Medical Billing Trends to Monitor: Outsourced Medical Billing

Medical Billing Trends to Monitor: Outsourced Medical Billing

Welcome to the start of a new series, where we discuss some prevalent medical billing trends, and what they mean for your organization! Let’s start off this discussion with the concept of practices outsourcing their medical billing. This trend has skyrocketed in popularity over the last decade or so, and isn’t going away anytime soon. So, why do practices outsource their billing function? Let’s analyze a few key reasons.


1. Specialization

Medical billing requires extremely specialized knowledge of complex billing codes, regulations, and compliance requirements. Outsourcing to a dedicated revenue cycle management firm ensures you have the most highly-trained professionals in your corner handling your practice’s billing, and is a good way to promote more accurate billing and timely revenue cycle management. Many practices try to get by with novice billers, and the results are often disastrous. By outsourcing revenue cycle management, you delegate your billing to the most qualified experts, which is quite attractive to many practices.


2. Potential Cost Savings

Another major reason practices look to outsource medical billing is to take advantage of potential cost savings. By outsourcing your revenue cycle management, healthcare providers can avoid the costs of hiring and training a high-level in-house billing staff, purchasing billing software and equipment, and maintaining an infrastructure to support billing operations.

However, it is important to note that when you outsource, you tend to get what you pay for. If you choose a lower-cost outsourcing provider, you will likely receive lower-quality services, which can cause substantial problems downstream. If you partner with a top-of-the-market provider, you may not be realizing any up-front cost savings at all, but will have a better team in your corner. It is critical that you keep this calculus in mind when deciding whether outsourcing is the right choice for you.


3. Increased Efficiency

The opportunity for increased efficiency is another major reason practices look to partner with outsourced revenue cycle management companies. Outsourced billers often have more streamlined processes and technology than individual healthcare providers. This can result in more timely claims processing and payments, reducing the time and effort required to manage billing operations. Better processes also means increased accuracy, and helps you increase revenue.

Additionally, when you take RCM off your practice’s plate, you also reduce incoming calls to your office, freeing up your staff to handle other tasks that more directly affect patient care and improving the patient experience. When outsourcing billing, you also won’t need to worry about any interruptions to billing if a member of your internal team calls in sick, goes on vacation, or resigns.


4. Compliance

Lastly, the issue of compliance. Medical billing companies stay up-to-date with constantly changing healthcare regulations and compliance requirements. It can be easy for your staff to fall behind, especially if they have other tasks on their plate. By outsourcing, healthcare providers can often reduce their risk of non-compliance penalties and lawsuits.


Why Do Your Own Billing?

So, with all of this in mind, what’s the argument for doing your own billing?

First and foremost, control. If you outsource your billing, your RCM partner becomes an extension of your practice, and plays an integral role in the way in which your practice is perceived. If your billing partner starts missing the mark, that reflects negatively on your practice in a way you really cannot control.

There is also the issue of complete dependence. If a practice dissolves its RCM staff and completely outsources the function, it becomes completely reliant on its billing partner. What happens if your billing partner goes out of business, and you don’t have any in-house staff capable of overseeing billing?

Outsourcing the billing process also causes your practice to lose some visibility in regards to reporting and data, which can make the path to improvement considerably less clear. Make sure you are closely monitoring timely filing of claims, days in A/R, timely reimbursement, appropriate reimbursement, and ensuring timely follow-up on denials to ensure your billing partner is hitting the mark.

As we touched upon earlier, there is the issue of quality, as well. When organizations outsource, they are typically looking to realize cost efficiencies. However, when you choose lower-priced outsourcing options, you may recognize cost-savings up-front, but your billing quality may suffer, potentially damaging your relationship with your patients. Many outsourcing organizations also make use of overseas staff, and there can be a bit of a language barrier at times. This can occasionally frustrate patients calling in to check on their bills.

Lastly, there’s the issue of confidentiality and security. You are passing over protected health information or PHI to a third party that is not your practice, or insurance. You must be sure your patients are aware of this movement of data, and that your billing partner takes proper compliance measures to ensure your patients’ data is protected (signing a BAA is a must).


What Does This Mean For Your Business?

As a medical practice, you must carefully weigh the pros and cons of outsourcing billing. If you are struggling to tackle billing on your own, outsourcing may make sense (check out some of our partners)! However, if you are doing a good job billing internally, there is likely no need to outsource this process unless considerable cost savings can be realized, without seeing a dip in quality. Investing in your own team is never a bad decision. By equipping them with great software and providing expert training, you can get exceptional results from internal billing. Always keep your options open, and realize that outsourcing is not a fit for every practice.


If your organization is looking to get the most out of its medical billing process, we can help. EZClaim has been the medical billing software of choice for practices and RCM firms alike for over 25 years. If you are interested in learning more about how we can help your business improve its billing capabilities, schedule some time to meet with our team!

Tokenization: Making Payments Secure and Easy With Payment Services

Tokenization: Making Payments Secure and Easy With Payment Services

The healthcare industry increasingly relies on electronic payment systems to process transactions in today’s digital age. This includes everything from automated medical billing systems to online patient payment portals. However, with the increased use of electronic payments comes a higher risk of security breaches and data theft. That’s where payment tokenization comes in.


What is Payment Tokenization?

