How to Choose a Medical Billing Service for Your Practice

How to Choose a Medical Billing Service for Your Healthcare Practice

Small practices provide physicians with more flexibility and deepened relationships with their communities and patients. Studies have also found that physician-owned practices have fewer preventable hospital admissions than hospital-owned practices. A Medical billing service can help streamline the billing process and increase revenue.

Over half of physicians - 55.9% - work in small practices of 10 or fewer physicians, highlighting the popularity of private practices.

Statista distribution of medical practices by size, 2018

However, the benefits of small medical practices don’t come without a unique set of challenges of their own. This is particularly true of small-practice medical billing. That's where any inefficiencies, inaccuracies, and medical claims denials lead to valuable money and time wasted.

The good news is that small practices don’t have to do it all alone. NCDS Medical Billing has all the tips and insider knowledge on how to find a great medical billing partner.

Why Work with a Medical Billing Service Provider

Rising administrative burdens and low and falling payment rates have been identified by the AMA as threats to private practices.

Recent studies have found that Americans owe at least $195 billion in medical debt. This increasing medical debt has led to implications for medical practices.

56% of medical groups found that their payments have spent more time in accounts receivable in 2022. More time in A/R means decreased cash flow and decreased revenue cycle management performance.

MGMA accounts receivable findings from August 2022

Working with a medical billing company can help you keep up with industry trends and regulations. This will also ensure you get payments on time without sacrificing time with patients.

Increased Efficiency and Accountability

Partnering with an experienced medical billing company will allow the entirety of the process to happen outside of your day-to-day practice management. By working with expert medical billers, you will not have to focus your efforts on:

• Billing management

• Billing training

• Coding

• Working through denied claims.

All accountability falls to the medical billing company. All medical billing steps will be fully in the hands of the team you’ve hired to do so. These experts are assigned and focused on each aspect of the revenue cycle, and reports will regularly be shared back with your practice.

NCDS SOLUTION: Simply put, all we do is medical billing. We don’t have to manage patients, schedule appointments, or speak with referring providers. We’re fully engaged in every step of the process.

NCDS helps you get paid quickly, efficiently, and accurately because it is our sole goal. We are removed from the everyday distractions that inhabit the abilities of in-house billing staff.

Save Staff Time and Energy

80% of healthcare leaders shared that their stress levels and feelings of burnout have increased in 2022.

Stress levels in healthcare from MGMA

Most healthcare leaders are feeling a lot of pressure these days. One way to help balance things out and take some stress off your team is to find ways to remove tasks and stressors from your business.

By hiring a medical billing company, the stress of medical billing is completely removed from you and your staff. Your staff can focus on their medical work and have more of a balanced and rewarding workload.

Ensure Compliance with All Regulations

Practices often focus on providing quality care for patients and building meaningful relationships. But, it can get overwhelming to simultaneously follow the constantly changing regulations of insurance company claims and the healthcare industry.

It’s a medical billing company’s job to understand all federal, state, and local regulations. Medical billing companies stay on top of all the changing regulations and rules so that you and your practice don’t have to.

Working with a medical billing company helps guarantee that you will be in compliance with all regulations.

NCDS SOLUTION: We take compliance, privacy, and security seriously. NCDS exceeds the standards required by the Healthcare Business Management Association (HBMA). This has permitted NCDS to maintain accreditation as an Excellence in Compliance Company for years on end.

No Missed Payments

Missed payments can get lost in the shuffle. Following up on missed payments and admin tasks is often overlooked since practices are busy with patients.

Part of a hired medical billing company’s job is to ensure follow-up on missed payments. They also ensure your practice is paid for the services provided.

Increased Cash Flow

When working with a medical billing expert, a very positive side effect is seeing an increase in your cash flow. By having professional medical billing experts and coders, claims are processed faster and have a lower rate of rejections.

Firms that make faster and more accurate claims tend to have shorter A/R cycles, which leads to a healthier cash flow and revenue cycle.

