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Want Good Quality Service From A Medical Billing Company? Size Matters
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.
For instance, If a $150,000 per year billing system administrator is required, then a medical claims billing company with 200 clients only needs each of its client to carry $750 per year of that person's cost. If a practice of four providers employed this person, then each provider would need to carry $37,500 per year of that person's cost; this is the value of scale. A medical practice can achieve significant advantages by leveraging the superior scale of a mid- to large-sized medical insurance billing company.
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:
- A state-of-the-art billing system, offering advanced reporting and claim management capabilities. Such systems are often too expensive for a small to medium sized medical practice to afford; so they select a sub-standard system that they can afford.
- A pre-submission claim scrubber that applies the payers' adjudication rules before the claims ever leave the medical insurance billing services four walls.
- Competent billing system managers, who stay up-to-date with the regularly-changing rules used by payers. A good system manager can help you collect on claims caught up in the system because of changing rules.
- 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 deep bench of employees that won't skip a beat when one of the staff has to leave the team (most practices slow down to a full stop when a key billing staff member leaves).
- 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.
A significant amount of the cost associated with the technologies and process steps outlined above is fixed (for instance, the cost of the core medical billing system and the salary of the billing system administrator). Medical Claims Billing Services spread these fixed costs across their entire client base, which can be hundreds of physicians. This is one of the reasons that small medical billing services are struggling to properly serve their physician clients - they typically cannot afford to deploy processes or technologies that are any more powerful than what an average medical practice can afford.
The bottom line is that it's always a good idea to check the scale of your medical claims billing company. The bigger ones are better able to collect from insurance companies and payers, who tend to do whatever they can to keep their money.
Copyright 2009 by Carl Mays II
About the Author 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.
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