Medical Billing & Coding Outsourcing in the changing Revenue Cycle Management

Billing Outsourcing ServicesPerhaps no other industry can depict the benefit of outsourcing than healthcare. According to a recent report, the global healthcare BPO market is growing at a healthy CAGR of 21.4%. The report further stated that,

healthcare provider outsourcing has the highest growth rate of 31.9% from 2011 to 2016 due to conversion from ICD-9 coding system to ICD-10 and ICD-10 coding system to be implemented by October 2013 in the U.S. Healthcare payer outsourcing market will also grow at about 30% in the forecast period.

Medical Billing and Coding outsourcing is a critical part of the overall healthcare outsourcing canvas. For RCM it’s an exciting time. Its importance is slated to reach even higher heights as harder times begin to be visited on healthcare providers who will scramble for cash.

Even with internal billing, coding collection and ancillaries, RCM remained a tough nut for provider practices. With high expenditure on biller salaries, employee benefits, federal and state employee charges and expensive technology system procurement, maintaining an optimum cost structure has proved futile. In addition, while top-notch medical billers and coders are hard to find, novice or semi trained resources need to be trained by seasoned trainers before they hit the floor. Specific skill based training itself is an altogether expensive play. And once trained, there are issues with attritions. As in the case of any industry, attrition is rampant in healthcare too. In-house practices are finding it hard to thrive in such attrition-prone environment and find it impossible to run their medical billing solutions effectively and seamlessly.

However, in light of the changing economic times and altering complexities, healthcare market is about to witness an unusual and tremendous change in near future. According to ST Advisors, LLC, the U.S. RCM market is projected to grow from approximately $4B in 2010 to more than $9B by 2018, predominantly buoyed in part by acceleration of regulatory compliance challenges.

The move to ICD-10 coding standards from longstanding ICD-9 is leading to more complex rules and reimbursement coding. An increasing number of healthcare providers, hospitals, urgent care centers are not able to meet these standards on their own and seeking help from external resources. There are urgent needs to minimize claims processing time, claim denials and rejections, reduce days outstanding of accounts receivable, space requirements and overhead, reduce bad debt expense and gain insightful reports with current information and balance due on all patients. All of them together have accelerated the need to outsource medical billing and coding services to quality (ISO), security (HIPAA), technology and infrastructure (SAS 70) certified specialist outsourced providers.

Companies like VeeBill have an intense focus on maximizing collections for physician groups, hospitals or medical billing companies. It has built a successful healthcare and health plan processing firm by helping clients realize income faster and reduce AR days significantly. Its commitment and expertise together are well matched as its billing and coding outsourcing services enable them to reduce their onshore cost and minimize the demand on their time. VeeBill is an ISO 27001:2005 certified organization which delivers maximum security compliance with every transaction. In addition, its use of OCTAVE and 131 additional controls points means that clients' business and data are 100% secure. Image: David Castillo Dominici/