Outsourcing in Hospital Billing, Considerations

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A company specialized in Medical Billing Services or “Third party medical billing ” is a company that is dedicated to exclusively managing the payments, accounts and invoices that are generated in a center. The appropriate synchronization between the billing company and the health center will create a relationship that can get to optimize the organization. How to diagnose the possibility of contracting this option?

What are the key problems you want to solve and why? Are Patient Payments Taking Too Long? Do you have too many old accounts receivable? Are your administrative staff having difficulty recording all scheduled appointments?

After this analysis (never before) you can start a search for billing companies that have strengths right where you have weaknesses.

An alternative solution is to hire technology that can easily and clearly process all the information internally. It is to have access to the tools of third parties but within the total control of the administration. Cirrus is precisely the type of tool that allows you to organize the billing and collection area super efficiently.

Medical Billing Services


“When you outsource to third parties, you lose some of your control,” said Barnabas Health Alwell “Now I have to monitor performance by analyzing reports and having weekly meetings with our associated billing management company. I have to work harder to stay connected. ”Now patients need to call the partner company’s line to answer any questions they have about billing. Before, they used to solve these problems simply by talking to their doctor’s reception staff. It may be more tedious and impersonal to resolve situations that way.


A problem with outsourcing can be the loss of internal experience in the billing sector, which is why it is not possible to totally depend on the billing company, it is necessary to have internal processes in parallel that include the mechanisms used by the billing partner.

You try to establish built-in incentives for them to invest good energy in solving the most acute problems that their collection and billing system suffers from if they do not reach the agreed objectives, then they are paid less; if they meet the objectives, they are paid the normal amount stipulated in the contract; And if they exceed the targets by a certain percentage, they get paid a bonus.

 Patient satisfaction now affects how providers are reimbursed, as well as their quality scores, so it cannot be ignored. If an external partner does not talk about how they will preserve – and enhance – patient satisfaction, and yet have patient-oriented responsibilities, I would say, ‘thank you, but no thank you.’ “Before choosing, make sure that the new partner understands. The vision of patient-centered service.

Legal terms

In practice, hospitals are merging, consolidating and being acquired, and although a collaboration with a billing company may start as a multi-year agreement, if something happens in the market, or there is a merger or acquisition, the two parties they need to have an easy way to redefine their relationship. “I’ve seen some big disputes between hospitals and their collection agencies when a hospital terminates the collection agency contract, but there is nothing in the contract that says who gets what,” says Wolfskill. “Does the agency have to keep the accounts? Can they hold them for a specific period of time before they have to return them? In these cases, having more details in the termination clause can avoid unwanted situations.”


The medical organization affiliated with a third-party billing partner should make sure to monitor key metrics to track the partner’s performance and address potential issues as they arise. Both organizations should consider reviewing the same metrics to evaluate the success of an internal department through area-specific KPIs.


Do not forget to inform all your staff correctly. You need to communicate with your team, inform and educate so they can see the value of what you are doing and why you are taking this approach. “The explanation about the effects that the change will have on their daily routine should be very sincere, with pros and cons.” If the organization is not clear on this, it can lead to unpleasant dynamics. If staff members are not committed to outsourcing, they can become part of the problem rather than part of the solution.