What Type of Medical Billing Firm Do You Need?

October 23, 2018 by Antonio Arias, MBA, CHBME

Topics: Practice Management, Medical Billing Company

When they’ve never used a medical billing firm before, doctors and practice managers can be hesitant to outsource revenue cycle management. Often, it’s an issue of perception.

When billing operations are managed entirely in-house, leaders tend to believe that the practice has stronger “control” over its cash flow (even if their poor metrics prove otherwise). By outsourcing, the thinking goes, aren’t they just handing the reins over to someone else?

They’re not. Medical practices have options when it comes to RCM: They can outsource pieces of the operation if they’re not comfortable with end-to-end billing management. Or, if they have unique need around technology and service design, they can address those too.

In fact, the most successful practices use outsourcing services to help them streamline medical practice management – rather than just lift-and-shift their existing approach to a separate firm.

But regardless, there are many different models for medical billing options, and companies are wise to consider which one aligns with their needs.

Tech-enabled ‘light service’
With the right technology in-house to help with claim scrubbing, some practices prefer to continue to handle everything up-to-and-including claims submission on their own. But even when practices have the basics of RCM operating smoothly, they still sometimes need expertise (and extra manpower) to manage major issues.

That’s why some opt to keep a “light service” provider on hand to handle payer relationships, and manage the communication and coordination required to work complex rejections or payment issues.

Fully-service, end-to-end
If you have less staff bandwidth onsite (or a motivating need to use it to differently), then a full-service billing company can handle more aspects of cash flow for you. These service firms may even equip you with more technology tools that make medical billing easier on the back end – like check-in portals for patients that help streamline eligibility verification and demographics updates.

From there, they also manage claims submissions and denial work from soup to nuts… with some even providing more consultative offerings to help practices avoid rejection-causing mistakes.

Boutique, specialty, or customized
Some billing efforts take more specialized knowledge (or oversight) than others. In some cases, running niche specialty practices requires extra help for providers to handle the business aspects of running their practices. In others, there are niche pieces of RCM – like payment posting or AR – that providers need short- or long-term assistance with.

As a firm specializing in holistic billing solutions and technology-driven firms, we understand the value that specialized knowledge and customized service offerings deliver to customers. Learn more about our billing services here, and contact us to learn how we can help you.

Are you interested in learning more revenue cycle management tips? Visit our blog! 

...and if you need help from a medical billing company...


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