Additionally, medical billing companies help create strategies to improve your medical billing process in many ways.

KFF found that four in ten adults have some form of medical debt. The rising costs of healthcare impact both patients and medical professionals. A medical billing expert can help you and your patients choose payment methods and plans that work best for both of you. They can also ensure that you get paid for your services.

Healthcare debts identified by KFF

For other ideas on improving your revenue cycle and cash flow, read up on how to maximize your revenue in 6 tips.

If you are sending patients to a collection agency for past due balances, this may be an indicator that your internal collection efforts are failing. Though some outstanding balances are unavoidable, they need to be within limits.

NCDS SOLUTION: NCDS uses technology, customer service, and quality vendor partners to create a customized patient collection routine. This produces the best results for your practice. This will minimize any accounts that need to be referred to a third-party agency. This improves your return on investment and overall patient satisfaction, too.

Reduced Overhead Costs

Practices are looking for ways to reduce costs now more than ever. In 2022, 90% of medical practices have shared that costs have risen faster than revenues.

Medical practice cost data from MGMA

Reduce overhead costs by working with a medical billing company and taking the medical billing overhead cost off of your staff.

The cost structure changes when hiring a medical billing company, making medical billing no longer a fixed departmental expense. Rather, medical billing becomes a variable cost - one that’s directly tied to revenue collections.

NCDS SOLUTION: The labor market is tight these days, and wages, as well as other costs, are rising. NCDS can insulate your practice from the additional expenses and the burden of hiring, firing, and managing employees, and benefits. Our pricing model is set up so we only get paid if you do. NCDS charges are contingent on our total collections for your business so “good for you is good for NCDS,” too.

Reduced Claim Rejections

Medical billing expertise reduces rejected claims. Experts know all the tricks and tips to submit clean claims, as well as the most up-to-date regulatory rules.

In the event of a denial, your medical billing partners know the tactics to follow up and correct the reason for denial. With a medical billing partner, claims will be submitted right the first time - and in the event of a denial, recovery happens quickly.

For tips and tricks on how to submit clean claims, read more from NCDS.

What to Consider When Choosing a Medical Billing Service

When choosing a medical billing service, it’s important to make an informed decision. You want to ensure you’ve found a knowledgeable partner with both your patients' and your practice’s best interests at heart.

Medical Billing Company Size

To start off your research, you need to determine what type of medical billing company is the best match for your practice’s needs.

Different medical billing companies often have specializations with different scales. Some firms are best suited to large practices that interact with a variety of insurance carriers, have a large roster of physicians, and have many medical specializations.

On the other hand, there are also firms that partner solely with small practices that have small teams. These teams tend to have low budgets and don’t accept as many types of insurance.

For an example of a medical billing partner for a small practice, check out how NCDS medical billing approaches physician practices.

When identifying the best medical billing company fit for your practice, take stock of the following:

• Practice size
• Practice budget
• Insurance carriers accepted

Once these factors have been taken into consideration, there are three major types of medical billing companies to choose from.

Small Medical Billing Practice

Small medical billing practices are the perfect match for small healthcare providers. They focus on smaller budgets and smaller teams, with a focus on providing customized, reliable service to their clients. Small medical billing firms are also typically more affordable. One important piece to consider with small firms is to verify their experience and expertise.

Professional Medical Billing Partner

Professional medical billing providers tend to be on the more expensive side. They also require a larger budget for billing and coding. However, they take on the brunt of your administrative and medical billing work.

Physician Practice Management Company

Many practices need physician practice management companies. These firms are highly established and have all the necessary tools and knowledge to handle high volumes of data and complexity. These companies are typically best suited for larger medical practices.

Medical Billing Company Type

There are varying types of medical billing companies. The major differentiation point is if a company is full-service or if they are specialized in certain expertise areas. It also depends on the type of medical practice you are in and what needs are required to be met.

