Is your medical billing taking away valuable time from patient care? Are you confused by the continuously changing medical billing codes? Are you tired of ever-increasing denials, high operating costs, and declining reimbursements? Do you want to improve the efficiency of your medical billing? A medical billing service is the answer to all your problems. Medical billing services handle all doctor or physician billing needs including efficient patient billing, claims submission, tracking your accounts and following up of rejected claims.

What are the benefits of medical billing outsourcing?

Medical billing outsourcing facilitate several direct and long-term cost savings. By hiring medical billing service providers, you do away with the need of hiring full-time staff for your billing requirements. If your office staff is involved in processing your medical claims, you can save valuable employee time that can be used for other more productive work. In the long run these medical billing services provide significant cost benefits and increase your overall income. Medical billing services are also capable of processing higher volume of claims at faster turnaround rates.

Medical billing services staff are better trained to handle billing requirements than your in-house staff. They have the necessary up-to-date knowledge about changing codes and insurance regulations, which minimizes the number of rejected and denied claims. Additionally, if a claim is rejected, medical billing services immediately re-submit the corrected forms. Lastly, medical billing service providers are paid on a percentage basis of successful claims, which gives them a much higher incentive to collect.

How does medical billing outsourcing work?

The following steps explain the working of medical billing services:

Data delivery to service: Firstly, you need to send patient data, diagnosis codes, procedure codes and insurance data to the billing service provider. Most providers support multiple ways of data delivery including e-mail, mail, fax, and scan. Providers may also allow you to enter the information into a secure web page on the provider’s website. Lastly, providers may install software on your office computers that transmits billing data to their computers through a secure internet connection.

Submission of forms: After receipt of the billing information, the service staff checks your data and requests for any missing information, fills up the appropriate claim forms and submits them to a claims clearinghouse.

Approved claims: The explanation of benefits forms (EOBs) and checks are delivered to you for all approved claims. Incoming checks and EOBs can be handled in two ways. You can have them delivered to your office and send the information back to the medical billing service, by scanning or entering the EOBs into the medical billing system. Alternatively, you can use a bank lockbox that ensures scanning and electronic delivery of your payments. This is a much quicker way of receiving the funds.

Rejected Claims: These claims are sent to the medical billing company for correction and re-submission or else are returned to you.

Feedback: Professional medical billing services provide you regular feedback and reports about your claims and payments.

Wait! There are some more benefits of medical billing outsourcing.

Top medical billing companies also offer financial service, like medical financing to adjust your short-term cash flow problems. They loan you money against your submitted claims for a small fees. They may also provide training to help you improve you claim submission process and coding. Some medical billing companies also offer medical practice management and electronic medical records software to integrate different aspects like diagnosis information with billing. Though you can purchase these systems independently from other vendors, having a single provider for all your billing software can simplify integration issues.

Here is some help to evaluate medical billing services:

Ownership of software: Some medical billing services develop their own medical billing software while other services license the software from a third party developer. If your medical billing services provider owns the software, you will get excellent software support, improvements and upgrades. They will also quickly fix problems with the software. On the other hand, services that license software are more focused on the medical billing services and getting client’s claims paid. If you choose a service provider who licenses the software from a third party, make sure to check the track record, customer satisfaction and software releases of the third party developer as well.

Ease of Use: Another crucial aspect to consider before hiring a medical billing service provider is the ease with which the software can be learned and used. Ask the service provider to give you a demonstration of the software, try out common tasks on the software such as entering and finding billing information, and determine its usability. You can also get your billing staff to test the software before making a decision.

Local vs. web-based software: Local software runs on your office computers. It enables you to access billing information even in case of internet failure but the onus of maintenance falls on your IT staff. In case of Web-based or ASP systems, you enter information on a secure web site for transfer to the billing provider. Both software solutions must meet the HIPAA security requirements to ensure confidentiality.

Security Features: The medical billing software should include security features such as multiple access levels that enable you to give different access right to different staff members, change logs to keep track of the information that different users have accessed or edited and SSL for transmitting data securely over the internet. These features are included to ensure confidentiality of information and must comply with the HIPAA standards. Some software systems also allow you to restrict access of different computers within your office and based on the time of day.

So, how do you choose a medical billing service provider?

Look for a provider with considerable medical billing service experience and a successful track record. Get an idea about the provider’s approach to the medical billing process and see if it meets your requirements. Ask for references and inquire about their satisfaction, quality of service, problems faced, and whether the provider observes strict compliance with the HIPAA standards. Find out about the training, knowledge and expertise of the medical billing staff. Also, inquire about the location of the staff, as offshoring is very common in the medical billing industry. Additionally, ask providers if they will offer you a dedicated account manager who will be responsible for all interactions with you or whether specialized teams dedicated to specific parts of claims processing will interact separately with you.

Report quality and availability is another feature you can use for assessing different medical billing services. Your medical billing service provider should provide you with clear, easy to read reports that can be easily filtered and sorted for different types of information. Monthly overview reports should accurately depict your entire billing picture and accounts receivable reports should enable you to track the effectiveness of the billing service, one to three month after claim submission. Additional reports must be available to you when using a software-based or web-based billing service. Ask to see sample reports to determine if they meet your requirements.

Your medical billing services provider must comply with the HIPAA standards.  Inquire about the security infrastructure of the service provider to ensure that patient information is safe. Physically secure computers, backups, power backup and redundant servers are some of the security safeguards that should be taken by your medical billing service provider.

How much does medical billing services cost?

Medical billing service providers charge a percentage, usually from 4-15 percent of collections. Top medical billing companies may charge a higher percentage but they also help your medical practice increase your total collections. Price of medical billing services depends on three factors, volume of medical claims, average size of claims and the types of services. If you have a high volume of claims, you will have to pay less. Additionally, larger the dollar amount per claim, lesser will be the percentage charged. The services you add to the basic medical billing services also affect the price of medical billing services. For instance, you will have to pay a higher percentage for faster turnaround of claims or 24-hour support. You may also incur some additional costs such as paying a fixed fee for patient statements and data exports. Assess all these costs before selecting a medical billing service. The term of your contract also varies. It may be anywhere from two months to three years. Setup fees are generally waived for longer-term contracts.

Compare a few qualified medical billing services companies and carefully evaluate your needs before selecting the medical billing service provider that best fits your healthcare practices needs.