Medical companies have an obligation to provide a high degree of care to their patients. From the moment a patient steps into the facility for the first time to the minute they have completed all formalities and have been discharged, patients expect a smooth and comfortable experience.
While medical companies are well equipped to provide excellent medical advice, often, they fail to provide a frictionless administrative experience. A recurring area of trouble is medical billing, which can take up a lot of resources and valuable time of the staff.
Finding skilled staff to execute vital billing activities is one part of the problem, with training and retaining critical staff adding to the challenge. Mistakes can be costly as they not only have an adverse impact on cash flow and revenue, but can also cause reputational damage.
To reduce the burden of medical billing, more and more medical practices are turning to specialized medical billing companies for claims management. By partnering with medical billing services in California, your practice can receive specialized support in line with all the laws and regulations applicable in the state of California.
In this article, we’ll take a look at what all falls under medical billing, the services provided by medical billing companies in California, and how, regardless of their size, practices can benefit by outsourcing their billing to a specialized service.
What is medical billing?
Medical billing is the end to end process of preparing, submitting and managing claims and invoices generated for healthcare services provided to insurance companies. The goal of medical billing is to ensure the medical practice receives reimbursement for the services provided to a patient.
While medical billing sounds simple enough, it has a lot of nuances that make it a specialized field of work. And this is where medical billing companies come in.
What services do medical billing companies provide?
Medical billing companies provide a variety of services, each aimed at creating an interrupted billing and reimbursement process.
- Patient Enrollment: Claiming reimbursements starts with collecting information about the patient, the medical services being provided, and their insurance plan. Accurate collection and input of data such as the patient’s personal information, their condition, diagnosis, treatments and insurance benefits into an electronic system that can be pulled up instantly is vital.
- Billing and Reconciliation: Billing patients often takes place in phases, particularly for longer treatments. Medical practices will have their own billing process such as time based billing or amount based billing, which their medical billing partner will execute. The aim being to collect maximum revenue for the practice.
- Collections: Medical billing companies take care of accounts receivable collections. A sound collection system ensures the medical practice doesn’t suffer from any credit or collection bottlenecks.
- Claims Management: Preparing and submitting claims to an insurance company or other payer for reimbursement is just part of the work. When claims are questioned or denied in whole or in part, medical billing companies handle the queries, resubmit claims and continue with follow ups to ensure your practice receives the required revenue.
- Verifying Insurance Benefits: A key part of the medical billing process involves ensuring the insurance policy of the patient covers the treatment being provided. Without verifying the benefits, medical practices may be left holding the bag where there is a mismatch. Medical billing companies handle this task at the beginning of the process which prevents future issues.
- Reporting: A sound financial reporting system helps medical practice owners understand how well their existing processes work, and what they can improve. A good medical billing company will provide transparent reports as directed by the practice, including advising on best practices and areas of improvement.
Taken together, the medical billing services for small practices companies help streamline the financial process leading to improved revenue collection and cash flows.
What are the benefits of using medical billing companies?
Engaging the services of a medical billing company can have several benefits for your practice:
- Higher Revenue: The main reason for working with a medical billing company is the assurance of increased revenue. By optimizing processes and timely execution, these companies ensure no revenue falls through the gaps.
- Qualified Expertise: Medical service companies not only hire qualified professionals, but invest in their training and development as well. By working for several clients, these professionals bring a variety of experiences and inputs that benefit your practice.
- Reduction in Errors: A natural result of working with qualified and experienced professionals is fewer errors in collection of data, generating and submitting claims, and better follow ups. This reduces the chances of a submission being rejected on account of mistakes or errors.
- Improved Cash Flow: With complete and correct claims being submitted on time, medical practices see the benefit of faster cash flow, as the time taken to receive payments reduces.
- Cost Savings: In the mid and long term, outsourcing medical service billing results in cost savings for the practice. There is no need to invest in in-house talent, training, infrastructure etc.
- Reduced Administrative Burden: While medical billing involves dedicated staff, it also requires other staff as well as doctors to take on certain additional responsibilities. Outsourcing allows your staff to focus on their core work and leave these tasks to trained professionals.
- Advice and Improvements: Medical billing companies work with several other medical practices, each providing value insights and experience which they can share with your practice. Their reporting and analysis can help identify weaknesses and they provide solutions as well.
The above are some of the key benefits of working with medical billing companies. Another extremely important benefit that emerges as a result of all of the above is increased patient satisfaction – crucial to maintain a good reputation and for your practice to grow further.
Further, depending on your practice, its requirements and the outsourcing partner you go with, your practice may enjoy additional benefits.
Medical billing can be quite a laborious exercise. It consists of several smaller tasks which, in turn, have their own sub tasks. Keeping an eye on each stage of the process is vital, and something that can prove to be quite difficult to manage.
For medical practices based in California, outsourcing the billing process ensures you get the benefit of the entire range of services offered. While the tangible benefits of increased revenue, improved cash flows and improved patient satisfaction scores are undoubtedly vital, the intangible benefits of outsourcing these services must not be forgotten. Reducing the administrative burden on your staff leads to lower stress levels while increasing morale, vital for retention and growth.
Before selecting a medical billing company as your partner, ensure you do sufficient research into their capabilities, experience, infrastructure used as well as how sound their customer service is. And while costs are important, remember, you’re investing into an area that will have a direct impact on revenue and reputation.
Going with a highly rated company as our partner will improve your practice and help it grow, while ensuring you provide the right care to your patients.