The medical billing market size is projected to increase at 6.5% CAGR by 2023.
At some point, every healthcare practice needs to streamline its medical billing needs. You can either choose to outsource it or handle it in-house. In other words, you can use the services of medical billing companies.
Looking for Medical Billing Software? Check out SoftwareSuggest’s list of Medical Billing Software solutions.
Outsourcing them can help you save time and money. Moreover, you can successfully leave your back-office tasks to experts in insurance claims and billing. But how do you pick one?
To solve this dilemma, we have compiled this 9-step guide to choosing the best medical billing vendor for your practice. Ready? Let’s dive in!
Tips For Choosing the Right Medical Billing Software
1. Determine Your Practice’s Needs
The first thing you need to understand is that different medical billing companies specialize in different account sizes. But, what does this mean?
This means some are designed to handle large medical practices with many physicians and accept different forms of insurance. At the same time, others are suited for smaller practices with lower budgets, few insurance carriers, and physicians.
So, to determine your account size, consider three things:
- Your practice’s size
- Budget
- Accepted insurance carriers
Once you have done that, you can then choose between three different types of medical billing services.
A. Small-Scale Billing Services
These medical billing companies can provide great services for smaller practices. They can provide more personalized services and are highly reliable.
Moreover, their services are cost-effective and can save you a good amount of money. However, make sure these companies have significant experience to keep up with your billing needs.
B. Physician Practice Management Company
A majority of practices will need the medical billing services of a physician practice management company. These companies usually provide billing and other services for practices with 200+ staff members. Moreover, these are well-known names in the industry and can process high volumes of data at a time.
They can take off all administrative and back-office tasks from your hands. However, they may charge a bit extra for their billing and coding services. This can get costly for some practices. Before finalizing one, make sure you understand how their billing works.
C. Professional Billing Company
Well, partnering with these medical billing companies can allow you to add some great features to your account. They lift more weight off your shoulders so that you can solely focus on patient care.
However, you need to allocate a larger budget for your coding and medical billing needs. When looking for professional medical billing services, make sure to check out all plans, the features available, and the additional cost you will need to pay.
2. Find Companies That Match Your Expectations
Well, let’s face it. Some medical billers have a single area of focus but are experts. At the same time, others have several areas of specialty and work with a variety of practices.
The number one thing you need to ensure is that they have sufficient experience in your specialty. This is important as the main cause of denied claims and revenue loss for healthcare practices is incorrect billing and coding.
Working with a company that focuses on just their specialty will get you their undivided attention and, in turn, eliminate errors. You can also choose to work with a company that has worked with several practitioners in their field successfully.
Here are a few questions you can ask to ensure that a medical billing company has sufficient experience in your specialty:
- What’s the total experience of your billers in my specialty?
- Is your staff well-trained in my specialty?
- How many billers will be looking after my account?
- How do you keep up with the changing billing and coding updates in my specialty?
- Do you have any testimonials from other organizations in my area of specialty?
These questions will help you gauge the reliability of the billing company and make the right decision.
3. Ask For A Cost Breakdown
When it comes to outsourcing essential services, you definitely want a good return on investment. But there is much more to take into account than a price quote. In addition to keeping costs down, you must understand what exactly you are paying for each service.
There will be different ways a medical billing company can charge you. Many will charge a percentage of your revenue, say between 3-9% of your net collections.
In comparison, others may charge a flat fee or a flat fee and a small percentage of your revenue. Here is how you can do a cost-benefit analysis between different companies:
- Decide how you want to be billed. Would you pay a percentage of your revenue or pay a flat fee? Once this is sorted, you can narrow down the companies by how they charge.
- Compare rates between a few companies. Keep this comparison between 5 companies or less to avoid confusion.
- Read between the lines when comparing prices on quotes. Just because one service is x dollars cheaper than another doesn’t mean it will provide excellent services.
4. Ensure Compliance
All healthcare practices need to abide by compliance rules and regulations. It is mandatory if you want to stay in business and be successful.
When speaking with medical billing companies, make sure to find out how they follow compliance rules. Ask them to provide you a list of compliance procedures they follow as a company. Also, observe how each employee is following rules and regulations.
5. Research Company Reviews
Make sure that the company you hire has a good reputation in the market. It’s best to get online and look up some client reviews. You also need to ask yourself questions like:
- Did prior clients have an excellent experience with the company?
- Does the medical billing company deliver on its promises?
- Did previous clients experience any errors or issues that resulted in revenue loss?
You can also ask for testimonials or references that can prove their expertise. Before you sign a contract, make sure you are in good hands. Once you make the decision, it can be very difficult to get out of the contract.
6. How Many Billers Will Assist You?
Some medical billing companies prefer to assign just one biller to each account. At the same time, others will assign several billers. There are advantages and disadvantages of each method. Having one biller working on your account can get you personalized attention.
Whereas you may be able to get more done with several billers at work, it depends on the size of your practice and the relationship you hope to establish with your builder.
You will also need to find out the years of experience, credentials, and specialties of each biller assigned to your account. This way, it will benefit both you and the medical billing company.
7. Check Software Compatibility
Are you using an internal solution for patient accounts, back-office tasks, and handling financial data? You must look for medical billing companies that use software compatible with your existing system.
Transitioning into a new software means spending extra time, money, and resources. Moreover, you will need to train your colleagues to use the new software.
If you are willing to do that, you can ask the vendor if they include software training with the contract. If yes, do they offer it for free or charge extra for that?
Additionally, you must make sure that your staff is comfortable with the user interface. As healthcare professionals have too much on their plate, you will want to streamline your workflow and prevent any complications with data entry.
You must remember that you are outsourcing your medical billing needs to ease your workflow, and the chosen service should make it easy for you.
8. Establish Communication Expectations
A common issue you will face when outsourcing medical billing services is establishing communication with the vendor. When billing takes outside the office, you cannot simply walk in and ask questions to get an immediate response.
But, since financial management is essential to your company’s day-in and day-out duties, you will need to have a mechanism to get timely responses.
Before hiring a medical biller, ask them about their communication style. Here are some questions you can ask them:
- How soon do you respond to calls, requests, and questions?
- How do you deal with urgent requests for information?
These questions are imperative to develop a solid and transparent relationship with your medical biller.
9. Ask How They Handle Rejected Claims
Did you know 65% of medical billers never edit and resubmit rejected claims?
This can lead to a huge issue for healthcare practices as it can lead to heavy revenue losses every year.
Before you pick a service, make sure you ask them how they handle rejected claims. If they have a well-laid process for resubmission, you can be sure of getting the money you have worked hard to earn.
Also, ask about their rate of rejected claims. If a service reports a high volume of denials and rejections from insurance companies, it is a sign they are not billing and coding correctly.
Wrapping Up
These are some of the factors you must take into account when looking for medical billing companies. Considering them will help you outsource your billing in the right hands and save time and money.
Tried out medical billing solutions yet? Share your experience in the comments below!
A digital marketing and content curator at SoftwareSuggest, a software recommendation platform. I am passionate about Digital Marketing, and all things digital. Also interested in technology and innovation. In my spare time, enjoy playing cricket, and Badminton.
