Medical Billers and Coders Registers a Surge in Outsourcing of Physicians Billing Requirements


As the US healthcare industry is buffeted by rising healthcare costs, gigabytes of health and health-related technology information, and the latest reforms and regulations, it is inevitable that the providers are going to adopt new patterns to successfully manage their professional duties while keeping track of their reimbursement processes.

In order to cope with this dynamic scenario, a significant number of providers have chosen to focus on the core areas of their practice such as patient care and research by opting to outsource the non-core areas such as revenue cycle management and affiliated administrative services to experts who specialize in handling them.

Medicalbillersandcoders.com, the largest consortium of medical billers and coders in the US across all specialties, have observed a spike in the outsourcing of the physicians’ billing requirements across various specialties.

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Why do physicians feel that billing is a specialist job?

With the introduction of latest compliances such as HIPAA 5010, ICD10, PQRI (Physician Quality Reporting Initiative), CPOE (Computerized Physician Order Entry), HIE (Health Information Exchange), and the latest EHRupdates, physicians have realized the wisdom of treating billing as a specialist job. Add to it the emerging options in physicians’ practice such as part-time practice, Tele-health and Tele-medicine for some specialties, and other possibilities such as IPAs, ACOs, and PCMH, and one can begin to see how these changing patterns have led to the simultaneous revolutionizing of the reimbursement processes.  

  • A physician’s billing cycle is a complicated one including almost 12 individual steps. 
  • The reimbursement regulations for each payer can differ, and can even be contradictory; sometimes, payers change their regulations arbitrarily while, at other times, more than one party (primary, secondary, or even tertiary payers) might be responsible with coverage gaps.
  • The unique billing and coding requirements for each physician specialty further add to these complex and stringent billing imperatives.
  • As payers fine-tune their claims adjudication process, physician practices will have to face more stringent objections to get paid.

Physicians are finding it increasingly cumbersome to manage and incorporate these changes within the limited resources of their staff as it requires aggressive and pre-emptive efforts, the problems only compounding in the case of smaller or single practices. The paucity of trained and experienced billing staff and the difficulty in their retention exacerbates the issue. In fact, the routine processes involved in medical billing and other RCM functions are inevitably intricate requiring specialized skills and are better outsourced to expert professionals for optimum realization.      

How is MBC equipped to provide expert billing services across specialties? 

MBC, in its role as an established and responsible billing and coding consortium has expanded their RCM and consultancy services across the states of the US to cater to the needs of the evolving healthcare industry. We have practically hundreds of trained billers well versed in the billing intricacies and issues of each specialty, with hands-on experience in single practices as well as multi specialty clinics and hospitals.  We offer complete RCM services as well as consultancy and partial outsourcing services for compliance programs, coding services, and accounts receivables follow-up.

With its comprehensive and customized solutions for optimizing your RCM as well incorporating the latest innovations in healthcare technology, regulations and compliances, Medicalbillersandcoders.com is well-equipped to provide specialized support to healthcare providers who would like to invest their time, efforts, and resources in focusing on their core competencies.

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