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Medical practices rely heavily on the effectiveness of their billing operations. Healthcare might be the top priority, but your medical practice is still a business and needs to make money to survive. As any healthcare professional knows, billing is complicated process with a number of opportunities for things to go wrong. From coding errors and processing delays to dealing with insurance companies and trying to track down unpaid patient accounts, billing departments have to balance a number of tasks and complete them all perfectly; otherwise, you might not get your money for already-rendered services on time, or at all.
In-house medical billing vs. outsourced revenue cycle management
If you opt to have your own staff cover medical billing, you’ll need practice management software to keep track of your patients’ balances and send bills to payers. You’ll also need a certified medical coder on staff to oversee the operation, and the practice will be responsible for responding to any rejections or denied claims.
It’s also crucial to stay on top of the ever-changing regulatory framework and new policies; for example, ICD-10 coding has largely been implemented across the industry. Keeping billing in-house is often cheaper and gives you more control over the process, but for a small practice that already needs its staff to wear many hats, billing can be time-consuming and complex. Worse yet, if the proper time and attention are not given to the billing process, you might end up losing out on a substantial amount of money.
Medical billing services can help alleviate that burden, but it might end up being more expensive. Often, for a percentage of your collections or a subscription fee, a medical billing service can take over your revenue cycle management and free up your staff to focus on other tasks. A good medical billing service will increase your collection rate, reduce rejections and denials, and even provide an analysis of your accounts receivable. You’ll typically be able to generate on-demand reports and view your day-to-day finances through the company’s software as well.
How to choose a medical billing service
When selecting a medical billing service, there are a few things to keep in mind. Of course, you’ll want to know what the costs of the service are, but you’ll also want to know exactly what you can expect from a billing partner.
“Your lifeblood as a medical practitioner resides with this function,” Montana said. “If medical billing isn’t working, not only are you not getting paid, but you won’t make payroll, and you can get in so much legal trouble with the insurance companies. You need to know what you’re getting.”
These are highly variable based on the size and specific focus of your practice. You’ll need to contact a sales representative for hard numbers, but some billing services’ websites offer a general estimate of what they charge. Companies most commonly charge a percentage of your monthly revenue as payment, often between 4 and 9 percent. It’s important to consider what the costs in time and money would be to keep billing in-house versus what the financial cost would be to outsource relative to the potential increase in revenue.