Scale is key when selecting a medical billing company. By scale I mean that the medical billing company should have tens and hundreds of providers across whom large, necessary investments can be spread.
Here's an example. Let's say billing system administrators are paid around $ 150,000 a year. If one decided to work with a medical billing company that served 200 physicians, then each client of the billing company will easily support him with only $ 750 of their yearly payments. But if the administrator worked for a practice (or billing company) with 4 physicians then each physician must pay at least $ 37,500 a year to support the administrator -- 50 times more than the clients of the 200 provider medical billing company. A bigger medical billing company is always better able to handle such expenses.
A good medical company uses resources and technology that stand-alone medical practices can't afford to support. Here are some examples of such resources and technology:
- Advanced (and expensive) billing systems that offer state-of-the-art claim management and reporting abilities.
- Pre-submission claim scrubbers, which apply different adjudication rules from different payers before claims are submitted.
- 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 formatting 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.
- Dedicated staff that follow up with payers when they fail to pay on time.
There are even more technology and process elements that lend themselves to scale. Without 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.
Most of the costs of maintaining these technologies and procedures are fixed, so medical billing companies tend to distribute the costs among their clients. This is why bigger medical billing companies can afford to serve practices better than smaller ones. Smaller medical billing companies may struggle to simply keep up with developing industry technology.
To sum it all up, your medical practice can get huge advantages when choosing a properly-scaled medical claims billing company. You'll be better able to collect from payers who make it a point to keep as much money as they can.
Copyright 2009 by Carl Mays II
Before you select an electronic medical billing service make certain to speak with ClaimCare, one of the leading medical billing providers in the United States. In addition, be sure to visit the ClaimCare medical billing blog. Here you will find articles that will lead you through the process of selecting the best medical billing company for your practice.
Orignal From: Why The Size Of A Medical Billing Company Can Dictate The Quality Of Service
No comments:
Post a Comment