Have you started a medical business and facing the billing problems to be resolved? Do you have less space for installing hardware and infrastructure for your billing staff? It is time to outsource a medical billing company. Outsourcing a medical billing firm can be challenging, as well as it requires a lot of research. Secondly, you outsource a company randomly and are not satisfied? You need to change it or replace it with a better one. Transition time is essential as well as scientific. Many businesses prefer to stick to one company because of the time involved during transition or outsourcing the medical billing company. Whereas A fear of loss of revenue also accompanies the decision to outsource. This blog will try to explain the answers to all these questions.
Types of medical billing companies
Medical businesses outsource medical billing services to decrease the workload of their workforce, attain the services of expert medical coders, and improve their revenue cycle management.
Based on the project size and complexity, there are three types of medical companies in the market.
Small Scale Service Providers.
Small-scale medical billing service providers provide services to companies with a small amount of data and a limited budget. Most small-scale medical billing companies offer task-based outsourcing facilities. To check their working quality and process, you can outsource minor tasks to them.
If you partner with a small-scale medical billing service provider, the only criteria are their experience in the healthcare industry.
Professional Medical Billing Company
Professional medical billing companies offer value-added services and a complete set of coding and billing services. They have vast industry knowledge and experience. Due to their volume of services and industry experience, they are more costly than small-scale medical billing companies.
General practitioner “Practice Management Company.”
The companies that are specialized in healthcare practice management fall under this category. The staff of these companies is over 200, and they are well equipped with infrastructure and modern technology. They offer premium coding and medical billing services and complete outsourcing of administrative tasks that are pretty expensive.
A healthcare provider’s responsibility is healthcare outcomes. On the other hand, you require consistent claims clearing and cash inflows to run your business. This part of your practice makes medical billing significant for your business.
Medical billing company enables healthcare practices to concentrate on healthcare outcomes leaving the billing and coding process.
Before selecting a medical billing company, take these factors into consideration.
To overcome the threat of loss and ensure that you make the right decision, you need to check the following factors.
Data Security
Being a healthcare business, your company deals with the massive data of multiple patients. Patient data includes Patient general records like geographical location, mobile number, National ID card number, etc., and health records.
In case of a breach, anyone can use this data. When you outsource a medical billing company, you will give them access to your data. Isn’t it a risk? You can minimize this risk by selecting a medical billing company committed to keeping your PHI safe. Overlooking data security concerns can be a massive risk for your business.
Accessibility
The companies that care for their customers provide easy access to the company. A company with interactive customer service tries to solve the queries at the earliest. For Example, if you have one point of contact with the company, there are chances that any discontinuation at that point will leave you nowhere. Select a company that has multiple access channels and have regular meetings with them to discuss your financials.
Secondly, is your company restricting you from accessing your claims data? Are you unable to run any financial report by yourself? Then you adopt the wrong medical billing company. It would help if you switched to another service provider.
Expertise
The change in the medical industry is regular and consistent. The medical codes change at regular intervals. Select a company with certified staff and conducts regular educational training programs for its employees. A coder with updated knowledge is a surety for clean claims. Hire medical biller and coders with knowledge of coder modifiers
Medical Billing Software
A lot of EHR software is available in the market. Ask for the billing software the company is using. Is it secure? Interactive? Can your company rely on it? Your company’s primary concern is data security. Try to collect knowledge regarding EHR software available in the market.
Analytics and Financial Reporting
Business analytics and financial reporting are important requirements of every business, especially medical businesses. The company must give you access to the market trend through CPT tools.
Other statistics, For Example, several patients, the amount collected each week, clean claims turnout ratio, and reimbursement rates, are required to analyze your business’s performance. Consistent financial reports and analyses are necessary for the future decision-making process.
VOB Verification of benefits
VOB is a process to ensure that a provider’s services to the patients will get payment. Different companies provide different insurance plans to their employees. It is significant to select a company that reimburses the payments faster than others. VOB is also important to have a list of services that reimburse through specific insurance companies.
Reimbursement of the code billed.
There is a separate code for every medical procedure. Some codes have higher payments than others; even the services are nearly the same. For Example, a code with a blue cross has a high payment rate. Insurance companies do not accept all the codes, and they keep on changing their coding requirements. So, it is crucial to select a company that is up-to-date with industry trends.
Technology Induction
An average medical billing company provides you with the services you require. Whereas a top-rated company continuously upgrades its technology to meet the industry’s challenges. For Example, a company providing an online payment portal for the patients will help your company to reduce accounts receivables. Search for the company with upgraded technology to make your practice management healthy and profitable
Appeals
It is important to check the appeal rate of the billing companies. A higher rate of appeals shows that the billing company is submitting erroneous claims. On the other hand, it is a sign that the medical billing company never gives up on the claims. You can ask whether the company charges for the appeals or not. Or who will bear the cost of the legal advice? These are the matters to be discussed before hiring the company.
Reputation
The outsourcing market is filled with medical billing service providers. To pick up one randomly or trust your gut feelings can result in a wrong decision or loss of money. It is vital to look for the reputation of the medical billing company before outsourcing your billing services. Check their period in the billing business. Check the number of satisfied clients. When selecting a medical billing service provider, satisfied clients and industry experience are a rule of thumb. You can check the online reviews thoroughly, including the number of reviewers.
Coding Expertise
Proficiency in ICD-10 codes increases the chances of claims clearance. Before selecting a medical billing company, it is important to check their adeptness in the latest version of ICD-10 (International Classification of Disease code). Select the company with re-known coders. You can compromise on cost if there is a surety that the company has proficient coders.
Demand Proofs of their specialties
Healthcare providers have the slightest knowledge about medical billing processes or financial processes. Whereas in the market, many companies declare a lot about their specialties. You can ask for proof of the declarations. Demanding the proof of specialties is your right. For Example, ask for credentials like the National Tax number, etc.
Ask them to disclose the staff size.
Staff Size is important in the case if you are willing to outsource a complete section of your business—staff size matters when the company offers a wide range of services. If a company has limited staff, they indulge in multitasking, and the chances of mistakes increases.
Assess the Cost
Before outsourcing a medical billing company, you must check their method of charging for a service, hidden charges, and discounts. Usually, companies offer discounts if you avail yourself bulk of services. Ask every query regarding payment before you sign the contract. Inquiring about prices and discounts will help you select the company that is fit for your budget.
Check for the flexibility in payment options.
Medical billing companies offer flexible payment options as well. In some cases, the billing companies offer task-based payments, while others may offer many services under one payment. To avoid any misunderstanding regarding payment, clarify every point before selecting the medical billing company.
Analyze promised with real-time benefits
The proper analysis of the benefit you will avail yourself of after outsourcing a billing company is necessary. The best way to analyze the quality of the service and the benefits is to outsource a part of the complete service. Your search is over if the company fulfills your requirements and their analytical reports show their working capability. If you face problems working with the company, keep searching for a better option and switch whenever needed.
Deadlines
Ensure that the billing company meets the deadlines because deadlines are equally crucial for the care providers and insurance companies. So, selecting a result-oriented medical billing company will solve your billing problems. Otherwise, your headache will increase.
Support in denial Management and emergencies
Rejected claims need appeals and resubmissions for reimbursements. Teaming up with a medical billing company that supports denial management can help you in the long term, whereas what will be the backup of medical billing company in case of emergencies like epidemics or disasters.
If you are wondering about selecting a medical billing company, the tips mentioned above can help you make your decision easy.
