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Why Outsource?

Meeting the Unique Needs of Your Healthcare Business

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There are four key reasons to consider outsourcing:

  1. Access to Experts: It is very difficult for many provider offices to maintain the expertise they need in order to deal with the ever growing complexity of medical billing and collections.
  2. Lower costs. It costs less to outsource the billing for many provider offices, than to create and run an internal billing department.
  3. Higher revenue. Medicare and other payers often change the rules and deny medical claims. Outsource billing company personnel know the rules, and assertively pursue denied payments. Result- higher revenue.
  4. More time to build the medical practice. By outsourcing billing, providers can focus on patient care and growing the practice, avoiding the distraction of managing a billing and collections operation.

Access to Experts:

Each day seems to bring new rules, complexity and acronyms to health care. Just a few of the topics active at this time:

  • Accountable care organizations (ACO)
  • Pay for performance (P4P)
  • Meaningful use and EMR certification
  • E-prescribe penalties and incentives
  • Cures Act
  • Bundled case reimbursement
  • 5010 transaction standards
  • ICD 10 diagnosis code mandate
  • Patient portals
  • Mobile devices
  • HIPAA breach requirements
  • Health care exchanges
  • Credit balance management under the False Claims Act
  • Increase fraud, waste and abuse (FWA) activities

Upon partnering with HealthPCP you will work directly with our Client Implementation Team. Your practice will be assigned a Team Lead who will personally oversee your account. You will have access to experts in a wide array of health care topics.

Lower Billing Costs:

The costs to support a billing and collections operation includes salaries, health insurance benefits, payroll taxes, vacations, sick days, holidays, taxes, rent, overhead, software, software maintenance, workstation costs, electronic claims filing and clearinghouse charges, patient statement costs, postage, office supplies and more. By outsourcing you tap into the efficiencies gained by spreading costs over many practices and the ability to tap into bulk buying arrangements.

Reduced payment collection cycle times will improve the practice’s cash position and reduce the need to borrow funds.

Freeing Up Your Valuable Time:

Many providers who outsource view the greatest benefit being that of time. More time to spend with their patients. More time to spend growing and expanding their practice. More time to spend with family or in pursuing other areas of interest. A medical practice of any size is a substantial business. By outsourcing to HealthPCP our clients have found a way to offset some of the burdens of their businesses.

Increased Revenue:

Many years ago, denied claims averaged 5% of the total claim volume of a typical practice. Today, practices may experience a 25% to 30% or higher rate of rejected claims. This reduces revenue and puts a heavy additional burden on a practice’s internal billing department. Billing department personnel often also serve at the front desk, greeting patients and pulling charts. The process of limiting denials, and then aggressively pursuing unfairly denied claims is a full time job, often the least pleasant of a billing specialist’s duties.

HealthPCP has developed a proprietary approach for managing payer denials. This is embedded in a daily workflow and a series of reports that allow us to look for payer trends. We will also review your fee schedule and make recommendations for changes. As fee schedules have in general been flat, most increases in revenue are coming from various incentive programs. We would assist you in understanding those programs and if you so elect, we would help you pursue the incentives.

Maximize Profits

You want to take your practice into the future with an emphasis on increased profitability through efficiency, technology and staff that are experts in the industry. HealthPCP’s software innovation can support your vision with optional fully integrated EHR offerings. With HealthPCP as your medical billing service provider, your organization can focus on treating patients and leaving the financial aspects of your operations in the hands of a trusted partner with a proven track record of success.