Being a small healthcare practice owner is a juggling act of dozens of hats. You’re responsible for patient care, staffing, supplies and you still have to keep the lights on, and keep your finances afloat. This is why medical billing services for small healthcare practices are becoming so popular among numerous small clinics, to save them from the burden of paperwork and to enable them to get their dues quickly.
Introduction:
Medical billing services are third party organization or persons (as the case may be) that handle the entire revenue cycle process of a healthcare practice. This includes coding patient visits, chasing insurance company denials, posting payments and patient statements.
Why small practices struggle with billing In-House?
- Limited staff bandwidth: Most of the time, there will be an employee working at checkout, who will take care of check-in, check out and billing all in one, which leads to errors.
- Low claim denials: In most cases, the industry average denial rate is higher than normal since the small practice doesn’t have coding knowledge.
- Cash flow gaps: Delayed payments could result in severe financial difficulties for practices without a good amount of cash on hand.
- Compliance risk: If you make a mistake in coding, or break HIPAA regulations, you may be subject to an audit, penalties, or even worse.
A good medical billing service has the following features:
Not all billing companies are the same, and there are numerous types. These are the main attributes of a medical billing service that a small medical practice should consider when evaluating such services.
1. Claims submission and scrubbing:
A service provider with good billing experience will review every claim before sending the billing report to the third-party payor so as not to encounter any of the following denial problems: missing modifiers, mismatched codes, incomplete patient information.
2. Dispute Resolution and Appeals process:
Denials are still possible even with the best practices. It is important that they’re resolved quickly and effectively.
3. Patient Billing & Collections:
Your billing service needs to not only handle claims on your insurance, but also process patient statements, patient payment plans and follow up over unpaid bills as well.
4. Reporting and Analytics:
It’s important to know your revenue cycle at any point in time. Look for services to offer dashboards or periodic reports of collection rates, days in accounts receivable, denial trends and payer performance.
5. Credentialing Support:
Lots of billing companies also support with provider credentialing and payer enrollment— it is important for getting reimbursements at all, especially if you are a brand new practice or a brand new provider joining a different practice.
Here are some of the advantages of Outsourcing Medical Billing:
- Faster reimbursements: Claims submitted by specialized billing teams tend to be cleaner and are paid quicker.
- Reduced administrative burden: You won’t be calling on your employees to find insurance companies; you can call on your employees to find patients.
- Access to expertise: Billing companies remain up to speed on coding changes, payer policies and compliance.
- Scalability: The more prevalent the practice, the more your billing system can scale, and you don’t need to continually recruit employees.
- Fewer uncertainties in cash flow: Budgeting and planning is much easier with regular, on-time collections.
If you think about them, be aware of some of the disadvantages of you consider them at all:
- Less direct control: You’re handing over a key component of your profit stream to another company.
- Communication gaps: When the billing company is not responsive, it’s possible for it to be hanging around longer than necessary.
- Cost structure: The higher your revenue, the higher your percentage fees, so don’t forget to do your research and see if you can find a flat fee or an in-house option.
- Data security concerns: The vendor must be completely trusted to follow HIPAA data handling procedures.
What is the price of Medical Billing Services?
The pricing model can have different forms, but most can be categorized as a few forms:
- Revenue collected as a proportion of revenue collected. This is typically 4-9% of revenue collected. This puts the interest of the billing company in line with the success of your practice.
- Flat monthly service, Monthly charge, more likely to be predictable, and less flexible in growing practices.
- Per claim fee, A fixed fee for each claim that is filed, beneficial for lower volume practices.
How to Pick the ideal Medical Billing Services?
- The first step is to determine the special needs:
Billing in a dermatology practice is different than billing for a behavioral health practice or physical therapy practice. Select a service that has experience in your particular specialty.
- The compliance and certifications are checked:
Verify the vendor is absolutely HIPAA compliant and the vendor’s coders have relevant certifications, such as Certified Professional Coder (CPC).
- Make inquiries about technology, for example:
If the service integrates with practice management or EHR systems, find out what they are. If this doesn’t correspond, it can make a lot of trouble within the workflow.
- Reports on the Reporting Transparency:
Request sample reports. The collection rates, any trends in denials or claims outstanding should be easy to see at a glance.
- During this step we will learn about the Onboarding Process:
A good vendor will have a straightforward, clearly defined onboarding process, which will take 2-6 weeks depending on practice size and billing backlog.
- Read Reviews & Request for references:
Interview other practices regarding their “real world” experience with the vendor, preferably in your specialty.
Conclusion:
When it comes to medical billing services for small healthcare practices, the difference between a practice that’s constantly chasing cash and one that has a predictable cash flow could be a matter of choosing the right medical billing services for small healthcare practices. The right partner relieves you of the administrative burden, fewer denials, and you can concentrate on the real work – the patient.
At CareSolution MBS, we help small healthcare practices simplify their billing process with reliable revenue cycle management solutions, expert coding support, denial management, and timely follow-ups. Partner with us to take control of your practice’s financial health while you focus on your patients.
FAQ’S:
1. What are medical billing services for small healthcare practice?
Medical billing services for small healthcare practices are services provided by a medical billing company to help small healthcare practices with medical billing operations. Services that can handle claim submission, claims coding, claims denials, claim follow-up and patient billing for a practice, thus allowing the time that staff members can use for patient care.
2. How much would it cost for medical billing services?
Depending on practice size and volume, and/or flat monthly fees and per claim fees, the average amount is 4%-9% of collected revenue.
3. However, can a medical practice that’s small in size outsource medical billing?
Yes, outsourcing can often yield higher collection rates and lower denials for most small practices and also provide flexibility in freeing up staff time, but it also entails a loss of some direct control.
4. How long does it take to onboard to a billing service?
The process of onboarding varies from practice to practice, ranging from two to six weeks depending on the practice size and if there is a claims backlog to work through.
5. Do medical billing services have patient statements, too?
Most complete billing services companies take care of patient billing, which involves collections follow-up, insurance claim processing, statements and payment plans.
