Billing leakage is a major reason why over 60% of physician practice revenue is falling through the cracks. If your billing practices aren’t as tight as you would like them to be, then you’re losing money daily that would otherwise be going towards revenue. When you have an efficient system in place, it opens up more time for you to spend with patients and can boost your income. There are challenges to finding the right medical billing service though, which means you need to carefully consider your options. Keep reading to learn about the benefits of an efficient billing service and how to make the best choice for your practice.
The Challenges of Medical Billing
The health of your claims process ties directly to the health of your practice. Get the most out of this process and find a collection, compliance, and follow-up system that’s accurate and efficient. Your billing process needs to address today’s major issues.
Incorrect Coding
Physicians can lose two-thirds of their revenue because of incorrect coding. This makes it difficult to pursue unpaid claims. It’s often difficult for clinics to have the time and resources for both patient care and upkeep of billing practices. Your billing team need to be efficient in pursuing each claim. They also need to keep up with the constantly changing rules and policies. The results of clinical miscoding and mistakes in documentation can have a powerful effect on the success of your practice. The healthcare industry changes at a fast pace and it can be difficult for staff to keep up. Not only do they stay updated on changing codes, but the software itself sometimes becomes a challenge.
Software and Technology
The steady advancements of industry software can become difficult for medical coders and billers. Navigating digital records, especially in today’s day and age can be a new challenge that leaves room for error. Hospitals have large amounts of data and don’t have the advanced technology to capitalize on it and manage it in the best way possible. Vital information like billing data becomes lost in the flow and staff aren’t able to access and analyze it.
Slow Credentialing
Another major source of revenue loss is when your credentials process is too slow and can’t meet the demands of insurance providers. As an extensive and time-consuming process, it’s also vital to every physician’s practice. You don’t want to lose money while playing the “waiting game.” This could result in losing patients because they rely on their insurance coverage. You also lose precious time because you’re stuck doing endless paperwork. A healthy medical billing practice will have an efficient credentialing process included. This gives physicians more time with their patients, adding value to their services.
Choosing the Right Billing Process
A physician’s practice relies on its revenue to continue, and the size and flow of that revenue depends on how well the medical billing process functions. Healthcare professionals face two choices: in-house medical billing or outsourced medical billing services. An in-house medical billing team requires certified coding staff who are regularly updated and trained on changes. It also requires staff who are in charge of pursuing claims when they languish. Additionally, this in-house staff must have a clean system in place that promises to create, edit, and submit every claim in a timely fashion. Any mistake or hiccup in the process flow can leave a major gap in the year’s revenue.
Training and maintaining an in-house medical billing team comes with significant challenges. These challenges aren’t always doable for a busy clinic or hospital. This is why the medical billing outsourcing market is projected to reach USD 19 billion by 2026. When an in-house billing team isn’t enough, physicians can outsource their needs to medical billing companies. These companies will specialize in an efficient and fool-proof system. Companies like these offer a variety of professional services to help clinics boost their revenue and open up more time for new patients. The goal is to reduce medical billing errors and it requires a team that fits your practice well.
How the Right Vendor Will Grow Your Practice
When a physician chooses to outsource medical billing, their main concern is usually that costs will be higher. While the cost may seem greater at first, the investment will result in a boost in yearly revenue. Choosing to use an outsourced billing service will open up time previously spent on revenue cycle management. With this major task taken care of by another party, staff can focus on other important tasks. The right vendor will help your practice grow in ways that make the transition worth it. You will see an increase in collection rate, fewer rejections and denials, and you’ll be able to stay updated on regular reports and finances.
Economy of Scale
This is one of the major advantages of outsourcing your medical billing needs. Instead of financing your own staff, a medical billing service will spread their expenses across their entire client base–which means savings for you. With more time to spend with patients and stress less, you’re also getting more savings and a higher return.
The Best Staff Possible
A medical billing service has one focus in mind, which means they’re going to hire the best team of specialists to install their services. Their goal is to maximize your revenue by using their specialized billing process. This means they’ll take the stress off your shoulders usually put towards pursuing patients’ payments. Outstanding claims will be tracked, services are coded without mistakes, credentialing is completed in the fastest possible way, and the overall billing cycle is watched from end to end.
