BILLING ANALYSIS
Taino Consultants Inc.
Dr. Jose I. Delgado
BASIC ISSUE
Cost Effectiveness of outsourcing billing
 Variables under consideration
 Costs Center
 Efficiency
VARIABLES UNDER CONSIDERATION
 Human Resources
 Hardware and Software
 Claims Processing
Employees
IT
Process
HUMAN RESOURCES
* http://www.bls.gov/oes/current/oes433021.htm
Median billing Salary ($16.80/hr) $ 34,944.00
Federal and S...
HARDWARE AND SOFTWARE
Software $229/month/Provider $ 2,748.00
Hardware $ 2,400.00
Subtotal $ 5,148.00
CLAIMS PROCESSING
Patients/day/Provider 20
Working days/month 20
Claims/month/Provider 400
Clearinghouse Cost (.05) $ 20.0...
IN HOUSE BILLING COSTS
Human Resources $ 72,008.40
Billing/Hardware $ 5,148.00
Claims Processing Costs $ 33,840.00
Estimat...
OUTSOURCE COSTS
CollectionsOutsourced Costs
$ 240,000.00 $ 14,400.00
$ 360,000.00 $ 21,600.00
$ 480,000.00 $ 28,800.00
$ 5...
COST COMPARISON
Providers 1 5 10
Avg Collection/month $ 30,000.00 $ 150,000.00 $ 300,000.00
Human Resources $ 72,008.40 $ ...
OTHER ISSUES TO CONSIDER
 Staff turnover
 Priority of billing versus other tasks
 Expertise and experience
 Collection...
SUMMARY
 Outsourcing is more cost effective
 Research company before outsourcing
 Not all billing companies created equ...
TAINO CONSULTANTS INC.
19 years in business
Healthcare, IT & Business Consultants
Veteran Owned, USA Based
Small Business ...
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Healhcare Billing Comparison

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Analysis for healthcare professionals and organizations considering the costs of in house billing versus outsourcing.

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Healhcare Billing Comparison

  1. 1. BILLING ANALYSIS Taino Consultants Inc. Dr. Jose I. Delgado
  2. 2. BASIC ISSUE Cost Effectiveness of outsourcing billing  Variables under consideration  Costs Center  Efficiency
  3. 3. VARIABLES UNDER CONSIDERATION  Human Resources  Hardware and Software  Claims Processing Employees IT Process
  4. 4. HUMAN RESOURCES * http://www.bls.gov/oes/current/oes433021.htm Median billing Salary ($16.80/hr) $ 34,944.00 Federal and State Taxes (15%) $ 5,241.60 Health ($500/Month) $ 6,000.00 Vacations & sick $ 1,320.00 Training $ 500.00 Subtotal $ 48,005.60 Billing Personnel (1.5) $ 72,008.40
  5. 5. HARDWARE AND SOFTWARE Software $229/month/Provider $ 2,748.00 Hardware $ 2,400.00 Subtotal $ 5,148.00
  6. 6. CLAIMS PROCESSING Patients/day/Provider 20 Working days/month 20 Claims/month/Provider 400 Clearinghouse Cost (.05) $ 20.00 Paper Statements ($7/statement) $ 2,800.00 Costs/month $ 2,820.00 Claims Processing Costs $ 33,840.00
  7. 7. IN HOUSE BILLING COSTS Human Resources $ 72,008.40 Billing/Hardware $ 5,148.00 Claims Processing Costs $ 33,840.00 Estimated Costs $ 110,996.40
  8. 8. OUTSOURCE COSTS CollectionsOutsourced Costs $ 240,000.00 $ 14,400.00 $ 360,000.00 $ 21,600.00 $ 480,000.00 $ 28,800.00 $ 500,000.00 $ 30,000.00 $ 720,000.00 $ 43,200.00 $ 1,000,000.00 $ 60,000.00 $ 1,500,000.00 $ 90,000.00 $ 1,750,000.00 $ 105,000.00 $ 1,850,000.00 $ 111,000.00
  9. 9. COST COMPARISON Providers 1 5 10 Avg Collection/month $ 30,000.00 $ 150,000.00 $ 300,000.00 Human Resources $ 72,008.40 $ 192,022.40 $ 384,044.80 Hardware/software $ 5,148.00 $ 18,540.00 $ 37,080.00 Claims Processing $ 33,840.00 $ 169,200.00 $ 338,400.00 In house/billing costs $ 9,249.70 $ 44,146.87 $ 88,293.73 Outsource/billing costs $ 1,800.00 $ 9,000.00 $ 18,000.00
  10. 10. OTHER ISSUES TO CONSIDER  Staff turnover  Priority of billing versus other tasks  Expertise and experience  Collection rate  In-house 96.3%  Outsource 99%  Liability and Compliance  Outsourcing Risks
  11. 11. SUMMARY  Outsourcing is more cost effective  Research company before outsourcing  Not all billing companies created equal  Verify key issues  Collection rate  Compliance actions  ICD 10 readiness  Certified Coders
  12. 12. TAINO CONSULTANTS INC. 19 years in business Healthcare, IT & Business Consultants Veteran Owned, USA Based Small Business Administration Certified WWW.TainoConsultants.com
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