patient. This is also a reason for reduced patient satisfaction. Outsourcing medical billing can free up time for healthcare providers, allowing them to spend more time with patients, improving the quality of care and patient satisfaction.
Payment Restructuring
The Medicare physician fee schedule (MPFS) is undergoing a major shift from the fee-for-service (FFS) model to value-based payments and bonuses for the physician quality reporting system (PQRS). Moreover, to gain incentives from the Centers for Medicare & Medicaid Services (CMS) for Meaningful Use, physicians are hard-pressed for time to provide quality care as well as do the documentation. Outsourcing medical billing can help healthcare providers keep up with the latest payment models and reporting requirements, allowing them to focus on patient care.
Increasing Pressure
Other factors, such as hiring skilled coders with an increased salary rise, increase in administrative tasks due to compliance issues by the CMS as well as insurance companies, working on patient collections, staff turnover rate, follow-up for rejections and denials, etc. pose challenges to medical practices’ performance. Outsourcing medical billing can alleviate some of these pressures, allowing healthcare providers to focus on patient care and practice growth.
Recourse in Group Practice
Taking recourse to form group practices or be a part of Accountable Care Organizations (ACO) seems a natural course of action to survive healthcare reforms. Expenses are shared, and experts can be appointed for particular tasks, which is unlikely to happen in an individual practice due to monetary constraints. However, not all healthcare providers want to join a group practice or ACO, and outsourcing medical billing can help solo practitioners manage their billing and coding needs efficiently.
Benefits of Outsourcing Medical Billing Services in 2023
Increased Revenue and Fewer Rejections
Outsourcing medical billing ensures the timely filing of claims and the accuracy of charge entry. Expert and certified coders provide the necessary knowledge and skills to manage billing across various medical specialties. This leads to a smoother billing process, ensuring steady revenue and more collections from alternate payment methods.
Access to Specialized Expertise
Outsourcing allows solo practices to access specialized expertise without the need to hire additional staff or invest in training. Medical billing partners have expertise in a range of billing and coding issues, including compliance with regulatory requirements and payer policies. This can help practices avoid costly errors and maintain compliance with the latest industry updates.
Improved Efficiency and Cost Savings
Outsourcing medical billing allows solo practices to focus on providing quality care to their patients, while the billing partner takes care of administrative tasks. This can lead to improved efficiency and cost savings, as well as reduced stress for physicians and staff.
Conclusion
The healthcare industry is undergoing a major transformation, with changing reimbursement trends and compliance regulations, particularly the ICD-10 implementation and Medicare Physician Fee Schedule changes. These changes have put solo medical practices in a difficult position, leading many to consider selling their practice, merging with larger groups, or outsourcing their medical billing services. Outsourcing medical billing services can provide many benefits, including timely filing of claims, accurate charge entry, reduced workload, and increased revenue. Rhinomds is a trusted medical billing service provider that can help solo medical practices to grow and increase their revenue. With a team of experienced and certified coders, Rhinomds can provide reliable and accurate billing services that comply with all applicable regulations. By outsourcing their medical billing services to Rhinomds, solo medical practices can focus on providing quality patient care and growing their practice without worrying about the administrative burden of medical billing. Outsourcing medical billing services can help solo medical practices to improve their performance and revenue while reducing the burden of administrative tasks. Rhinomds can provide reliable and efficient medical billing services that can help practices to achieve their goals and thrive in the changing healthcare industry.
