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If you are considering outsourcing your medical claims billing, you’re not alone. One of the widely outsourced services is medical claims billing brought about by insurance claims, interdepartmental coordination issues and delays.

The process involves hiring an independent contractor who specializes in handling the medical billing process. This is due to the costs involved with having in-house clerical staff doing this job. Hiring a medical billing service frees you to develop your practice or spend more time doing what you really want.

Outsourcing your medical billing process to a professional also decreases chances of fraud arising within your organization. Its common knowledge that most cases of fraud originate from within a company therefore having an outsider checking your finances, any inconsistencies will be spotted easily.

When looking for an outsourcing firm, it?s in order to ensure that the said firm charges a variable fee rather than a fixed one. If the medical billing drops, the cost also drops. The outsourced medical billing system should provide detailed information that will enable you to negotiate a contract with a malpractice insurance carrier. Since the outsourced billing service will be dealing directly with your customers, it will be the face of your company. Therefore, their customer service standards should concur with your public relations image. This information can be found in their staff guidelines on customer service.

The company should also be compliant with all regulatory policies. This is important because in the case of non-compliance you will be held liable. Your selected medical claims billing service should also maintain accountability by providing regular progress and performance updates.

Finally, the medical billing service relies heavily on electronic claim submissions therefore, they should have various IT resources in place. These automated systems are important if the company is to stay updated on changes in the industry.

Outsourcing medical claims billing has the advantage of reduced paper work, savings on employee remuneration and quicker revenue. Outsourcing also helps you gain a competitive edge ensuring the long-term survival of your firm.

During all the years I’ve been an independent life insurance broker in Canada, various people asked me many times to compare the US and the Canadian health system. Of course neither of them are perfect, but the lies about the Canadian system I sometimes encounter are just too much. So what am I talking about?

“The Canadian system is much more expensive than the system in the USA.”

First of all let’s have a look at this cost-related whooper. Compare the numbers yourself: US spends 15 percent of GDP, leaving at least fifteen percent of its population without any coverage, while Canada spends ten percent of its GDP, covering 100 percent of its population. For example in 2005, the US spent US$6,401 per capita on their health expenditures – that’s almost twice the sum spent in Canada that year – US$3,359.

“In Canada, it’s up to the government to judge who gets the treatment.”

Of course this assumption is totally wrong – only the doctors have the power to make a decision about the character and timing of the necessary treatment. Unlike in America, where it doesn’t matter what you doctor says – if your insurance administrator won’t allow a treatment, because it’s too expensive, then that’s it.

“The Canadian insurance sucks since it only covers the basic and the rest comes out of your pocket anyway.”

Every province has its own rules concerning what is and what is not included by the public health insurance. The least you can count on is that the doctor’s fees and all the hospital procedures will be covered by the insurance – which are habitually the most expensive items. Other stuff like medical equipment, dental & vision care would generally not be included. Because all these extras can be very well estimated (all the really expensive costs are included by the national insurance), some private plans are offered (i.e. FlexCare Program from Manulife) with low-cost premiums to cover them. All in all, compared to USA, the Canadians have much less to pay to get good health service, even if we include the “extra” insurance.

“In Canada, you’ve got to wait for so long to get the treatment you need. In fact, Canadians rather travel to the US for their treatment.”

This statement has something in it, but only to a certain degree: if you require some kind of specialist treatment, you could wait a few weeks or up to one month, and for selective surgery the waits could be even longer. On the other hand, all imperative operation, you will get it fast one way or the other. No matter if you’re how poor or rich you are. In those cases when the waiting list might be too long and it is not likely to access the treatment in an acute situation, the patient is sent to the States, but you don’t pay a cent: the insurance covers it all. Only those Canadians who pay out of pocket for their treatment in the US wish to get the treatment faster than their doctor finds necessary.

“The Canadian government employs the doctors. And the government selects the doctors for you!”

Nope… the doctors do not work for the government. Even though the Canadian are paid by the provincial government, they are not employed by it: the keep their own practises just like the doctors in the US. Don’t worry: you get to choose your doctor yourself.