Why Medical billing companies are important for healthcare providers

Last Updated on November 3, 2023 by SPN Editor

Medical billing is a crucial aspect of the healthcare industry, but it can be a complex and time-consuming process. Healthcare providers must navigate a myriad of regulations and requirements to ensure that claims are accurately and timely submitted, processed, and paid. As such, many healthcare providers opt to outsource their medical billing services to professional medical billing companies.

In this article, we’ll explore the benefits of outsourcing medical billing services, how medical billing companies handle common issues and the cost considerations of outsourcing.

Benefits of Outsourcing Medical Billing Services

Improve Cash Flow: Outsourcing medical billing can help healthcare providers improve their cash flow by ensuring that claims are processed accurately and paid in a timely manner. Medical billing companies have the expertise and technology to optimize billing and payment processes, reduce the risk of errors and delays, and improve revenue collections.

Free Up Staff Time: Managing medical billing in-house can be a significant drain on staff time and resources. By outsourcing medical billing services, healthcare providers can free up staff time to focus on patient care, administrative tasks, and other critical functions.

Access Expertise and Technology: Medical billing companies have a deep understanding of the regulations, requirements, and best practices involved in medical billing. They also have the technology and systems to manage complex billing and payment processes, including coding, claims submission, denial management, and collections.

Handling Common Issues by Medical Billing Companies

Billing Errors: Billing errors can result in delayed payments, denied claims, and legal issues. Medical billing companies have processes in place to prevent and correct billing errors, including resubmitting claims with corrected information, appealing denied claims, and working with insurance companies or patients to resolve billing discrepancies.

Patient Billing and Collections: Many medical billing companies offer patient billing and collections services, including sending statements, managing payment plans, and working with patients to resolve billing issues. By outsourcing these services, healthcare providers can reduce the risk of errors, improve cash flow, and improve patient satisfaction.

Denied Claims: When a claim is denied, medical billing companies work to identify the reason for the denial, correct the issue, and resubmit the claim. They may also need to appeal denied claims, which can be complex and time-consuming, but medical billing companies have the expertise and resources to navigate the process and increase the likelihood of a successful appeal.

Cost Considerations of Outsourcing Medical Billing Services

The cost of outsourcing medical billing services can vary depending on factors such as the size of the practice, the complexity of the billing processes, and the specific services required. Medical billing companies typically charge a percentage of the total amount collected on behalf of the healthcare provider, with the industry average ranging from 5-10%.

It’s important for healthcare providers to consider the total cost of outsourcing medical billing services, including any setup fees, training costs, and ongoing maintenance costs. While outsourcing medical billing can be more cost-effective than hiring in-house billing staff, it’s essential to choose a reputable medical billing company with a proven track record of delivering quality services and maximizing revenue for its clients.

Top medical billing companies in the US

Some of the top medical billing companies in the USA with a brief overview of their key features and strengths, as well as customer reviews and ratings:

AdvancedMD
Offers cloud-based medical billing services with an intuitive interface
Provides comprehensive revenue cycle management solutions
Has a rating of 4.4 stars on Capterra based on 270+ reviews

athenahealth
Offers end-to-end medical billing services with advanced analytics and reporting tools
Provides a patient engagement platform for streamlined communication
Has a rating of 4.2 stars on Capterra based on 1,200+ reviews

CareCloud
Offers a modern, cloud-based medical billing platform with robust reporting and analytics
Provides customizable solutions for practices of all sizes and specialties
Has a rating of 4.5 stars on Capterra based on 450+ reviews

Kareo
Offers a user-friendly medical billing platform with a variety of features and integrations
Provides flexible pricing plans and excellent customer support
Has a rating of 4.3 stars on Capterra based on 600+ reviews

MedicsPremier
Offers a comprehensive, cloud-based medical billing platform with a high level of automation
Provides advanced revenue cycle management features and customizable reporting
Has a rating of 4.8 stars on Capterra based on 30+ reviews

NextGen Healthcare
Offers an integrated suite of medical billing services and practice management solutions
Provides a patient portal for self-service and online bill pay
Has a rating of 3.5 stars on Capterra based on 1,000+ reviews

PracticeSuite
Offers a cloud-based medical billing platform with affordable pricing and a variety of features
Provides customizable workflows and robust reporting tools
Has a rating of 4.5 stars on Capterra based on 150+ reviews

Conclusion

Outsourcing the provision of medical billing services can present advantageous outcomes for healthcare providers, such as ameliorating cash flow, saving time for the staff, and providing access to expertise and advanced technology.

Companies specializing in medical billing can also be of great assistance in dealing with common issues, such as billing mistakes, patient billing, collections, and rejected claims.

Prior to making the decision to outsource medical billing services, healthcare providers ought to meticulously assess the costs and benefits and pick a reliable provider who has a documented history of success.

In doing so, they can optimize their revenue collections, diminish the chance of errors and regulatory violations, and concentrate on delivering top-notch patient care.