Outsourcing medical billing and coding reduces healthcare providers’ operational costs and overheads, including staff salaries, benefits, training, equipment, and software expenses. It also helps mitigate the costs associated with errors, claim denials, and delays while enhancing cash flow and profitability.  

Outsourcing ensures compliance with the healthcare industry’s rules and regulations, including coding standards, billing guidelines, and privacy laws. This reduces the risk of audits, penalties, and lawsuits, ultimately safeguarding healthcare providers’ reputations and credibility.  

Outsourcing can also enhance the revenue cycle management process, which involves managing healthcare services’ claims, payments, and collections. Outsourcing increases reimbursement rates and collection efficiency by improving the billing and coding processes’ accuracy, efficiency, and quality. 

1. Streamlined Enrollment Process

These credentialing services essentially hold your hand through the entire process, which means all the necessary paperwork is not only completed accurately but submitted on time, too. As a result, you’ll need to spend way less time on the enrollment process and refocus your time and resources back on providing health care.

2. Increased Revenue Potential

Becoming an in-network provider with an insurance company means you’ll be able to open up a lot more avenues for making money as a medical practice, which should obviously be a fairly high priority if you’re only running a small practice. This does, however, require you to have gone through the credentialing process, so this is where the main barrier for a lot of small practices is.

Fortunately, though, medical credentialing services come with all the expertise that’s really needed to make it through the contracting process properly, so once you partner with one of these services you’ll be able to grow your patient base and revenue potential.

3. Compliance and Risk Mitigation

Staying fully compliant with all the various requirements insurance payers set is absolutely paramount if you want to avoid receiving any potential penalties and legal issues.

These can obviously be massively detrimental to your small practice, so credentialing services will help you ensure that all your medical staff meet the necessary standards and regulations that are set by these companies to prevent this sort of thing from happening.

Healthcare providers are collecting more from patients than ever before, yet the healthcare billing experience remains confusing, complicated and downright unpleasant for most patients.

A recent survey of over 1,000 US consumers found that nearly four in ten consumers have switched providers because of a negative billing experience. About 41% of respondents also said they had left a negative review of a provider because of these experiences.

Lackluster billing experiences coupled with the growing cost of healthcare, especially for patients, are making it even more difficult for providers to collect revenue for services rendered. In fact, patient collection rates have declined after the COVID-19 pandemic, from about 55% in 2021 to almost 48% in 2022 and 2023. At that time, providers received barely a quarter of the total charges owed to them, writing more off as bad debt despite historically low uninsured rates.

Healthcare leaders understand that meeting patient expectations from a billing perspective is important. However, provider organizations continue to fall short of being “patient-friendly” when it comes to billing, payments and experience.