Types of Healthcare Billing Companies You Need

Accurate healthcare billing is extremely crucial to the healthy revenue management of any medical organization. On one hand, the providers and the organization get timely reimbursements for the services rendered. On the other hand, the patients also get billed properly without any overwhelming costs outside the expected limit. However, doing the entire process of medical billing and coding without any error is not an easy job. Thus you need experienced professionals from healthcare billing companies to help you out.

Outsourcing the billing service to other competent companies has become a norm in the current days. Be it large healthcare chains or independent stand-alone clinics- every facility needs a strong revenue partner to keep the backbone of the institution strong. But since the needs of the different facilities are distinct from each other, you should know which kind of healthcare billing companies will suit you the best.

Here is a list of mainly 3 kinds of healthcare billing companies that you will come across. Make sure you know these details before choosing one.

1.Light Healthcare Billing Companies:

Just as the names suggests, this kind of companies offer a supporting hand to the revenue team already in place for the entire billing process. They ensure accountability on their part to the kind of services they offer. However, the entire revenue cycle management is a typically complicated procedure. Hence mere support means offering of limited services to the client.

What are the types of services they offer?

Though these kinds of medical billing companies are limited in the kind of services they offer, leading companies are very much accountable in the quality of their work. Here are some of the features offered by them:

  • They mostly offer billing software solutions.
  • They are mostly concerned with the front end billing process as well as the claim processing system.
  • These medical billing companies are experts in handling the accuracy of coding. They mainly deal with the validation of the already entered codes.
  • They deal with the claim denial management process. This includes the denials due to patient ineligibility, wrongful pre-authorizations as well as patient demographics.
  • The workflow is more or less streamlined due to the guided technological processing.
  • The advantage in this case is the paper free methods which ensure that the mistakes are lesser. The reviewing of the codes also ensures the decrease in claim denial rates, which positively impacts the smooth cash flow.

Who can use these services?

As mentioned above, these kinds of companies mostly do the work of reviewing rather than maintaining the entire process first hand. Hence you need to have a robust team in place already. The in house team must ensure that the procedures are already in place. The medical billing companies and their assigned staff in this case can assist you to make your systems more refined so that you get the most out of your revenue cycle management.

2.Full Service Healthcare Billing Companies:

For the ones looking for an end to end revenue cycle management, this kind of a company is the ideal choice for them. From the formulation of the repeatable processes to realizing the actual revenue on a daily basis for their clients-they do it all. The leading healthcare billing companies also take care of the regular updates in the billing regulations. That means the staff at the healthcare organizations can dedicate their entire time to patient management while these companies take care of the revenue cycle.

What are the types of services they offer?

Here are some of the common features that you might find in the full service healthcare billing companies. Go through them all to know which problems resonate with the cause of your organization.

  • These services are offered by traditional medical billing companies. They are also offered by some of the billing software vendors.
  • They provide their services from the very beginning of the revenue cycle management. They help the organizations to map out their workflow management with the advice from experienced professionals under their company.
  • These companies offer the right technological tools to the healthcare organizations. These tools help to make the patient check in process smoother and hassle free.
  • The software tools or the dedicated teams in the medical billing companies guide the organizations to train their staff to handle the issues faced regularly by the companies.
  • The issues addressed here mainly include patient eligibility verification, patient demographics entry and card issuance information.
  • They analyze the rejected and denied claims and help the organizations to re-submit them within the correct filing time limit.
  • They are also responsible for identifying the repetitive problems that the organization faces and help to resolve them.

Who can use these services?

There is no pre-requisite condition that the organization should satisfy to hire these billing companies. Any kind of healthcare organization- both large and medium sized- can take their help to manage their revenue cycle from end to end. The investment made towards these companies proves to be beneficial in the form of healthy returns and regular reimbursements.

3.Boutique Healthcare Billing Companies:

These medical billing companies are unique in their service delivery. They have a different approach than the regular ‘one size fits all’ idea. Certain medical billing companies might have to take the support of outsourcing companies to address only some specific needs. These medical billing companies cater to these issues.

What are the types of services they offer?

Here are some of the common points regarding boutique healthcare billing companies:

  • They have specialized teams in different fields of revenue cycle management. Only domain experts handle the respective areas rather than the generalized teams.
  • They can help in any kind of specialized issues like payment posting, account receivables, follow up practices as well as claim submissions.
  • These services differ from company to company.It is advisable to get in touch withcompanies with a specific query to get the best outcome.
  • They charge usually on the higher side of the service fees and are hence taken up by healthcare corporations with sufficient resources.

Who can use these services?

These are mainly used by some specific healthcare facilities. If you already have expert professionals within your in house team but are struggling with certain specific issues then you can consider these healthcare billing companies. You do not need to invest in a full-fledged revenue cycle management but get your problems resolved too.

Other Services Offered by Healthcare Billing Companies

Healthcare billing companies provide more than just billing services. The offerings of leading RCM companies include other aspects of medical services as well to make sure that the entire financial ecosystem of your organization is sound. Here are some services that you can benefit from:

  • Provider Credentialing:

Provider credentialing is a crucial aspect of medical services. Your patients need to be in good hands and that is the reason you need to go through the critical credentials of the provider in question. The internal process of the provider credentialing procedure may be well handled by your in-house staff. However, getting credentialed by the insurance company of your choice can be a complicated and lengthy process.

Government and private insurance companies have different sets of rules to verify the credentials of the provider. Moreover, not all private insurance panels of your choice have open positions for a particular specialty at all times. Provider credentialing teams at RCM companies keep a track of the open positions of insurance companies. They offer an end-to-end provider credentialing system including collection of documents, primary source verification and application submission.

They all follow up with the respective insurance companies to keep a steady track of your applications. Some of the top revenue cycle companies offer software solutions to make the process easier. If you want to move forward on your own with a systematic approach, you can think about availing such software services.

  • Customer Support and Customer Success:

Customer support is critical for the smooth workflow of an EHR company. There are several technical issues that might crop up in the EHR system every day. Leading RCM companies provide you with professional teams with years of experience in customer support and customer success. They ensure that the problems get resolved without escalating to a more complicated issue and maintain short turn-around times.

RCM companies train their customer support executives to adapt to the leading software services used in the EHR industry. The domain experts are quick learners who know how to adapt to software solutions that are relatively new in the business. These services help the EHR companies focus primarily on their product development and client acquisition while the customer support staff takes care of the existing clients.

No matter what the kind of healthcare billing companies you avail, outsourcing can help you to lighten the burden on staff administration to a great extent. Hope this blog gave you a good idea about the types of healthcare billing companies you need. For suggestions, shoot your questions below and we will try to answer if relevant to the topic. For more queries and updates on healthcare services and technology, please subscribe to our blog. Do not forget to subscribe to our social media handles to get regular updates!


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