How To Select The Right Medical Billing Company For Your Practice

At some point, every healthcare provider is bound to decide how it is going to handle its medical billing needs. In other words, it can either choose to handle all the administrative tasks on its own or choose a professional medical billing company to manage them. As the primary task is to serve patients, it can be overwhelming and challenging for healthcare providers to manage the entire medical billing process without professional help.

There is a current market research report that indicates that the demand for medical billing services is growing at a very rapid pace. As per a Market Research Future report, the market for medical billing reached a value of USD 14.2 billion in the year 2022. Not only that, but it is also anticipated to witness significant growth indicating a rise from USD 15.88 billion in 2023 to USD 31.19 billion by 2030.

During the forecast period of 2023-2030, this growth is attributed to an impressive compound annual growth rate (CAGR) of 11.9%. The report says that there are several factors which are driving this expansion. This includes the increasing emphasis on compliance and risk management, a growing demand for enhanced efficiency in the medical billing process, and efforts to reduce in-house operating costs in healthcare. It is not possible for the Healthcare providers to manage the various stages of the billing process without the right expertise and professional help.

As soon as healthcare providers make this decision of getting rid of their administrative burden and outsource their medical billing process to the experts, it is important that they find the right medical billing that understands the requirements and effectively manages the entire revenue cycle.

Why It Matters To Choose The Right Medical Billing Company

There are various reasons why choosing a medical billing service provider is critical. The most important reason is that RCM is a complex and multifaceted process that involves capturing and collecting revenue from patients. It circulates around the entire cycle from a patient’s visit to a healthcare provider to scheduling appointments and insurance eligibility verification.

After that, coding and billing of claims is initiated and proper follow-up on unpaid accounts must be initiated for managing denials. This entire process demands meticulous attention to every detail at each step and a deep understanding of the ever-changing healthcare landscape. Medical billing expertise is vital to ensure that providers receive accurate and timely reimbursement, which finally contributes to the financial stability and growth of the practice.

The ever-changing industry landscape and regulations in medical billing are another challenge. Providers often find it challenging to keep up with constant advancements in technology, the increasing complexity of insurance policies, and evolving industry requirements and regulations. Staying up to date with these changes and ensuring compliance is a hectic and time-consuming process. And outsourcing medical billing to a specialized company can be advantageous in this situation. Here a knowledgeable and experienced medical billing company can make a significant difference.

How To Choose A Right Medical Billing Company For Your Practice

There are several factors to keep in mind when you are considering outsourcing your medical billing process to the experts. This blog will give you a decent idea of how to make the right choice, so you end up making an informed decision and selecting a medical billing company that fulfills all your billing requirements.

Before you choose the right medical billing company for your practice, you first need to understand that there are various types of medical billing companies present in the market. You first need to make the choice regarding what kind of medical billing company you are looking for.

Various types of Medical Billing Companies are:

Small-Scale Medical Billing Company:

There are various medical billing firms that work on a small-scale. If you are a healthcare provider, who has limited data to manage and have a limited budget, you can consider choosing a small-scale medical billing company for your healthcare.

Professional Medical Billing Company:

As the name suggests, a professional medical billing company is somewhat of an extra budget than a small company. However, the services provided are also worth the extra money you will spend here. So, if you want better quality services and are willing to spend more, you can consider selecting a professional medical billing company.

Physician Practice Management Company:

When companies have a large workforce and well-equipped facilities, they are considered Physician Practice Management Companies. Well-trained professionals work here in a well-developed hierarchy to complete every billing and coding task on time with utmost productivity. They can cost more than small and professional firms, but you can get rid of all administrative tasks after employing them.

The Factors To Consider When Selecting A Medical Billing Company

1.Level Of Security And Transparency

Healthcare Providers are supposed to handle the sensitive data of the patients. Therefore, security is a major concern and task that health professionals need to take care of. When you are looking for a medical billing company, ask about their protection framework and processes that they initiate to protect your data. It is important to choose wisely if you want to ensure the protection of confidential and private medical records.

Make sure your medical billing company is transparent to you and provides reliable information on time. Ask for all the details as their business practices are directly proportional to the growth in your medical practice.

2.Proper Analysis Of Cost Budget

It is obvious that a medical billing company is going to charge for the services it is going to provide. Make sure you keep to a strategic approach and ask them in advance if there are any additional fees. It is one of the most essential steps for a healthcare provider to evaluate their budget and then move forward to employ the services of any medical billing company. Every company has its own packages of services at different rates. Make sure you choose the right one that is within your budget.

3.Consider The Experience

When you are going to hand over the financial future of your healthcare to a company, you must consider the past of their medical billing business. Thanks to today’s digital environment which has made this job simpler. You can easily find the different reviews on social media and select the one as per your preferences. For how long the billing company has existed, what customers they have, what the ratings are, and other such things will make it easier for you to choose the right one.

4.Ensure That The Company Is Compliant

It is necessary for all healthcare providers to strictly abide by compliance rules and regulations. To safeguard your interests and take care of security, it is best to work with an ISO-certified company that is the Health Insurance Portability and Accountability Act (HIPAA) compliant. It not only gives you the peace of mind of knowing that the billing company's practices are compliant but also adds up to the authenticity of your organization.

5.Find How Many Billers Are Assigned To Your Account

Every billing company has its own way of working. Some will assign just one biller per account. Others will assign several billers. There can be pros and cons in each way. When you have just one biller working on your account, your relationship with that biller can be more personal, you will be given undivided attention. However, it is obvious that you may be able to get more done with more billers at work. It ultimately depends on the size of your practice and the relationship you want to establish with the biller.

6.See How They Handle Rejected Claims

Did you know the fact that almost 65% of medical billers never edit and resubmit rejected claims? This is one of the most prominent problems in the medical billing industry. And every year it results in significant revenue loss for healthcare practices.

When you make your decision to select the best medical billing company, the most important question to ask is how they handle rejected claims. Study if they have a process in place regarding resubmission, so you can be assured that you don’t have to compromise on the money you worked hard to earn. Additionally, make sure that you are aware of their rate of rejected claims. If there is a high volume of rejections or denials from insurance carriers, it’s a sign that they are not billing and coding in the right manner.

7.Timely Reporting

See if the medical billing company that you are partnering with provides you with weekly and monthly reports. This is not only essential for tracking the financial performance of your practice but also for monitoring the effectiveness of the medical billing process and addressing if there are any issues within time. When you get detailed reports, it provides transparency and insight into the revenue cycle and helps to identify trends. Reports should include information about submitted claims, payments received, outstanding balances, reimbursement rates, denial rates, and other financial information about healthcare.

By following these steps, you will surely be able to find a medical billing company that aligns with your requirements and supports your RCM process in an effective manner. When you look for a medical billing company, keeping in mind all the above-mentioned parameters, you will see that most of the companies lack one aspect or the other. There are some exceptions, like Eminence RCM, that will not only fulfill all the parameters but will also go beyond them.