Medical Billing Services Blog

Medical Claims Billing Services Selection Process

2008-08-25T06:41:00Z

Provides an overview of how to insure you select the correct medical billing service from the 7,000 medical billing companies in the US.
http://blog.medicalbillingservices.info/2008/08/25/medical-claims-billing-services-selection-process.aspx

Medical Insurance Billing Services - Scale is Key

2008-08-13T05:53:00Z

In my last entry I outlined the key benefits one should see from a strong medical billing service company. I also outlined the most frequent concerns that can stall the decision to outsource medical billing. In today's entry I will be talking about the first benefit I mentioned - Scale. By scale I mean that the medical billing company should have tens and hundreds of providers across whom large, necessary investments can be spread. If a $150,000 per year billing system administrator is required, then a medical billing company with 200 clients only needs each of its client to carry $750 per year of that person's cost. If a practice of four providers employed this person, then each provider would need to carry $37,500 per year of that person's cost; this is the value of scale. A medical practice can achieve significant advantages by leveraging the superior scale of a mid- to large-sized medical billing company.

A medical billing company should be deploying technologies and resources that a typical medical practice simply cannot afford or support. Examples of technologies and processes that lend themselves to scale include:

A high end billing system that offers sophisticated reporting and claim management/work flow capabilities. These systems will typically cost well into the hundreds of thousands of dollars.
A pre-submission claim scrubber that applies the payers' adjudication rules before the claims ever leave the medical insurance billing services four walls.
A dedicated billing system manager that stays on top of the ever changing rules from payers concerning how claims need to be submitted. I am sure you have heard horror stories about claims going for weeks without being submitted. This is often caused by changes in a payer's claim formating rules. A dedicated billing system administrator stays on top of these each and every day.
Sophisticated patient collection tools such as predictive dialers and utilization of a patient expected payment yield (i.e., the amount the patient owes times the likelihood they will pay).
A well-defined and managed billing process that will not grind to halt because a single employee is lost and eliminates errors before they propagate through the system.
A dedicated group of individuals that follow-up on claims that have not had a response from the payer within a reasonable time frame. There is a great example of the power of this in the following Medical Billing Blog from ClaimCare Medical Billing Services.

There are even more technology and process elements that lend themselves to scale. Without even including all of them you can quickly see that the average medical practice simply cannot afford all of the technology and personnel required to effectively fight insurance companies for the money the doctors are owed. A significant amount of the cost associated with the technologies and process steps outlined above is fixed (for instance, the cost of the core medical billing system and the salary of the billing system administrator). Medical Billing Services spread these fixed costs across their entire client base, which can be hundreds of physicians. This is one of the reasons that small medical billing services are struggling to properly serve their physician clients - they typically cannot afford to deploy processes or technologies that are any more powerful than what an average medical practice can afford.

In conclusion, selecting a medical billing company that has the scale to deploy sophisticated technology and processes can provide the average medical practice a huge advantage in terms of their ability to do battle with the payers that are working hard to keep every penny they can.

To learn more visit the Medical Billing Services Buying Guidewebsite or the Contact Us page.

Outsource Medical Billing - Deciding if it is right for you

2008-08-10T16:22:00Z

Over the next two weeks I plan to discuss a framework for thinking through whether outsourced medical billing is the right decision for you. Although I am focusing on outsourced medical billing, the basic concepts apply to any outsourcing decision. Today I will outline the main benefits to consider when making the decision about medical billing outsourcing and the most typical concerns and risks associated with the decision to outsource medical billing. Over the following days I will discuss each element in more detail.

The fundamental principal behind outsourcing is the focus on core competencies. The idea is that you and your practice are geared towards treating patients, not fighting insurance companies and pursuing personal balances. On the other hand, medical billing services focus on medical billing and should have the scale, focus and employees to do a better job than most medical practices or medical facilities. The primary benefits that a medical practice should see from the right medical billing service are:

Medical Billing Services have more scale to purchase and deploy the technologies required to properly submit claims, battle with insurance companies and collect personal balances.
Outsourced medical billing companies are able to attract a higher caliber of medical billing specialists and retain these individuals.
Medical billing services have a deeper bench of employees and this provides a layer of protection for your practice by decoupling you from the risk associated with losing a key (if not the key) billing employee.
Medical billing companies are better positioned to properly utilize the technology they have.
A medical billing company has a broader scope than any single medical practice or facility. This allows them to see patterns across practices, specialties, states and payers that can add money to your medical practice's bottom line.

The typical concerns that physicians and practice managers have when deciding whether they want to outsource medical billing are:

Will a medical billing company fight as hard for me with insurance companies as my own employees?
Can medical billing companies handle the unique elements of my practice?
Will I lose control and visibility into how my accounts are being worked?
Will medical billing outsourcing alienating my patients through heavy handed collection practices?
Will medical billing services only go after the low hanging fruit, and leave the more difficult money uncollected?

Over the upcoming two weeks I will go into more depth on each of the benefits and concerns outlined above. I will go ahead and give you a peek at the final chapter. The trick is finding the right medical billing company. Once you have a medical billing service with a proven track record you will be able to see substantial improvements in your medical billing, have a more attractive bottom line and have more time and energy for your patients, growing your practice and - heaven forbid - a life outside the office. If you cannot wait to hear more, then please visit Medical Billing Services Buying Guide to purchase a copy of our buying guide or a report card on medical billing services that you are considering.

Medical Insurance Billing Services – Tip of the day for the selection process

2008-08-10T04:11:00Z

So, you have decided that it is time to outsource medical billing. There are many important steps to insure that the medical insurance billing services company you select is the right one for you. Today’s post is focusing on one step of the process – checking references. As with the overall process, there are many important elements that need to be addressed to insure that your reference check is effective in verifying the attractiveness (or lack thereof) of your potential medical insurance billing company. The main element I want to focus on today is creating an effective interview guide.

Without a good interview guide you could easily finish your reference check process and not have gathered the right information for your final decision. So, before you start the reference calls make a list of your top hopes and fears concerning your new medical billing company. Then create a few questions that would allow you to come away from the reference check with the information you need to know how your potential medical billing company has performed in these areas for their other clients. Now, type out the questions in a logical manner and leave the space required to jot down the answer right on the interview guide. Before the first call sit down and look at the questions one final time. Make sure that the answers to these questions will give you the comfort you need to make a final decision. Start making the reference calls once you are confident your interview guide is ready.

One final tip: If during the reference check one of the references brings up a key issue you had not considered, add it to your interview guide and call back any references to which you have already spoken to get the missing data you need from them.

I will end with a shameless plug – if you want more details on this topic (including a sample of the interview guide used by Medical Billing Services Buying Guide) please consider purchasing a copy of our buying guide.