5 Reasons Medical Billing Professionals Should Handle Compliance


Like every other industry, medical practices are looking for ways to cut down operating costs without increasing risk or losing value. Certain services such as administrative tasks or transcription can be outsourced or performed by in-house staff equally well. However, medical billing is best handled by the professionals because in-house staff are not fully trained or equipped to perform this complex task including compliance with the most up-to-date rules and regulations. Here are 5 reasons medical billing professionals should handle compliance.

#1:  Claim Frauds

Fraudulent claims can cost your practice thousands of dollars each year. Whereas large frauds often receive a good deal of attention, smaller frauds can add up and be equally harmful. Expert billing professionals not only have the resources to discover the small claim frauds but also have a greater awareness of the red flags which in-house staff could easily miss. Employing medical billing professionals means you have a greater chance of catching thieves.

#2:  New Laws

There are almost daily changes in the laws regarding the medical industry. Staying on top of all these changes in rules and regulations can be overwhelming at best and near impossible at worst for the staff at your medical practice. Medical billing professionals are up-to-date on the latest code changes, legislations, and debt collection practices. Having billing professionals on board means you will not become liable when there are changes in the law.

#3:  New Policies

Simply being aware of new laws is not enough. Billing staff must understand how the law affects your practice and what policies it changes. This is essential to avoid penalties and protect your financial and legal interests. Medical billing professionals are trained to adapt current policies and hiring them means you are less likely to make expensive errors in implementation of new laws.

#4:  Supervision

One of the most time-consuming processes in medical billing is the creation of billing practices. These need to be managed and updated from time to time. A professional billing service will track which services are not financially feasible for your practice or which services you should consider adding. This expert advice on billing practices is invaluable for any medical practice.

#5:  Investigations

Surveys have shown that insurance fraud costs the nation more than 80 billion dollars every year. This makes it necessary for all hospital staff and medical personnel to be subject to investigation. An expert medical billing professional maintains an extensive paper trail and uses standard formats. This ensures the investigation process is simple because the claim can be tracked both pre- and post-payment and the investigators have easy access to the information they are seeking.

Contact us to find out how we can help make sure your practice is in compliance.

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