Why Outsource Medical Billing?

21+

Years of Experience

1000+

Experienced Resources

200+

Satisfied Clients

Struggling with Claim Denials? Why Medical Billing Outsourcing Is the Answer

Medical practices and hospitals generate bills and submit them as claims to insurance companies to get reimbursed for services rendered. It is important for healthcare providers to handle the billing process meticulously because their cash flow depends on it. Why outsource medical billing? For many practices, outsourcing is a strategic decision based on their specific needs and the expertise of their staff.

Medical billing has two components: front-end and back-end. The front-end comprises patient scheduling, pre-registration, registration, and insurance verification and pre-authorization. The back-end part of RCM comprises medical coding and medical billing which includes charge posting, claim review and submission, payment posting, patient payment collections, and AR (accounts receivable) management.

Outsourcing prevents reimbursement delays and claim denials, while allowing you to spend more face-to-face time with your patients. It also saves you time and money that would go into hiring staff and investing in infrastructure to manage the process in-house. Importantly, outsourcing gives you access to expertise in medical billing and coding, which are crucial for efficient RCM and optimal reimbursement.

In contrast, managing an in-house billing system requires significant upfront expenses for staff training and IT systems, which can increase overhead costs and strain resources. Also, in-house teams may struggle to keep up with constantly evolving regulations, leading to costly errors and delayed payments. This is why many healthcare providers choose to partner with agencies that outsource medical billing services, saving time and money while improving accuracy. Outsourced medical billing services combine human expertise with specialized technology to offer scalable and cost-effective solutions that adapt to your practice’s evolving needs.

Take the first step towards financial efficiency and success today!

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Benefits of Outsourced Medical Billing Services

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Faster Cash Flow and Revenue Growth

Medical billing outsourcing improves clean claims rate and expedites reimbursement cycles, leading to faster cash flow and consistent revenue growth for practices.

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Reduced Administrative Burden

As external billing experts are tasked with managing the claim reimbursement and payment collection process, internal staff can shift their focus from paperwork and claims follow-up to patient care.

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Improved Compliance

Outsourced providers employ certified billing and coding specialists, who stay up-to-date with the changing regulatory and compliance requirements, minimizing the risk of costly audits.

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Scalable Solutions for Any Practice

Whether your practice grows or faces seasonal patient surges, professional billing services can scale resources to match your practice’s demands.

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Advanced Technology and Reporting Tools

With outsourced partners, practices gain access to cutting-edge medical technology and automation tools that optimize billing processes and deliver detailed financial reports on the practice’s financial performance.

Top Reasons to Outsource Medical Billing

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ACCESS TO EXPERTISE

Instead of training an in-house team, outsourcing RCM to a medical billing company ensures they are handled by experts in the field. Outsourcing companies have skilled medical coders, billing specialists, and insurance verification experts who work to ensure accurate claim submission and reduce payment denials/delays.

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INSURANCE VERIFICATION

Outsourcing can ensure reliable support for insurance eligibility verification. Patient demographic and insurance information, coverage status, co-pays, deductibles, coinsurance, and other details are checked before every office visit, promoting claim accuracy. They also help you obtain preauthorizations on time.

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INCREASED CASH FLOW

Competent cash flow management is crucial for practices to get properly reimbursed for the services provided. Reliable physician billing companies not only submit claims, but also follow up on those claims with health insurance companies to ensure appropriate reimbursement. They don’t let your AR get bigger.

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REDUCE OVERHEAD COSTS

Setting up and maintaining an in-house billing team involves costs such as training costs, salaries, infrastructure, rental and equipment costs, and more. This could be financially challenging, especially for smaller practices. Outsourcing allows you to avoid these expenses and save up to 30-40% on your overhead.

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MINIMIZE CLAIM DENIALS

Partnering with an expert ensures end-to-end billing solutions to minimize claim denials, and accelerate cash flow. This includes patient appointment scheduling and registration, insurance verification and preauthorization to medical coding, charge entry and claim submission, payment posting and AR management.

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Accurate Medical Coding

Outsourcing ensures the services of skilled AHIMA- and AAPC-certified coders. They assign the most appropriate medical codes and modifiers based on a review of the clinical documentation. Proficient in ICD-10, CPT, and HCPCS coding, they can ensure that diagnoses and treatments are reported accurately.

