Medical Billing Companies In USA

Every day, doctors and health workers save lives by treating each patient individually based on his or her situation and needs, diagnosing illnesses, and advising on the best course of treatment. However, there is another critical aspect of effective healthcare practise to consider: the healthcare business side. Medical billing is a critical component of the healthcare industry. This is a very popular profession in the United States, where medical insurance covers more than 90% of the population.

Local company

The most obvious advantage of working with a local medical billing and coding company is on-site support. It is actually reassuring to know that if things do not go as planned, you can simply walk up to their office and have them fixed. This is one of the primary reasons why the vast majority of physicians have signed contracts with their local vendors. But how do you know if things aren’t going well in your practise?

local vendors

Many practises are unable to monitor the performance of their medical billing companies when using local vendors because there is no reporting mechanism in place that allows practises to look at the ageing of their claims. Among the many concerns of physicians are the lack of real-time financial ageing summaries and the inability to review pending patient responsibilities. Aside from that, practises must still seek insurances to verify insurance eligibility rather than relying on their billing software for the task. As a result, not only do you have very basic billing functionality, but you are also completely reliant on these vendors with no way of analysing how well they perform.

Offshore Billing vendor

Your issues with offshore billing companies are twofold.
a. Horrible support – accents, a lack of understanding of the US insurance system, keeping up with payer payment changes, and the misfortune of being transferred from one support representative to another rather than having your own billing account manager

b. Privacy Concerns – Are you willing to take the risk of sharing your patient’s financial information across borders in this era of ever-increasing emphasis on the protection of patient health information and the penalties associated with it? I don’t think so.

The advantages are that these are less expensive alternatives. Many of these companies charge you per claim rather than on a percentage basis.

You Have Your Own EHR Vendor (with the condition that they offer medical billing services)

My preferred option is to have your own EHR vendor. Outsourcing EHR to your own dedicated vendor will provide you with the obvious benefit of dealing with a single vendor, saving you the hassle of follow-ups, monitoring different vendors, and ensuring milestones are met. You benefit from owning specialised medical billing services. Furthermore, most billing service providers will provide you with their best EHR Software and Practice Management System (Medical Billing software) for free, allowing you to exercise reasonable control/ insight into the performance of your third party biller.

Checklist for Outsourcing

Here is a comprehensive checklist of things to consider before outsourcing your billing function:

Predatory Business Practices Should Be Avoided
You must make every reasonable effort to avoid falling victim to predatory business practises. That is, do not choose medical billing companies solely on the basis of low rates, without weighing the pros and cons and taking into account the risks involved.

Avoid Using Bait Marketing Techniques

Many businesses advertise low rates in order to attract uneducated buyers and gain market share. These companies typically do not offer a full suite of revenue cycle management services or include an elevator clause as part of the low rate. In any billing service contract, always read the fine print.

a) Many low-rate vendors have a high minimum revenue requirement, making the low offer ineligible or unattainable.

b) Some low-cost vendors only provide one-time claim submission and do not offer services such as working on denials or resubmitting claims. In these cases, the burden of working denied claims and collecting unpaid balances falls on the client.

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