medical billing threatsThere are times when continuing to do business the way you always have is an acceptable choice. You may not be as successful as some competitors, but you’ll still be in business.
This is not one of those times. The threats to medical billing companies using a traditional model are so severe that most (if not all) that choose the status quo will not survive.

There are five major external threats:
  1. Low rates. Billing companies with software that automates claims processing achieve such efficiencies they can offer a practice percentage rates that are about half of the industry average.
  2. Geographic reach. Using today’s sophisticated, cloud-based software, Medical Billing and RCM companies can successfully serve practices anywhere in the US, regardless of the client’s location or the service company’s location. Instead of a dozen local competitors, you’re now contending with a dozen national players with limitless resources like ADP, AthenaHealth, eClinicalWorks, or CareCloud –who all have strong recognized brands.
  3. Perceived value. Large billing companies are perceived by physicians as being better simply because of their size. Slick marketing campaigns and professional sales people don’t hurt either.
  4. Real value. All of the major national billing companies offer their physician clients a free EHR along with guaranteed successful implementation. This benefit is nearly irresistible to doctors, especially those who have experienced a failed EHR implementation or are under the gun to meet Meaningful Use requirements.
  5. Secure access and compliance. Today’s cloud-based systems allow physicians access to patient data from any device with an internet connection. They also bring practices into almost instant compliance with HIPAA (32 out of 49 rules), HITECH, Omnibus, PCI, e-prescribing, and now ICD-10.

It seems like a grim picture if you’re not already a large Billing Service —how can any small or mid-sized medical biller who’s just making ends meet compete against these types of threats? Despair not. With the right tools and business model, and a willingness to change you can successfully compete against even the largest billing company.
Clearly, you can’t combat these threats without a cloud-based, end-to-end system that gives you complete secure access to all of your practices’ clinical and financial information. These ‘unified’ systems automate the tasks that consume the majority of your time, so you can turn your attention to helping your practices eliminate administrative waste, shorten their revenue cycle, and increase their bottom line.
With the right system, you can achieve the same efficiencies as the national companies, so you can charge more competitive rates and still turn a profit, and offer your physicians a free or low-cost EHR. You’ll also increase your geographic reach: a cloud-based, end to end EHR/billing system lets you serve clients, or hire workers, across the country as efficiently as if you were in the next room.
The best news is that you can do more than just play on the same field as the medical billing giants—you can win.

Here are two significant advantages you have over the industry giants threatening to overwhelm you:
  1. Your services levels are higher. Lured in by technology and low pricing, many practices eventually are let down by the commiditized style of the big-name firms. Low rates mean low service levels on claim followup, patient statements, revenue recovery, or zero effort to really lower accounts receivable. Practices that contract for the lowest rates quickly see that those rates leave a significant amount of practice revenue unmanaged –as much as 3% of total monthly revenue –an item they conveniently left out when they were giving their slick sales pitch.
  2. You can function like a practice’s CFO. As discussed above and as we mentioned in a previous post, your business model can shift from simple claims processing to the Revenue Cycle Management consultant who addresses each financial leak and truly improves the practice’s bottom line.

By picking the right medical billing software, one that provides true RCM features and is an end to end cloud based Practice Management System with EMR, you’ll have two distinct advantages over your competitors: You’re reputation, and your relationship to the client. Instead of a competitor luring your client away with lower rates and better technology, you’ll now be the one offering physicians free EMR and bringing them up to date and into compliance with state of the art practice software.
It’s unsettling to realize that maintaining the status quo could mean the end of your business, but understanding these threats while time is still on your side, means you can take steps to ensure that you come out on the winning team.
PracticeSuite Medical CRM

Last Updated on December 18, 2013