Outsourcing Nursing Home Billing: Separating Fact from Fiction

A successful nursing home billing means efficient and accurate billing and coding process. Being a crucial part of revenue generation and functional stability in a nursing home these tasks are however often underestimated, and providers go through a daunting process of nursing home billing.   

Be it a patient’s’ record verification, obtaining prior authorizations, addressing claim denials, and adhering to the best possible care for the patients in fact can be quite demanding while doing so simultaneously and accurately. As ensuring accurate nursing facility billing and coding directly affect the bottom line of your practice. This is why mostly why more than 50% of Nursing home center and specialties are looking for outsourcing option. According to a new report, for the last few years it is expected to expand at a CAGR of 12.26% from 2023 to 2030 furthermore. And some of the factors driving the growing influence of healthcare claim outsourcing are increasing trends for greater bad debts, advancements in technological solutions, and shifting winds of regulatory guidelines. 

Today though the idea of outsourcing medical billing and coding has gained popularity among healthcare professionals, there are a still few bizarre fallacies that are stopping some of the providers from enjoying the benefits of outsourcing.    

Dispelling Five Often-Held Myths About Outsourcing Nursing Home Billing    

Myth: Billing and coding for nursing home facilities is the same   

Well, they are referred to as part of revenue cycle management in your healthcare facility. These two tasks can be performed by one person, but what are the odds of this? Have you ever thought about that?   

Nursing home billing and coding require a specific skill set and knowledge regarding the coding regulations and payors’ claim submission guidelines.    

Medical coders usually take information from a patient visit and transcribe it into universally recognized codes that make up the medical record of that patient visit.    

Medical billers take those codes to put the charges of services rendered to that patient.   

An outsourced billing company has a team of experienced medical billers and coders who understand the processes of medical billing for nursing homes and can ensure a streamlined service.    

Myth: It is easy!    

Coding and billing for nursing home facilities might seem easy, but it’s not! You must know comprehensive guidelines and industry standards.     

Furthermore, the claim submission guidelines vary from payor to payor. You must ensure you meet those guidelines to get accurate reimbursement.    

While outsourcing a team for your facility’s revenue cycle management, you have a team of trained professionals who understand and can implement the right process for your practice.    

Myth: Outsourced nursing home billing services are low in quality   

Consistent skill shortage and stratospheric wages in the healthcare industry is nothing new. Providers and healthcare facilities like yours are in constant combat with these two factors.   

Also, it has been identified by the experts that often the workforce available is not enough knowledgeable to accomplish the billing and coding tasks efficiently.    

Therefore, with an in-house team, you might put your practice at risk of high claim denials.   

On the other hand, with an outsourced nursing home billing company, you can not only enhance efficiency and productivity but also, you can track the overall performance of your practice.    

So, there is no chance of falling behind!   

Myth: Outsourcing is costly   

According to the Bureau of Labor Statistics, the hourly wage of a medical biller is $23.45. Now think about the expertise and experience.    

Also, you need to hire, train, and retain these employees which demands an ample amount of time and other resources. You need to maintain a separate infrastructure for the billing and coding processes as well.    

All this boils down to higher overhead costs. That means there is little room for you to enjoy the revenue.    

However, an outsourced company generally charges you a percentage of your revenue and offers flexibility and scalability. That counts as a fraction of the hourly wage mentioned.   

Additionally, you don’t have to invest time, money and other resources to hire, train, and sustain these employees.    

This will ultimately reflect on your revenue and organizational performance.     

Myth: A few errors don’t matter!   

That’s the biggest misconception about nursing home billing and coding processes.    

The healthcare industry is heavily regulated, and you must maintain all the stringent coding and billing guidelines.    

A minor mistake within the process will not only lead you to claim denials but in the long run can lead you to audits, penalties, and fines.    

That is not good for either your practice’s revenue or reputation.    

When you outsource your nursing home revenue cycle management, you have a team of experienced medical billers and coders who reduce the chances of errors within the process and hence leave little room for revenue loss and chances of audits.    

Take One Step Ahead with Sunknowledge   

Sunknowledge Services Inc. Is a widely appreciated healthcare revenue cycle management organization across the United States with the purpose of helping providers and payors with appropriate solutions.    

We have a huge talent pool, extremely experienced medical billers, and coders, along with consistent quality and certifications like cybersecurity and HIPAA.    

Being an extended operational arm of your practice with real-time and dedicated employees makes us different from other medical billing companies.    

Worried about productivity, are you?   

With a 10% buffer employee, we make sure you never fall behind on productivity and revenue generation.    

For more than 15 years we have been ahead of the curve, constantly trained by major health insurers. From radiology to cardiology and 30+ other specialties, we handle claims with utmost precision.    

Not only nursing home billing services, virtual medical assistance, medical coding, accounts receivable management, eligibility verification, prior authorization, payment posting, and of course complete revenue cycle management can have it all and many more by partnering with us.    

We implement strategies that transform your ROI into a positive direction, while you focus on your core competencies.    

Talk to one of our RCM experts today to understand what makes us one of the best nursing home billing companies.