A GUIDE TO CHOOSING THE BEST MEDICAL BILLING SERVICES OUTSOURCING FOR YOUR PRACTICE

Outsourcing your medical billing services is a smart way to reduce costs in the practice. It vastly improves the accuracy and efficiency of your back office systems, maximizing revenues through reduced billing errors and fewer unpaid claims. The challenge is in finding the right medical billing service for you – one that aligns with your practice goals and is easy enough for your team to use to its fullest potential.

CHANGES IN TODAY’S MEDICAL BILLING REQUIREMENTS: THE CHALLENGES

Ongoing changes in medical billing and reimbursements have made it more challenging for healthcare teams to stay on top of claims.

The medical billing outsourcing company you choose should be well-versed in current trends, including:

BILLING CODES – With the tens of thousands of unique billing codes in use today, the outsourcing company you choose should be well-versed and highly trained in coding accuracy.

ONLINE MEDICAL RECORDS – Your medical billing outsourcing company should have access to electronic health records to mitigate billing issues.

PERFORMANCE-BASED REIMBURSEMENT MODELS – The outsourcing company you choose should be able to demonstrate their understanding of changing regulatory frameworks to ensure compliance and improve the bottom line.

TYPES OF MEDICAL BILLING OUTSOURCING

There are two primary options with regard to the type of medical billing outsourcing company you choose: a terrestrially-based company (one that is local to your practice) or a software-driven solution. Each of these options has its pros and cons, but both should, ultimately, help you optimize back-office workflows and maximize revenue.

TERRESTRIAL MEDICAL BILLING COMPANIES: PROS AND CONS

Working with a company that is local to your practice provides some attractive benefits, such as it gives you the option of having billing personnel on-site to support your team when needed. However, since this option is powered by people, it can result in a slower payment process and there is greater potential for error.

On the plus side, working with a terrestrial medical billing company improves accountability. You will always have a key person to liaise with in case there is a problem, and it’s easier to establish a personal relationship between your team and theirs.

On the downside, this option may end up being more expensive in the long run as human error may be an issue. Plus, you may not have access to the same kind of 24/7 customer service that you would with a software-driven solution.

SOFTWARE-BASED MEDICAL BILLING SOLUTIONS: PROS AND CONS

On the plus side, a software-based solution gives you better potential for integrating with your current back office technology. It ensures that claims are processed quickly and efficiently; additionally, coding accuracy and payment timelines are much-improved.

On the downside, you may not enjoy the personal touch that you would have when dealing with a local company.

As you are shopping for medical billing vendors, there are several issues you should consider:

  • Pricing: Research the top vendors in this space to ensure that what you’re paying is in line with industry benchmarks.
  • Extra charges: Be sure you are aware of what’s included and whether there will be any “hidden fees” or extras charged back to you.
  • Minimum billing levels: Many medical billing outsource companies base their rates on a minimum in order to qualify for their best rates. If you don’t meet those minimums, you may be charged a premium.
  • Contract terms: Avoid signing a lengthy contract before you have had a chance to try out the service and see if it’s right for you.
  • Resubmissions: Find out whether the company charges for resubmissions and what their process is. If you end up with a lot of denied claims, this alone could make the service less financially viable in the long run.
  • Data Security: It should go without saying that your medical billing outsource company should be fully accountable to data security regulations and any local or national compliance protocols (such as HIPAA or the GDPR, for example).
  • Data ownership: If you should choose to go with another company at any point, you want to ensure that you can easily transfer your data to the new vendor without complications.
  • Performance guarantee: If the company does not offer a minimum performance guarantee they may simply not be a wise choice. If you are unable to realize a financial benefit from your outsourcing efforts, you have nothing to gain.
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