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AR MANAGEMENT

Medical billing companies track claims, identify potential issues, initiate timely follow-up, and handle denials efficiently. This reduces outstanding balances and prevents revenue leakage. They also handle patient collections with a patient-centric approach, maximizing revenue recovery and patient satisfaction.

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Positive Patient experience

Professionals can streamline the process by preventing common and costly billing errors such as wrong/missing patient data, coding issues, duplicate billing, unbundling, inadequate documentation, prior authorization not obtained, and so on. This improves the quality of care and increases billable revenue.

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We serve all 50 states

Trust Us for Specialty-specific Medical Billing Success

Established in 2002, we provide tailored medical billing support for all medical specialties. With a deep understanding of complex coding processes, billing regulations, and industry best practices, we can ensure accurate claim submissions, timely reimbursements, and optimal revenue for your practice. Take the next step towards hassle-free billing by contacting us today.

Our Medical Billing Process

Driven by expert knowledge and technology, our medical billing process involves the following steps:

1

Patient Registration

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Claim Submission

5

2

Insurance Verification

9

Payment Posting

6

3

Chart Review

9

AR Management

7

4

Medical Coding

9

Reporting & Analysis

8

1

Patient Registration

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2

Insurance Verification

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3

Chart Review

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4

Medical Coding

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5

Claim Submission

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6

Payment Posting

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7

AR Management

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8

Reporting & Analysis

1. Patient Registration
We gather and input correct patient demographic data, including insurance details and medical history, ensuring all information is current prior to the delivery of services.

2. Insurance Verification
Our staff performs thorough insurance verification to verify that each patient’s coverage is active, in-network, and accurately documented before appointments. We verify information like co-pays, deductibles, and coverage limits to avoid surprise billing or denials in the future.

3. Chart Review
We are meticulous in reviewing patient charts and clinical documentation to properly identify all billable services and ensure comprehensive and compliant documentation.

4. Medical Coding
We apply proper CPT, ICD-10, and HCPCS Level II coding, following payer-specific and specialty -specific guidelines for coding to correctly represent services and reduce errors that may result in claim denials.

5. Claim Submission
To ensure prompt receipt by insurance payers, we prepare clean claims for submission, file them electronically for faster processing, and track confirmations.

6. Payment Posting
Payments received from payers and patients are correctly applied, Explanation of Benefits (EOBs) are reconciled, and all write-offs and adjustments are meticulously documented.

7. AR Management
We track unpaid claims and actively pursue insurers, identify delays or denials, and prioritize aging accounts to speed up revenue recovery.

8. Reporting & Analysis
We ensure that denied or rejected claims are carefully examined, corrected claims are appealed and resubmitted, and provide performance reports with detailed insights to maximize revenue cycles.

Medical Specialties We Serve

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Physical Medicine & Rehab

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Why Choose OSI?

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Expertise

Our industry expertise, technology, and resources ensure you get paid what you’re owed. We tackle RCM challenges, recover overdue payments, and maximize every claim.

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An Extension of Your Practice

We seamlessly integrate with your practice, freeing your staff to focus on providing exceptional patient care.

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Pricing Transparency

We believe in transparency. No long-term yearly contracts or hidden fees, just clear, upfront costs for our services.

Affordable Pricing Options

Reduce administrative hassles and welcome efficiency with our skilled team supporting you. Choose from our flexible pricing plans based on your needs.

Full-Time Equivalent

In this model, services are billed based on the equivalent cost of a full-time employee (FTE) for a specified duration, usually monthly or annually.

Per Verification Billing

Like an FTE model, a person is dedicated to your practice. Perfect for a practice that is busy. They work as an extension to your business.

FTE/Per Verification Billing

This option is ideal for a practice that is unsure about their work requirements. This can have per request pricing for eligibility and other functions.

AR is only FTE

At present, we provide only the FTE pricing model for Accounts Receivable (AR). We are also considering a blended model for AR.

Healthcare and Dental Revenue Cycle Management Process

Let Us Manage Your Medical Billing

Call (800) 670-2809

FAQs

Will I have a dedicated team working on my account?

