Friday, March 4, 2016

Can Your Medical Practice Outsource Your Billing To An Overseas Company?

By Dinver Northwood


Medical billing outsourcing is becoming rather popular today. There is an overwhelming amount of billing that goes on in the United States on a day to day basis. It is estimated that nearly 25% of all healthcare companies will outsource their billing within the next ten years. It is not shock since physicians are now seeing the tough decisions that go into ICD-10 billing. Today, a biller has to be ICD-10 certified and know a lot about utilization management, revenue cycle management and benefit verification.

A lot of overseas companies will make promises saying that they can get you higher returns and save you lots of money on your investment. However, you may not be aware of the fact that they don't often comply with USA laws. On October 1, 2015, the new codes were released for medical billers. We went from using ICD-9 to using ICD-10. There are over 100,000 codes in ICD-10. ICD-9 only had 14,000. This is a big difference since we have yet to see the full results of how medical billers will handle this.

I can tell you that coding in ICD-10 is difficult. You must have a good understanding of the English language and be able to write down specific treatments before an insurance company will pay you anything on your claim. Many claims today are being sent back 2, 5 and 10 times. You may not see payment for 90 days or more. Sometimes you will never see payment if the claim is not submitted correctly. You must have knowledgeable people working on your claims that have a good foundation of ICD-10.

ICD-10 certification training is often taught in Universities. Many billers today have their certification and master's degrees in this field. Make sure that you check all of the credentials of the workers that will be working on your claims. You must obey all HIPAA laws. If you choose to work with an overseas company, make sure that you ask them if all of their workers are ICD-10 certified. They may say that some of them are or I think that they are. United States law requires all billers to have their ICD-10 certification if they are working on a USA physicians billing. Check with your attorney before outsourcing your billing. Many countries have their own sets of laws.

The most popular overseas companies are in India. You may receive a phone call at some point of someone offering you savings of 40% to 50%. However, will this come at a price? You must take into fact a lot of important decisions. They will have access to your patient's records and company affairs. You must also see what he international laws are concerning their responsibilities if something should go wrong? Could you sue them? When it comes to medical billing, the laws must be obeyed at all times. Many overseas companies do not care about USA laws since they live under a different set of laws in their own country.




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