Increase Revenue & Remain an Independent Practice – Here’s How!
Why Should a Practice Outsource Their Billing? Do the Math!
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nThe cost of setting up and maintaining a billing system, including the necessary staff to properly code, scrub, bill, post payments, and pursue denied claims, is a significant expense for any medical practice. Add to that expense the cost of employee turnover (and training), employee benefits, annual support and maintenance of computer equipment, the constant need to remain diligent regarding changes in reimbursement and CPT and ICD-9 coding (soon to be ICD-10!), and the necessity of conforming to meaningful use criteria associated with your electronic medical record, and you have a perfect storm brewing that could cost you a bundle!nnDepending on your specialty and volume, estimates from sources including the Medical Group Management Association (MGMA) and other industry experts peg the average expense of internal billing to be 8 to 15% of your collected revenue.nnOutsourcing your billing will range from 6 to 10% of your collected revenue. However, a number of studies have demonstrated that collections typically improve by as much as 5 to 10% when billing is outsourced due to improvements in the rate of denied claims, timely follow-up and appeals for incorrect or no-pay claims, and familiarity and expertise in correct coding in order to maximize reimbursement. Other intangible benefits of outsourcing include eliminating the administrative hassle of having to manage systems, staff, and expense, which allows you to focus more time and intellect on the practice of medicine.nnA general guide to comparing costs of doing it yourself versus outsourcing, assuming no increase in collected revenue (plug in your own numbers), includes the following:n
Doing it yourself:
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- A practice of one to three physicians requires a minimum of one and often two full-time equivalent (FTE) staff – cost including salary and benefits – $36,000 to $48,000/FTE/year
- Computer hardware and software expense including support and maintenance – $200/provider/month plus $500 for maintenance and support – $5,300/year
- Claims processing costs – clearinghouse fees, billing supplies, office space, office equipment – $15,000/year
- Total cost per year of internal billing/collections (assuming 2 FTE’s) = $116,300
- Assume two physicians collections = $950,000/year
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nTOTAL COST OF INTERNAL BILLING = 12% ($116,300/$950,000)n
Outsourcing:
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- Staff and software expenses – $10,000/year
- Billing service fee assuming no increase in collected revenue – 8% of collected revenue – $76,000
- Total cost per year of outsourcing = $86,000
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nTOTAL COST OF OUTSOURCED BILLING = 9% ($86,000/$950,000)nnIncrease in revenue available for physician distribution due to outsourcing = $30,300!!n
Contact Welter Healthcare Partners today for a free billing assessment* and more information on how we can help increase your revenue!
n*limited time offer through April 30, 2014
This is just a short delay to the industry’s inevitable transition away from the 30 year old ICD-9 to ICD-10. ICD-10 is coming and Welter Healthcare Partners, Inc. is pulling out all the stops to help our clients prepare for it and be successful. nnICD-10 is a richer data set allowing for more data to be used and transmitted. It will absolutely help the industry document care, document what treatments and modality’s work and how well they work. It will allow providers to better describe their services and why they are necessary.nnICD-10 will also help tremendously as we continue to transition away from a fee-for-service system of reimbursement to a quality and outcomes based reimbursement system like physician centric bundled or episodic payments.nnWe are excited about ICD-10 and the opportunity it will bring to our clients and the industry. We encourage providers, practices, and hospitals to continue training efforts already underway. Determine deficiencies now, as the clinical documentation improvement process and getting your staff proficient with the ICD-10 code set can take time! Take advantage of being ahead of the game! If you haven’t started, we encourage you to do so as this is a huge transition and being completely prepared is the only way to prevent negative impacts on productivity and revenue!n
W56.01XA — Bitten by dolphinnnW56.22XA — Struck by orcannW58.13XA — Crushed by crocodilennW61.09XA — Other contact with parrotnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2015 implementation date. Please don’t hesitate to 
The Senate voted today, (March 31st) to delay the switch to ICD-10 billing codes to October 2015. This is just a short delay to the industry’s inevitable transition away from the 30-year old ICD-9 to ICD-10. ICD-10 is coming and Welter Healthcare Partners, Inc. is pulling out all the stops to help our clients prepare for it and be successful.nnICD-10 is a richer data set allowing for more data to be used and transmitted. It will absolutely help the industry document care, document what treatments and modalty’s work and how well they work. It will allow providers to better describe their services and why they are necessary. ICD-10 will also help tremendously as we continue to transition away from a fee-for-service system of reimbursement to a quality and outcomes based reimbursement system like physician centric bundled or episodic payments. We are excited about ICD-10 and the opportunity it will bring to our clients and the industry.nnWe encourage providers and practices to continue any training efforts already started, as the clinical documentation improvement process and getting your staff proficient with ICD-10 can take time! Take advantage of being ahead of the game! If you haven’t started, we encourage you to do so as this is a huge transition and being fully prepared is the only way to prevent productivity and revenue loss!
The 2014 Medicare Physician Fee Schedule (MPFS) final rule stipulated a negative update to the MPFS that was to be effective January 1, 2014. That reduction was averted for three months with the passage of the Pathway for SGR Reform Act of 2013, which provided for a 0.5 percent update for services paid under the MPFS through March 31, 2014.nnCMS is hopeful that there will be congressional action to prevent the negative update from taking effect on April 1, 2014. CMS has instructed the Medicare Administrative Contractors to hold claims containing services paid under the MPFS for the first 10 business days of April (i.e., through April 14, 2014). This hold would only affect MPFS claims with dates of service of April 1, 2014, and later. The hold should have minimal impact on provider cash flow, because under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt. All claims for services delivered on or before March 31, 2014, will be processed and paid under normal procedures, regardless of any Congressional actions.
Z73.1 — Type A behavior patternnnZ73.2 — Lack of relaxation and leisurennZ73.3 — Stress, not elsewhere classifiednnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to