Learn the top essential reports required to optimize revenue, predict cashflow, monitor productivity and join the 99% Club of clean claim submission. Learn RCM from the nation's top Billers and RCM experts. Join our Live Webinar Series Thursday at 3pm Eastern.

medical billing profitIf it seems like it’s harder to turn a profit on your medical billing services every year, there are a few reasons for that. Here are 6 operational threats we have identified that could harm your medical billing business.

But first, let us assure you that medical billing companies with the right strategy and the right technology can turn those threats into opportunities.

1. Labor costs are high and rising.

The cost to hire an experienced biller has risen over the past few years, and experienced billers will be in even higher demand as we shift to ICD-10.

2. Retaining experienced billers is problematic.

Let’s face it: you’re caught between a rock and hard place. Your long-time employees know their stuff and are highly efficient, but they’re expensive. To make matters worse, if you don’t pay them enough to retain them, they are likely to leave and may take valuable clients with them. Regardless, it’s best to brush up on strategies to increase employee staff retention.

3. Keeping cash-flow levels up is a constant battle.

If you’re not paying near-constant attention to productivity and collecting from clients, you run into cash-flow issues. Late-paying physicians are only the tip of the iceberg here.

4. Tracking productivity is tedious.

Doing this task manually is extremely time consuming, but without data, you can’t properly manage your business.

5. Manual processing is labor intensive and error prone.

Billers doing manual claims processing simply cannot keep up with those using automated systems that catch eligibility issues, erroneous codes, and front-office mistakes like bad policy numbers before they result in a claim denial.

6. Managing client expectations is becoming more difficult.

Physicians planning to retire within a few years are willing to put up with the clumsiness of traditional claims processing. The opposite is true of the clients you want—growing practices expect 24/7 file access and low denial rates at a reasonable cost. They also want their encounters coded to the highest possible level, something that’s impossible to do without access to clinical notes.

Taken all together, these operational issues represent a significant threat to your business.

The solution involves shifting your business strategy from bookkeeper to CFO. End-to-end, cloud-based software allows you to automate processes (lower labor costs), speed up the revenue cycle (fewer cash-flow issues), easily track productivity (manage more easily and strategically), and with solid documentation (instant access to clinical notes) always code to the highest level of specificity.
By using the same level of software that enables large medical billing services to profitably offer quality service at the lowest rates, you’re able to not only compete with them, but offer better, more specialized service rather than commoditization that causes practice revenue to be left on the table.
Perhaps most importantly, it allows you to successfully market to the types of clients you want for your business—those who understand the value you can bring to their business and are willing to pay for it.

Newsworthy threats addressed recently:

Last month, Congress lawmakers added a healthcare compromise into their year-end spending package. Over the the last two years, hospitals and physician practices have relentlessly lobbied Congress to end “surprise” medical bills. This compromise created a solution would submit their “payment feuds with insurers to independent mediators” – a Politico article states.

Surprise billing is also considered abusive billing where charges up to tens of thousands of dollars can racked up last minute on a patient’s hospital bill from out-of-network to in-network. There are two sides to this compromise as now patients will no longer be billed for and forced to pay for “out-of-network specialists, air ambulances and other clinicians.” On the other hand, it under accentuates the pertinence for corporate medicine in a time like the pandemic.

Key aspects of the legislation include:

  • Protecting patients from surprise emergency care bills, patients will only be billed for the rate in their network
  • Protect patients admitted to an-in network hospital for a planned procedure even if external network staff are brought into the procedure
  • Out of network providers must give patients 72 hours notice on upcoming charges
  • Bar air ambulance services from sending bills more than the in-network amount

what to look for in a medical EHR

Last Updated on March 11, 2021

Create a Sandbox Account