Yes. Our dedicated Account Managers will be your first point of contact. These experienced managers will assist with all your medical billing needs on a day-to-day basis. We understand that project integrity is maintained when the team works together. So, we assign a separate team of billing and coding specialists for each project.

With the right experienced team handling your account, you can stay focused on delivering excellent medical care to your patients.

What is your payment posting process?

After receiving the check and/or EOB copy from the doctor’s office via our secure FTP server, the files will be sent to the payment review department. Our payment team reviews each EOB carefully and applies the payment into the billing software against the appropriate patient account. We will line item post your payments. The under/over payments and denials are immediately identified, and necessary refund requests or appeals are generated. This is then forwarded to the analysts for further action.

How do you manage patient collections?

Our team is well-versed in managing patient responsibility. Our patient responsibility management services include sending patient statements in a timely manner (sometimes adjusted according to client preference). In addition, we follow up with a demand letter and phone calls. We see that timely follow-up helps in obtaining quicker reimbursement. If for any reason we find the efforts futile we will work with your collection agency or your attorney for collections if our client feels that step is necessary.

How do you ensure a smooth transition of my process?

We take certain steps to ensure that all required details are collected even before the transition takes place.

We gather information from your office that will include all aspects of your present billing and collections cycle
We evaluate your current billing practices to identify gaps, shortcomings and other issues
Based on these metrics, we create an appropriate, effective and more efficient solution
We finalize our plan after discussing it with you and then educate your staff on the processes they will be responsible for
We will ensure that our billing and collections department understands the protocols and rules that you have set in place along with other specifics concerning the practice
A few dry runs will be conducted to make sure every area in the billing and collections process functions properly and that all expectations are met
We will have staff, software and everything on hand to ensure a smooth transition

How do I keep track of my practice performance?

We provide performance reports to our clients such as weekly collection reports, denial reports, and month-end reports that include physician financials, procedure code usage reports, collection by carrier reports, aged summary reports, detailed management summaries, and year-to-year analysis. We assure that the informative medical billing reports we provide are accurate and easy to follow for proper financial analysis and comparisons. We assess your billing collections performance by comparing your practice to industry benchmarks.

Insurance verification - what details do you verify?

Our expert staff verifies payable benefits, co-pays, co-insurances, deductibles, patient policy status, effective date, type of plan and coverage details, plan exclusions, claims mailing address, referrals & pre-authorizations, lifetime maximum, and more. We do this by calling the insurance companies directly – we do not rely solely on the website information which may be outdated. All calls are logged with each insurance company’s agent name and a reference number. We also record the calls for added efficiency and quality assurance.

How do you work with your clients? Do we have to give you our whole revenue cycle management to start with you?

Not at all necessary. We are extremely flexible when it comes to our outsourced revenue cycle management process. We have client who want us to take over the whole RCM process. Some want us to focus purely on eligibility verifications and authorizations. And we have clients who wants to pick and choose what they want us to do. Talk to us to learn about our medical billing outsourcing process and then decide what works for you best. We remain flexible. That is our strength.

What is your turnaround time?

All of our billing is completed under 24 business hours unless it requires further analysis. When it comes to AR management, we follow most claims in 30 days if payment have not been received. Why most? It is because of the type of insurances we deal with. Depending on states, some insurances might only pay in 45 days and some might pay faster. Knowing that allows us to be productive and efficient.

When it comes to scheduling, medical coding outsourcing, payment posting or any other area of RCM we remain flexible to adjust the turnaround time to your needs. In eligibility verifications we can work on future appointments as well as STAT requests and add-ons keeping you 3 to 5 days ahead of schedule.

Depending on which area of medical billing outsourcing you are interested in, we can provide quick turnaround times from immediate to 2, 4, or 24 to 48 hours. Like we mentioned earlier, tell us what your reasonable expectations are, and we will make sure our service level agreements are constructed accordingly.

We realize that when it comes to revenue cycle management with medical billing outsourcing, it is a very tough and an involved decision for any practice. We want you to feel comfortable with making your choice. This is why we offer free trials for some aspects of our services.

Why Outsource Medical Billing to OSI? Your Complete RCM Partner