Medical Billing service providers were created to provide a very valuable service to medical health facilities at a nominal charge which usually deviates them from their original obligations. However, these service providers do need to be evaluated comparatively to their competitors so that the industry not only remains competitive but also innovates in providing better service not to let the Physicians think about the billing issues and protecting sensitive patient data. Here are some of the metrics you need to know about so that you can quickly evaluate your medical billing services provider to see on which spectrum they fall on in their industry.
Prerequisites:
Here are the prerequisites for your Medical billing service.
● They should have competitive pricing with their competitors in the industry.
● They should be using the latest in software and hardware. They should also have a feature-rich and reliable Patient management system (PMS) that keeps all transactions and records accurate, transparent, and secure.
● They must have the required experience and expertise in medical billing services that can bill all sorts of insurance companies.
● They should have staff that is fully certified by the American Medical Billing Association (AMBA), which is the regulatory body for medical billing.
● Your Medical Service provider should be fully compliant with the guidelines laid down in front of them by the Health Insurance Accountability and Portability Act or HIPPA, which is the regulatory body that protects patient privacy and data.
● They should have good customer support that has several channels to contact them. They must also have tutorials that educate the staff at your end on how to navigate and use the Patient Management system.
● They must have the capacity to take your workload without any bottlenecks that can hamper your ability to do your job.
● Must be able to share and give insight on how to promote and improve your practice as well.
What are the Basic Services You Can Expect?
Medical billing service providers are hired by medical practitioners to lower their administrative burdens and obligations. When you outsource this work to an agency that calls itself a "Medical Billing Service Provider", these are the services you can expect from them.
● They can generate an insurance claim on behalf of your patient and also submit it to their insurance provider.
● They must have the capacity to follow up on the claims to their insurance providers.
● They must show high levels of efficiency about pursuing insurance claims that are denied.
● They must have the ability to process all payments with no regard to their size.
● They must be capable of generating accurate invoices that are transparent, mentioning all incurred charges by the patient.
● They must have multiple channels available in case a patient needs care and support concerning their payments, invoice, or other payment-related problems.
● They must be able to collect the payments from the insurance providers or the patients by efficiently coordinating with all avenues.
These are the essential services you can expect from your medical billing service provider, and they must be able to execute these services with very high efficiency and capacity.
Additional Services:
There are a few extras that a reputed Medical billing service provider can offer to their clients. These services are:
● They can schedule appointments with your patients.
● They can verify a patient's insurance coverage.
Payment Structure:
A medical billing service provider can be paid for their services in three ways:
● They can be negotiated to be paid out from the entire collection they do. The higher-end for this is 9% which can include the additional services as well. Any more than this is not worth it.
● They can be paid out-right by negotiating per patient or per month fees which can be higher or lower than your percentage-based fees.
● A Hybrid combination of both where additional services might be purchased on a per-patient rate while the basic services are given at the percentage-based system.
Measuring the Performance of Your Provider:
● Once you have spent a few months with your medical billing service provider, You should start to measure its performance. Do a complete audit. See if all your patients from all the locations you practice have been fully accounted for and no procedure has escaped the billing system.
● Another way to analyze is by looking at the collections. A good medical billing service provider would provide at least 80% per month. You should also see how well they work with denied claims.
Conclusion:
A medical billing service provider can be a vital ally and service in your medical facility. They ensured and were specifically created so that doctors do not have to deal with the mundanity of billing and other such services. However, when you choose a provider, you must be sure that they can provide you with the service with no bottlenecks and slowdowns that might come from their resources being heavily targeted at some other customer. They must also be able to protect the data of your patients and must be fully compliant and aware of the guidelines set by the various regulatory authorities.
