Friday, December 9, 2022
Medical billing

Medical Billing Solutions: How to find the right one for our practice?


To enjoy the so- called revenue boost and streamlined workflow benefits of outsourcing, you need to choose that perfect medical billing solutions to match your requirements. There are two aspects to consider when you decide on this. One being, what is your level of expectations from them and the second is, what are the extend of services they will be able to render in general. Let’s elaborate on either of these.

Scope and expectations

The first one is, be sure on what are your expectations fromthe billing service before you outsource the process to medical billing solutions. Have long terms goals set for your clinic, then decide on the scope and needs required to be fulfilled by outsourcing to external vendors.  For that, have clarity on the specifics listed below.

1.      How much support will you require with respect to the billing process?

Are you only looking for help with the back-end process of billing like coding, charge capture, claim processing and claim tracking? Or will you be requiring a full bundle of services including patient engagement, appointment scheduling and reminders? What about electronic health record maintenance at the clinic? Think about all these.

2.      What percentage of the process do you want to conduct in-house?

That mainly depend on the existing manpower and resources at your clinic. If your process is already set with enough number of coders and transcribers and you just need backing with claim submission, clearing house for clean scrubbing claims, compliance audits and denial managements you can choose a service limited to these.

3.      Decide on the patient factor:

Medical billing solutions work with a standard set of rules and payment strategies, if you are used to making exceptions for some patients regarding services and payment, the billing software of the service provider might not be able to do those for you.

4.      Have clarity on your reasons to outsource

Are you outsourcing the process because you don’t have enough staff at the facility to tackle the file volumes due to increase in number of patients? Or have you been facing back-to back claim denials, failure to receive reimbursements on time and revenue loss due to that? What are the reasons behind the decision to outsource? It needs to be communicated clearly.

Efficiency and Services rendered

Having said that, bellow listed are the queries you need to raise to the medical billing solutions vendor before choosing them to serve you.

1.      How do they tackle the existing paperwork at your clinic?

It is a very crucial factor to consider how is that shift from in-house billing to outsourced billing being managed by the medical billing solutions. Yor existing volume of records needs to be migrated and integrated to the new practice management cloud to proceed with the claim management. If it means added work to our in-house team, their other duties in the everyday activities at the clinic will get affected, you don’t want that. Choose a service which has the resources and strategy to make a smooth migration of all the electronic health records without missing any data and continue billing on the new platform.

2.      Ask them what is the type of technology back up they have?

There are many advanced practice management software’s and billing software’s available in the market which the medical billing solutions have integrated with their process to serve you better. Pick the company that uses the best software solutions in the market, so that you can enjoy all the good benefits of cutting -edge technology at your practice. At the same time make sure that it is compatible with the speciality of your practice and easy to use and learn

3.      Look into how much they value compliance

Whether it is documentation of electronic health recording, medical coding, charge capture or claim processing, compliance is key. One cannot stress enough on the importance of keeping up with the shifting sands of new codes and policy changes brought about by the state and insurance companies. Check how often do the medical billing solutions of your choice upgrade themselves in terms of latest standards in the industry. Ask them about the education and ongoing training their staff undergo to meet the current compliance standards. Lack of compliance to billing standards is what often lead to claim denials and future litigations

4.      How efficiently will they manage your account receivables?

Any smart vendershould be able to bring your account receivable days to a minimum. Ask them how fast can they start processing the claim after the patient leaves the clinic completing the treatment. If they are equipped with expert manpower and enough resources, they should be able to start Medical coding and bill capture at the earliest, so that claim is sent out at a faster rate to the respective insurance company to ensure faster reimbursement. Shorter the billing cycle, better will be your income inflow. So, make sure your probe into it.

5.      Check for cost effectiveness

Last but not the least, compare the expenses of doing the billing inhouse and outsourcing it to medical billing solutions to see which merits your bottom line and overall profitability better. If outsourced wisely to the right vendor, you will surely see a boost in revenue in a short span of time.

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Habib Kazi is a General Blogger & writer who has been an expert in the technology field for a few years. He has written several useful articles which have provided exciting and knowledgeable information on Finance, Business, Construction, Tech, Travel, and Sports.