Medical billing is an essential component of any health care practice. It is no secret that billing is difficult and causes many headaches for healthcare providers. The disadvantages of not having an effective billing workflow can sometimes outweigh the benefits. Steady cash flow is essential to the overall success of the private practice. Insurance claim payments account for a significant percentage of incoming cash flow for many practices. However, for private practitioners who do not have the time to dedicate to the insurance billing process, insurance claim submission can be overwhelming and burdensome.
To avoid cash flow delays, some private practitioners look to a billing service option to make sure that claims are submitted with accuracy and remitted efficiently. Each method has its pros and cons. There are no definite deciding factors as to which method is better when it comes to medical billing operations. Truthfully, it depends on the needs of each clinic and provider. It would be best if you analyze the factors involved such as the age of your business, the size of your practice, and your financial state. Those factors will help you decide which method would be the most beneficial for your practice.
3 Main Private Practice Billing Service Options
Private Practices have three main billing service options:
- Hiring an in-house biller
- Working with a third-party billing service
- Working with a billing service integrated with their EHR.
Some practices hire a biller on a part-time or full-time basis to handle insurance claim submission and remittance. This in-house biller is frequently also the office manager for the practice. Because the in-house biller is on staff to complete insurance billing on a cadence demanded by the practice, the claim submission process will most likely be expedited. If the practice prioritizes hiring a biller with extensive insurance billing experience who is capable of accurately submitting claims and posting remittances, the in-house biller’s work will most likely be of high quality.
Hiring an in-house biller, on the other hand, can be costly and time-consuming. Hiring a high-quality biller will quickly add up in terms of employee benefits, taxes, and wage expenses, especially for smaller practices. Having an in-house billing staff member also increases the practice’s burden of managing the biller, which can be especially difficult for solo provider practices. If a biller leaves unexpectedly, it can be disastrous for the practice’s income. Delays in the practice’s insurance billing cycle can also be caused by vacation, sick days, and family emergencies. Employee training can also be very expensive.
Third-Party Billing Service
A third-party billing service is a billing company or an independent biller that submits insurance billing claims and facilitates payment recovery. Medical billing services typically charge a percentage of the claims process. Because the service is incentivized to collect on claims, the billing completed by these third-party services will generally be of high quality. If the service does not receive payment for the claims they submit, they will not be paid their percentage fee. The third-party biller option is typically less expensive than hiring an in-house biller, but this is also dependent on the number of claims submitted per month by the practice.
Third-party billing services frequently submit claims on a weekly or even monthly basis, which can cause cash flow delays for the practice. Depending on how the billing service operates, the practice may need to send information for claim submission in a separate location from where it is recorded in an EHR or practice management system. Having to replicate and send claim information to the third-party billing service can cause additional delays while also lowering the practice’s visibility in the claim submission process.
Importance Of Third-Party Billing Service
- Guaranteed Returns and Profitability
- Unmatchable Skillset and Proficiency
- Attentive and Responsible team
- Safe and Compliant
- Transparency with Regular Reporting
- Time Advantage
Billing Service Integrated with EHR
In today’s digitally driven world, treating patients isn’t all that difficult for doctors. However, in the event of an emergency, this is sometimes dependent on the medical history of the patient. However, thanks to advancements in healthcare technology, the need to bring a paper-filed medical history with us on every visit has been reduced with the help of electronic health records (EHR)/electronic medical records (EMR).
A billing service integrated with an EHR platform includes the practice of paying an additional fee to their EHR platform in order for the EHR billing team to handle the insurance billing process. Integrated billing services submit claims and post payment using information from the practice’s EHR system, such as session notes, diagnostic and CPT codes, and patient demographic information.
Most EHR billing solutions, like third-party billers, charge fees based on a percentage of claim collections. This means that they are also motivated to collect on claims because that is how they are paid. The costs of using an EHR integrated billing service may be offset by increased remittance incoming to the practice as a result of the high-quality billing. Working with an EHR billing service also provides access to a dedicated billing specialist team that works consistently to ensure that claims are paid in a timely and error-free manner. Since all of the information required to submit claims is already in the EHR system, practices do not need to duplicate and forward any information to billers. This means that the integrated billing service can efficiently and accurately bill insurance for practice.
Importance Of EHR In Billing
- Paperwork- reduced
- Better and efficient interoperability
- Automated billing processes
- Higher patient satisfaction
- Better Analytics
Factors that are preventing you from achieving full cash flow and causing you to fall short of your profit goals. A private practice’s cash flow is influenced by several factors that have a direct impact on the practice’s overall efficiency. The key to optimizing private practice cash flow is to identify issues with your revenue cycle management processes. Some key areas to look into would be your top denials by payers and your patient collection process. A well-managed account receivable process is essential for a practice’s cash flow to remain stable.
But if you happen to be a provider who has nailed down an excellent billing process with the right tools and help, then you know just how financially fruitful insurance billing can be.
Following these steps can help providers maximize reimbursements and strengthen their bottom line.
- Implement Quality Technology
- Full-Service Claim Submission
- Claim Denial/Rejection Follow Up
- Credit Card Integration
- Benefit Verification
- Working with a quality vendor
- Dedicated Account Manager
- Billing Experts
Zee Medical Private Practice Billing Service
Physicians heading into private practice frequently find the idea of billing insurance to be very challenging, as it is frequently assumed to be a very complicated process. A stable private practice is built on producing predictable, consistent revenue from a diverse set of payers. Such stability requires a properly organized medical billing system in which each aspect of the revenue cycle is given individual attention by properly trained and managed personnel. Zee Medical Billing Services takes pride in our full-service, all-inclusive billing process. Every step of the way, we are there for our clients.
Private Practice billing service with Zee Medical Billing help you:
- Reduce compliance risks
- Improve cash flow and revenue
- Increase billing and coding efficiency
- Easily access robust reporting and analytics
We provide front-end office advice on patient engagement and information collection, allowing the physician billing cycle to run more smoothly from start to end. We also identify errors and educate practice staff on any necessary changes. This lowers the cost by reducing the number of denied and underpaid claims.
Your practice is no longer dependent on one or two key employees to submit claims, track audit trails, post payments, pursue delinquent insurance claims, or answer patient billing questions. Each practice at Zee Medical Billing has its own team of employees.
The keys to proper workflow are consistency and accuracy. Having multiple employees monitor each account establishes a system of checks and balances, ensuring that every charge is captured for insurance submission, every claim is followed up on, and errors are greatly reduced.
Medical billing errors can have a significant impact on your private practice reimbursement. That is why Zee Medical Billing provides tailored solutions for the private practice revenue cycle. Physician practices, independent practices, and health systems can rely on our depth of expertise and knowledge to ensure their medical group performs at a high level.
Almost every private practice owner must make the decision to outsource their medical billing at some point. The answer to this question is heavily influenced by the practice and the provider. While many doctors prefer to outsource their billing services, others prefer to have more control over collections and handle everything in-house. When weighing your options, it is critical to carefully assess your practice’s needs in order to determine which solution is best for you.