Consistency in Production and Pay
An in-house billing staff normally comes with interruptions when individuals are sick or on vacation. When you outsource your medical billing, these interruptions are no longer a roadblock in getting your payments processed and filled quickly. An excellent vendor will leave your practice less vulnerable to interruptions in cash-flow. When coding rules or healthcare tech changes, you won’t have to worry about updating your staff and slowing down the workflow.
Visibility and Control
Some practitioners have concerns about handing over the reins to a third party when they choose to outsource. It may feel like you’re losing control over a major aspect of your practice.
If you’re choosing a billing service that works best for you, then you will still have open access to the information, process, and analytics of your medical billing. The expert team you choose will be open to regular meetings and reports so you can stay updated and confident.
More Time to Do What You Do Best
When you can set aside all that time previously spent on billing, you’ll find that you have more time and energy to focus on current patients while gaining new ones. This arrangement will give your practice the boost it needs to increase its revenue and be the best it can be.
Things to Check before Choosing a Medical Billing Service
The market for outsourcing billing services is growing rapidly, which means there will be a lot of choices out there. Here are some things to check before choosing your medical billing vendor.
HIPAA Compliance
You’ll want to verify that the vendor you choose is handling their information in compliance with HIPAA. Additionally, you should check that the company is compliant with all federal and state laws that apply to your practice.
Experience in Specialty Practice
Depending on the specialties your practice provides, you’ll want to make sure that the company and their process will work for you. If you plan on expanding in the future, talk with the team to see how future changes might be made.
Size of Staff
As you learn more about each billing service, request to know the size of their staff. This number is important because it will help you decide whether they can take on the size of your projects. Also, a good-sized staff will be able to take care of your patients’ billing needs promptly and efficiently.
Cost of Services and Payment Options
Talk with the vendor about how much their services will cost and if there are any hidden charges. These answers will help you in your decision. Don’t base your choice solely on the cheapest service available. You’ll want to invest in a vendor that provides high-quality services. You can check up on payment options for your business to help the decision process.
Strong Reputation and Experience
Go beyond reading online reviews of the company and look closely at reviews from other medical professionals who have used their services. This will give you a more accurate grid for whether they will suit your needs. Also, ask questions about the company’s past experience. How long have they been in business? Were their clients satisfied with their services? What types of medical businesses have they worked with in the past? You’ll want to choose a vendor who has been in practice for a good amount of time. Often, a physician-owned medical billing company will be your best option because they will know the ins and outs of every step of the process.
Honored Deadlines
It’s important that your billing service sticks to deadlines for providers, insurance companies, and patients. Delivering on time means your practice can function efficiently. It also means both practitioners and patients will be happy. Make sure your billing service will be able to honor strict deadlines, no matter what happens.
Know the Software
An essential aspect of efficient billing practices is the software that is being used for each step. If your practice relies on specific software, verify that the billing company can comply. Don’t underestimate the importance of updated software. Look for cloud-based billing software and tools like automatic reminders. Each vendor will be different and this key element can affect whether a company is suitable for you.
Denial Management
Denied or rejected claims occur often in the medical billing process. When you speak with a vendor, learn about how they handle denied claims. The level of support they offer in these occurrences will be an important factor.
Performance Transparency
The billing company you choose will become a major part of your practice. You don’t want to choose someone who isn’t completely open and honest. While you’re learning about a vendor’s process and infrastructure, assess how transparent they are in their process. How much do you as the practitioner get to see? How easily can you access reports and view their performance?
Make the Best Choice for Your Practice
When you want to take power over the success of your practice, the first step is to tighten your billing process that may be losing revenue. The performance of a healthcare billing service is tied to whether a clinic will succeed. The most effective way to do this is to outsource your billing services to a team that can dedicate all their time and expertise to your billing needs. This frees up time to focus on your patients while opening up doors to increased revenue and happier patients.
It’s important to make the right choice and work with a billing vendor who fits with your practice well. Look at the company’s reputation, size of team, availability, and honesty. You should also be familiar with their software and compliance with regulations. A medical billing service who fits well with your practice can catch the percentage of revenue normally lost through the cracks. Find a billing service that you can trust and get started on a move that will transform the future of your practice.
