Coding and Billing

Outsource HR and Billing to Improve Practice Quality and Efficiency

By Paul Karpecki, OD, FAAO

Outsourcing your practice’s human resources and billing can allow you to better focus on your role as doctor, while increasing the quality of the patient experience.

Recognize Usefulness of Outsourcing
The biggest change that has taken place over the last 50 years in the practice of optometry is the move from providing vision exams and screening/detecting eye disease for referral to comprehensive vision, medical eyecare and chronic disease management. This has made the management of an optometric practice far more complicated, requiring much more sophistication and efficiency in daily functions and creating the need for outsourcing. Without the added sophistication of experience and properly educated staff members, an optometric practice simply will not be able to compete in this rapidly changing health care environment.

Billing & Coding Outsource Options
In addition to Optometric Medical Solutions (OMS), you should be aware of the following two key outsourcing providers:

Paychex: Tax services, human resources and benefit administration.

Automatic Data Processing (ADP): HR solutions, employee benefits, Professional Employer Organization (PEO) and HR Business Processing Outsourcing Overview (BPO)

One way to gain efficiencies in management is to outsource those functions that are not easily and efficiently managed within the office. An area that may be critical to outsource is human resource management such as employee testing, career path determination and team building. The HR area is most important, because if a better staff is in place, more sophisticated management can occur. Other areas for outsourcing include accounting, financial planning, insurance credentialing, insurance verification, medical insurance billing/mitigation of claims and monitoring of regulatory issues.

How much financially do you have to gain from using an outsource vendor?  One client of  an outsource vendor solely dedicated to optometry, Optometric Medical Solutions (OMS), reported a 10 percent increase in overall patient revenue and a 15 percent increase in net income after outsourcing billing and human resources functions, such as insurance claims processing and insurance benefit verifications, to OMS.  Another client increased revenue by over $100,000 in less than one year.  The gains came from reduced write-offs, increased collections and increased efficiencies in processing and staff re-allocation to revenue generating functions.

Create a Virtual Billing Office
Utilizing the rapid developments in communication, information technology and data management, outsourcing creates a scalable virtual medical billing office. This model can be used to outsource voluminous and repetitive work, allowing doctors and staff more freedom and time to concentrate on the core competencies of building a practice and dedication to patient care.

The most apparent advantage of outsourcing is the reduction of overhead, thereby increasing profitability. By outsourcing, practices can increase their production volume without additional investment in infrastructure and manpower. Due to the standardization and centralization of workflow, effective maintenance and output of results are typically greater outsourced than provided from within a practice. Outsourcing can also provide risk mitigation against employee turnover, theft, fraud and abuse for non-compliance.

Pick an Optometric-Focused Outsource VendorIn the area of HR, there are numerous companies that service many corporations ranging from factories to health-care services including optometric practices. In the area of medical practice logistics, companies exist that specialize in providing outsource services to optometrists. One such outsource vendor solely dedicated to optometry is Optometric Medical Solutions (OMS).  Through back-office systems and education, OMS standardizes the administrative process flow (insurance verification, credentialing, accounts receivable tracking, protocol-driven billing models, insurance updates, third-party billing and coding, etc.) ensuring medical claims reimbursement to the practice without the hassle of all the issues surrounding third-party reimbursement.

Outsourcing is an area that is just now becoming a key component of successful optometric practices. Perhaps the greatest benefit from outsourcing services, which are not easily managed from within, is the peace of mind one has in knowing someone else is helping to manage critical parts of the practice for success, allowing doctors to be doctors, while decreasing costs and increasing profitability.

*Special thanks to Walter Choate, OD, Jerry Godwin, CEO, and Arthur Medina, OD, of OMS, for their contributions to this article.

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Paul Karpecki, OD, FAAO, is an ocular surface specialist and co-founder of Eyecare Educators, a provider of continuing education services to optometrists. To contact him:

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