Full-Service Medical Billing Company

Full-service medical billing companies are a good fit for medical practices. Especially those that have a wide variety of services offered and need a breadth of expertise, rather than specialized knowledge.

Specialty Medical Billing Company

Some medical billing companies have one or a few specialties that they have deep expertise. A medical billing company must have strong knowledge and experience in the type of medicine your practice provides. So, consider your practice and whether specialty or full-service will be the best fit for what you offer your patients.

Understand Full Costs of All Services

Transparency is very important in medical billing service costs. Medical billing services cost money, but at the same time, they should help you save and earn more money as well.

It’s necessary to understand exactly what you get with your services and what you will receive from your medical billing services.

Medical billing companies charge in a few different ways:

• Percentage of net patient collections (typically between 3%-9%, specialty dependent)
• Flat fee
• Flat fee + small revenue percentage

Our tips for considering the best fit medical billing company based on payment include:

• Preference in billing type (revenue percentage vs. flat fee)
• Compare rates across companies (but don’t go crazy - keep the number of companies low to avoid any analysis paralysis!)
• Read each line to ensure you understand everything that’s covered within your service options

Confirm Privacy Guarantees

Healthcare has strict compliance rules and regulations due to its highly sensitive nature. For a healthcare practice, abiding by all compliance regulations is absolutely crucial for business success. Small practices need to make sure that their services are compliant with all federal and state regulations.

During the process of meeting with medical billing companies, check for the following three things:

• Ask for a list of company compliance procedures

• Learn how their business follows compliance rules

• Understand how it’s guaranteed that all employees follow all necessary rules and regulations

Research Company Reputation

Company reputation in medical billing is incredibly important. It is important for businesses to be able to trust their data storage providers. This information can contain highly sensitive information such as company financials and patient data. Knowing that a provider is reliable and has performed great work in the past is essential before providing them with this type of information.

Research online to read up on reviews of companies that look like they could be a good fit for your medical practice. Confirm the information in reviews such as:

• Positive or negative testimonials
• If the business achieved the intended goals
• Medical billing errors that caused financial or regulatory issues for the healthcare practice

Another option is to request references for current or previous clients that could speak to the medical billing firm’s work.

Discuss Customer Support Methods

Consider this: how would you prefer to interact with your medical billing expert of choice?

Once billing and coding are no longer done in-house, practices often worry that billing communication will become siloed and broken down.

A good medical billing company will alleviate this concern. Financial management is an integral piece of a practice’s day-to-day success and function. Many billing and coding questions require an immediate, quick response.

Discuss communication styles with your potential medical billing partner. Ask questions such as:

• How do you communicate with clients?
• What platforms do you use for communication?
• How soon do you respond?
• How do they handle urgent requests? Will they be there to reply ASAP?

Building trust and an open line of communication is a key part of success when working with a medical billing provider.

Determine Software Compatibility

Think about what software you use to manage your data and information internally. What tools and software are crucial to your day-to-day tasks? Your ideal medical billing company would be able to work with your electronic health records (EHR) system. 

It’s important not to overlook software compatibility between your practice and medical billing partner. Ask potential medical billing providers what software they use. You want to see if they use software that is compatible with the systems and infrastructure that your company currently uses.

Consider How Denials Are Managed

Even with the best medical billing practices, denials still occur. With denials being an unavoidable part of the medical billing process, ask your potential medical billing company candidates how they manage rejected claims. Outsourcing your medical billing can streamline the process as long as it's the right fit for your practice. 

You’ll also want to ensure that any firm you select does not run into denials regularly due to coding errors.

Recouping revenue from rejected claims brings cash flow into your practice that would have been otherwise lost. Denials are a source of significant revenue loss. Medical billing companies always follow up and resubmit rejected claims to ensure you’re getting paid for the services you’ve provided.

Ready to find the right medical billing partner to effectively improve and enhance the financial health of your practice? Contact NCDS Medical Billing to start improving your revenue cycle!

Questions?