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Choosing the Right Medical Billing Service: Key to Your Practice’s Success?

Healthcare is increasingly moving to a “consumer driven” model. The good news is that consumers are demanding the right to choose their own practitioners and financing, but the bad news is that this means consumers must also be the sole decision-makers when problems arise.

Caught in the crossfire of this evolving model are medical practices who are finding it increasingly difficult to operate under decreased revenue and increased operational cost. Add to this the ever changing coding and billing requirements forced by large health benefit payers like Medicare, Medicaid, and BC/BS, and some practices are finding it easier to have a professional billing company handle the complexities of their billing. Finding the right out-sourced medical billing company can turn the billing process into a smooth and financial rewarding experience.

Following are some of the key factors practices weigh out when considering to outsource their billing to a third-party medical billing service company:

  • Increasing complexity of reimbursement calls for specialized skills of coding
  • Reduced rate of reimbursement requires a professional to negotiate your contract.
  • Passing of benefits coverage to patient calls for additional steps in collecting patient balances.
  • Negotiating payer contract rates requires knowledge of coding, billing, and the reimbursements rates in the practice vicinity (RVU’s), and these are generally known by a professional billing company.
  • Practice staff turnover and absenteeism leads to disruption of cashflow
  • OIG requirements on medical billing practices calls for a professional billing and coding professional to oversee billing.
  • Ensure that Best Practices for timely filing, claim follow-up, denials, and collections are diligently adheard to.

Needless to mention, these values can be only derived from professional and qualified medical billing companies.  Practices often fall prey to inexperienced medical billing companies resulting in revenue loss and cash flow disruption.  Practices should check for proper references from reliable sources to ensure that the responsibility of the critically important revenue cycle management of the practice is bestowed in the hands of the right medical billing company.

According to medical billing experts AMBS, there are many clearly measurable advantages of outsourcing your medical billing activities:

  • No downtime due to staff turnover or staff absenteeism
  • No training and re-training, absenteeism
  • No employee benefits
  • No delay in cash flows during absenteeism
  • No computer hardware / software headaches or expense (i.e. upgrades, trouble shooting…)
  • Increased, more predictable cash-flow
  • Increased incentives (we work on a percentage of collections)
  • Most current coding & reimbursement techniques
  • Increase accountability
  • Full-time, professional attention to your cash flow
  • No office distraction
  • Increased office morale
  • Detailed management & negotiating reports
  • Pre-sorted mailing for quicker delivery (Claims & Statements)
  • Daily electronic filing
  • Increased patient satisfaction (due to prompt, accurate and professional filing – and their calls being answered within two rings!)
  • Free your office to do what you do best…Care for your patients!

Practices’ feel they lose control over revenue, AR, write-offs and financials by engaging a billing company. Being in control of financials is an important of a business; this can be accomplished by engaging billing companies that use web-based software that is tightly integrated with their practices scheduling, electronic health record and reporting. Practices should be able to run real-time reports with key performance indictors that depict key financial matrixes. The alternative could also be asking billing companies to use their in-house software for billing purposes. The in-house software should be secure and web-enabled through pure web technology such as java, or asp; such that the productivity of the remote billing company is not affected due to application speed. Applications using Citrix, Microsoft remote desktop sharing, gotomypc etc are often found to be counterproductive accessing remotely due to speed issue.

To summarize, the value derived from a medical billing company can be tremendous, particularly for small and solo practices. These benefits can be reaped only through an effective collaborative partnership with the right medical billing service company.

5 thoughts on “Choosing the Right Medical Billing Service: Key to Your Practice’s Success?”

  1. I like how you talk about how hiring outside medical billing services allow the most modern coding techniques to be used and an increase in office morale. The medical office I work for has been considering hiring some kind of medical billing service to help us out since everyone has been having trouble keeping track of all the money in the practice. I\’ll definitely tell my bosses that hiring this kind of company would be a great idea since it will allow for their to be no more distractions in the clinic anymore and we will be able to focus more on our patients.

  2. I agree that you want a medical billing solution that provides timely filing, claims follow up, and denials. It would be smart to consider past customer reviews in order to know if it will be right for you. In addition to this, you would want to consider what your own employees have to say about the service to make sure that they will adapt quickly.

  3. Thanks for explaining that you want to find a medical billing service to help ensure that things like filing, claims followups and denials, and collections are processed correctly. Finding a service that is well known for good service and quick processing times would be nice as well. One way to find out about the service would be to talk with others who use this service to ensure that they are satisfied with it.

  4. Thanks for explaining how a medical billing service can help by leading to less downtime from staff turnover. Finding something that allows you to transfer seamlessly would be really helpful as well. You may want to talk with current clients to better understand all the benefits of different billing services before you choose them, though.


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