Payment tokenization is a security measure that involves converting sensitive payment information (such as credit card numbers) into a secure token. This token is a unique, randomly generated string of characters that represents the original payment information. The tokenization process takes place on a secure server, which a payment tokenization provider manages. The importance of payment security in the healthcare industry cannot be overstated. Medical practices handle sensitive personal and financial information daily, and any breach of this information could have serious consequences for the practice and its patients. Payment tokenization helps to protect against these risks by providing an extra layer of security for electronic payments.


How Payment Tokenization Works

The payment tokenization process begins when patients provide payment information to a medical practice. This information is then sent to the tokenization server, which converts it into a secure token. The token is then used to process the payment rather than the original payment information. This helps to protect sensitive data from potential breaches or theft. The tokenization server plays a crucial role in the process, as it generates and manages the secure tokens. The server is also responsible for decrypting the tokens when it is time to process the payment. This ensures that the original payment information remains secure throughout the transaction.


The Benefits of Payment Tokenization for Medical Offices

Payment tokenization offers several benefits for medical practices, including:

Enhanced Security

Payment tokenization is an effective way for medical practices to enhance the security of their electronic billing systems. By converting sensitive payment information into secure tokens, payment tokenization helps to protect against data breaches and theft. This is particularly important in the healthcare industry, where personal and financial information is often sensitive and at risk of being compromised. Tokenization helps to safeguard the information of both the medical practice and its patients by ensuring that sensitive data is not stored in a way that is easily accessible to unauthorized parties. This helps to reduce the risk of data breaches and can help medical practices to comply with industry regulations and standards, such as the Payment Card Industry Data Security Standard

Enhanced User Experience

Tokenization helps improve the overall payment experience for patients. This is because tokenization allows for automated billing, which can be particularly helpful for medical practices with high patient volumes. For example, if a medical practice uses a traditional payment system, patients may be required to fill out lengthy forms and provide sensitive payment information each time they make a payment. This can be time-consuming and inconvenient for patients. With payment tokenization, however, patients can make payments more quickly and easily by simply providing their payment information once and using a secure token for all future payments. This enhanced payment experience can be particularly beneficial for medical practices that rely heavily on electronic billing systems, as it can help to reduce the number of payment-related issues that arise and improve patient satisfaction.

Improved Compliance

Payment tokenization helps medical practices to comply with industry regulations and standards. For example, the PCI DSS requires that sensitive payment information be stored securely. Tokenization helps to meet this requirement by reducing the amount of sensitive payment information stored on the medical practice’s systems. Tokenization can also help medical practices comply with other regulations and standards relevant to their specific industry. For example, medical practices may be required to comply with HIPAA regulations, which outline requirements for protecting personal health information. By using payment tokenization, medical practices can help ensure that they comply with these regulations and standards.


Implementing Tokenization in a Medical Office

If you are a medical practice looking to implement payment tokenization, there are a few key steps you should follow:

Choose a payment tokenization provider: The first step is to choose a payment tokenization provider that meets your needs. This should be a reputable provider with a proven track record in the healthcare industry.

Integrate with existing payment systems: You will need to integrate the payment tokenization system with your existing payment systems. This will typically involve working with your tokenization provider to ensure that the integration process goes smoothly.

Train staff: It’s important to ensure that your staff is familiar with the payment tokenization process, as they will be responsible for handling patient payments. This may include training on how to use the new system and any relevant industry regulations.


Best Practices for Using Payment Tokenization in a Medical Office

To ensure the security and effectiveness of payment tokenization in your medical practice, it’s important to follow a few best practices:

Keep tokens secure: It’s essential to keep the tokens generated by the tokenization server secure at all times. This includes properly storing and handling tokens and regularly updating your tokenization system to ensure it is up to date with the latest security measures.

Complying with industry regulations and standards: Payment tokenization can help medical practices comply with industry regulations and standards. It’s important to stay up to date with these requirements and ensure that your payment tokenization system meets all necessary requirements.

Provide a seamless payment experience for patients: Finally, it’s important to ensure that the payment experience for patients is seamless and efficient. This may involve integrating the payment tokenization system with your patient portal or other online payment portals and offering multiple payment options (such as credit card, debit card, or electronic check).


Unlock the Power of Tokenization with EZClaim & BillFlash

Payment tokenization offers several benefits for medical practices, including enhanced security, improved compliance, and enhanced user experience. If you are a medical practice looking to streamline your payment processing procedures and increase efficiency, consider implementing payment tokenization with reputable providers such as EZClaim and BillFlash, a NexTrust service. EZClaim integrates with BillFlash to provide a powerful end-to-end suite of billing and payment solutions for medical practices, including BillFlash Pay Services powered by EZClaimPay. Schedule a free consultation today to discover how together EZClaim and BillFlash can streamline your billing process, increase revenue, and improve patient satisfaction.


The medical billing process is as important to your business as it is tedious for those who aren’t making proper use of automation. Automating parts of the medical billing process not only makes your process more efficient but more accurate, resulting in smoother operations for your entire business.

At EZClaim, our goal is to help your business reach its full potential with medical billing software. We make automation easy and provide a centralized home for all of the critical information you need to run your business that seamlessly integrates with your other tools and technology. Request a free consultation today to learn more about how EZClaim can help your business grow.