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Choosing Between In-House and Outsourced Dermatology Billing

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Managing a dermatology office involves important medical billing. You can manage dermatology billing in two ways: create an in-house team or hire an outside expert. Outsourcing the financial management to a third party can also be a wise decision. One reason is that It’s tough to handle many codes, players, and changing coding rules alone.

Understanding Your In-House Billing Team: What They Do and Who They Work With

Your dermatology practice’s in-house billing department takes care of managing your revenue process, and tracking patient care from appointments to final payments.

The team sends claims to three main places: a clearinghouse, private insurance companies, or government agencies.


A clearinghouse receives electronic claims from your practice’s software, checking for errors to prevent claim denials.


Private insurance companies offer health plans, which patients get from work or independently.


Government agencies, like Medicaid or Medicare, handle claims and payments for state health programs.


Handling Tedious Process


Your clinic’s own billing team handles payments, decides costs, and gets patient fees. The way they manage claims might be long, but it’s needed to get paid that you deserve.


To start, the billing team adds patient info to the PMS. This info has important details (like diagnosis, treatments, tests) that the payer (like insurance) needs. They check if the claim is okay.


Then, the clinic sends the claim to the clearinghouse. This place checks the claim again. If it’s free from mistakes, they send it to the payer.


Later, the clearinghouse gets a message from the payer – yes or no. They tell the clinic’s billing team. If a claim is denied, the team fixes it and sends it again.


Modern Medical Billing Software


Medical billing companies use advanced software for better communication. One helpful feature is online updates for healthcare clients.


For dermatology clinics, entering patient data is quick. Softwares can do quick entries for all specialties and clinics, whether they are physicians immediate care in Algonquin or any part of the world. This goes to the billing company to start claims. This way, payment arrives on time.


Paperwork is used to slow things down, but electronic billing is faster. It cuts unpaid claims, improving revenue collection.


Before, lost papers caused payment delays. Now, electronic records speed up billing and reimbursements.


Securing Patient Information


When you outsource dermatology billing, patient data stays safe. Companies focus on cybersecurity. They shield data from hacks, breaches, and online threats.


Keeping data safe is vital for healthcare trust. Billing firms follow HIPAA standards. These rules protect patient privacy.


HIPAA’s Security Rule sets e-PHI standards. It needs tech, admin, and physical safeguards. Following these prevents legal issues. Tech helps ensure data safety


Why Choose Outsourcing for Medical Billing?


Firstly, running an in-house dermatology billing department has drawbacks. It’s costly to set up and maintain. You have to bear the cost of building an office, buying software and hardware, and training staff.


Secondly, you will need software like PMS for billing and hardware, leading to more costs and expenses. Also,  systems and software will need regular updates for security.


Thirdly, Dermatology billing staff will have to attend training to keep themself updated about the new Coding rules and regulations. Also, you have to provide them with insurance benefits yearly leave quota, and other financial incentives. 


On the other hand, Outsourcing means letting other dermatology billing services providers handle your tasks. They handle it off-site, unlike internal billing. 


This works well for small dermatology startups with fewer claims. It’s cheaper than having your own billing team.


Many healthcare businesses use this. It saves costs and gets specialized billing. This is great for new dermatology practices.


Outsourcing cuts costs like employee salaries, office supplies, and tech upgrades. The practice does not need to worry about these things.


Can Outsourcing Medical Billing Save Your Practice Revenue?


A post on the National Coalition of STD Directors website explains how much clinics can save by outsourcing medical billing.


Let’s break down the example. Imagine a clinic with one practitioner, handling 4,000 yearly claims at $125 per claim. That’s $500,000 in total.


Running billing in-house brings costs like employee pay, software, hardware, and claims processing fees.


Outsourced billing costs $1,600 for managing info (2 hours/week at $15/hour). Hardware expenses are $750 for computers and printers. The medical billing company charges $24,500 for collection services.


Outsourced billing collects more (70%) compared to in-house (60%). External teams are better at claim collection




Choose between in-house billing or outsourcing for your dermatology clinic after analyzing costs and benefits. If projected revenue outweighs costs, outsourcing may be better. But if costs are higher, reconsider. Remember, there’s no universal solution in medical billing




What’s the ’24’ modifier in dermatology?


The ’24’ modifier shows another E/M visit after a procedure. The ’79’ modifier indicates an unrelated procedure during a post-op period.


What are CPT codes for dermatology?

Dermatologists use codes like 96920, 96921 for laser therapy, 96900 for UV light, and 96910 for photochemotherapy.


What does the term ‘modifier 59’ mean in dermatology?


To code and get paid correctly, it is vital to know about dermatology CPT codes and modifiers. Modifier 59, called ‘Distinct Procedural Service,’ helps flag procedures that aren’t usually billed together but could be in certain cases.
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