Medical Billing Services

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Buyers Guide

Last Updated: March 29, 2023

While patient care remains a top priority for all medical practices, they are still businesses that need to create profit in order to survive and compete. Being such, high efficiency of billing processes is imperative for medical practices.

Medical billing comprises complex processes involving multiple variables at various levels. These variables could be in the form of manual errors during coding, claims denials from insurers, delays in claims processing at insurer’s end etc. Consequently, this crucial operation can end up consuming resources to the extent that it impacts the top priority of any medical practice.

Fortunately, there are business organizations that take up the responsibility of handling all billing-related processes so medical practices can dedicate solely to patient care.

This Buyers Guide discusses such organizations, known as medical billing service providers, and elaborates on the basic things to know before hiring one.

Here’s what we’ll cover:

What are medical billing services?
Common offerings of medical billing services
What type of client are you?
Benefits of medical billing services
Key considerations

What are medical billing services?

Medical billing services (or medical billing service providers) are organizations that take care of billing-related processes on behalf of medical practices. These HIPAA-approved services also take over a practice’s claims management, including submission of claims to clearing houses and following up on denied or rejected claims.

Common offerings of medical billing services

The first step toward selecting the right medical billing service provider is to understand their typical offerings. According to our research, the following are the common aspects you should be aware of:

Claims management	Capture, organize, bill, and file medical claims related to patients’ diagnosis, treatment, and medication.
ICD-10 compliance	Manage the intricacies of ICD-10 cataloging and maintain proper coding compliance.
Payment processing	Securely and reliably accept payments via different modes, including online and cards.
Patient visit documentation	Capture patient details during visits and document subsequent procedures such as diagnoses and prescribed treatment.
Insurance verification	Gather patient insurance information and verify eligibility.

What type of client are you?

The next step is to understand the types of medical practices that seek out billing services. This knowledge will help you select billing services based on your practice requirements.

Here are the key benefits of medical billing services:

Integrated EHR software users: Several EHR vendors bundle billing services with their software tools. Using services from your EHR software vendor allows you to consolidate EHR functions (such as patient charting, scheduling, e-prescribing, and patient portals) with billing processes at a central point.
Standalone medical billing clients: Some medical practices have complex billing and compliance needs, such as multi-jurisdictional claims management, and they are typically fine with keeping their EHR and billing processes separate. Such buyers can go for standalone billing services from specialized providers.

Benefits of medical billing services

Here are some important points to consider before you finalize a medical billing service provider:

Specialized billing expertise: Medical billing service providers maintain specialized staff to handle billing processes specifically. Their staff undergo regular training and assessment to remain updated on new billing rules and compliances. This helps ensure billing processes with minimal errors and high claims approval rate.
Enhanced patient care: The service provider will free up resources by absorbing your workload, thus allowing you to focus on delivering better patient care.

Key considerations

Even though you might be hurrying to meet GDPR requirements, it is important to consider some of the below parameters when buying GDPR software.

Data ownership: Patient data is highly sensitive and protected by strict regulatory policies. Transferring billing responsibilities also means sharing the responsibility of patient data ownership. Inquire with vendors about data security measures at their end to ensure maximum possible protection of your patient data. Additionally, learn about their data storage and transfer conditions to ensure hasslefree operations in the event you decide to change the service provider at a later stage.
Service level agreements: Despite a provider promising high-quality services, there could be unexpected challenges that hamper your billing operations. Reviewing and negotiating service level agreements will help ensure that your practice is protected against the impact of such challenges.

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