Medical billing and coding outsourcing- the way ahead

In todays complex healthcare environment medical billing and coding can be burdensome for small and mid-size medical setups. Medical billing and coding are very closely related to the existing healthcare industry. It requires a lot of time, attentiveness, carefulness and accuracy to deal with every detail. Due to this, it has become common to outsource the medical billing and coding activities to dedicated firms. These firms provide overall services for billing and coding, claim settlements, account and revenue management. The prerequisite of outsourcing is the proper integration of existing medical records and software in use must be assessable on the overall administrative platform. The benefits, in turn, are mentioned below:

a. Focus on core job objectives: Medical practitioners can focus on the core job objectives of the medical profession and research, instead of investing time in billing and other tertiary activities.

b. Elimination of errors: Outsourcing of billing and coding to a dedicated firm ensures the elimination of accounting and related errors

c. Cost-effectiveness: It is cost effective for a hospital or medical practitioner to outsource other than the core jobs to dedicated professionals

d. Improved revenue: This helps to generate revenue, as the focus is on the core objectives.

Service offered by medical billing and coding services

Medical billing and coding firms offer best medical billing services, complete patient coding and full-fledged financial services for medical professionals:

1. Medical billing services: Submission of bills and regular quality checks at multiple levels are the primary jobs of medical billing and coding companies.
2. Medical coding services: Maintenance of patient medicals records like history, medication, etc
3. Medical claim processing: Online and offline claim processing along with quality checks
4. Accounts management: Follow up with insurance companies and account maintenance through dedicated software
5. Revenue management: Effective claim financial support reduces the operational cost of hospitals and improves cash flow management.

Criteria to choose appropriate Medical Billing and Coding firm

The present competitive market provides the medical practitioners, many options of firms to choose from. Following criteria may be adapted to screen the available choices:

1. Pricing: It shall offer affordable rates for the required medical billing and coding services requirements and the customization associated with it.
2. Software capability: It shall use robust software capable of effective data and financial management.
3. Compliance: It shall comply with the codes and regulations and carry out regular audits of every stage of the process.
4. Data security: It shall offer a robust data security system to ensure the confidentiality of the patient data.
5. Quick settlement and Response time: It shall offer quick settlement and regular follow-up.
6. Business infrastructure: It shall have trained staff, effective dispute settlement and robust process in place.


Medical billing and coding firms assist the hospitals and medical practitioners in dealing with financial matters. This helps them to focus on the core job objective of healthcare and research. The best use of this outsourcing activity can be realized by the optimum selection of the financial firm based on the requirements of the hospital and medical practitioners.

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