The AMGA 2017 Medical Group Operations and Finance Survey reported that operating costs losses per physician jumped from a 10 percent loss of net revenue in 2016 to a 17.5 percent loss a year later. Thus, the total losses per physician during this two-year period went from $95,138 to $140,856.
With these increasing revenue losses, to help reduce operational costs more and more healthcare providers are choosing to outsource their medical billing rather than keeping it in-house.
If you are considering a move to outsource your billing, it behooves you to understand the 3 types of medical billing companies. This basic knowledge will help you decide which type best fits your needs, allowing you to focus on your core operations.
Medical billing companies vary with the services they offer, and are categorized as such:
1. Light Service Medical Billing Companies
These are billing software vendors. Their services include handling of coding validation and working rejections due to authorizations, eligibility, and patient demographics.
Due to the limited services such companies deliver, which include processing the front end billing process and processing your claims, they are designed for practices that have an expert in-house medical billing staff in place.
2. Full Service Medical Billing Companies
These are the traditional medical billing companies that initiate their services during the earlier stages of your revenue cycle. They are equipped and skilled to:
- Provide your practice with technology tools and training for demographics, card issuance information, and eligibility verification, which is most helpful during the check-in process
- Work with rejected claims and assist you on how to avoid this from happening in the future
- Communicate with practices regarding how to manage rejections.
They have the capacity to handle all of your medical billing concerns. This makes them the ideal choice for medium to large practices aiming to focus on their core operations.
3. Boutique Medical Billing Companies
Sometimes what’s required is a medical billing company that can provide more specific assistance to your specialized practice. This is where boutique types of medical billing companies are extremely valuable.
Boutique medical billing companies can deliver customized services to specialized practices and facilities that wish to go beyond the common simple payment postings, claims submissions, and account receivables follow-up. However, this also means a higher service fee because of their unique customized approach to medical billing.
Which type of medical billing company would best suit your practice or facility?
It depends on your requirements. If you have a limited in-house billing staff, choosing a full-service or a boutique billing company would be ideal. However, if you have the resources to handle most of this on your own and only require a software to assist you, then a light service medical billing company could help you achieve your goals.
About ClaimCare
ClaimCare has over 17 years of medical billing experience with all employees being 100% U.S.A.-based. Our services include denial management, electronic medical record implementation, fixing of broken medical billing processes, and expedited billing service. Subscribe to our blog or call us toll-free at (855) 376-7631 for any of your medical billing queries and concerns.