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What Should You Prefer in A Medical Billing Company Before Making A Decision?

It has become inevitable for healthcare professionals to adopt innovative solutions to deal with upcoming challenges. Therefore, most modern healthcare facilities prefer to outsource their medical billing processes.

Due to the global pandemic of COVID-19, physicians and other medical providers are dealing with a host of issues regarding resource management. Especially, when the government announced lockdown all around the country for this much longer period of time. It has become difficult for every business owner to land on the right expertise.

Although, doctors and healthcare providers are lucky in this aspect. Because there is a well-reputed market of a multitude of medical billing companies that are offering their help even during this tough time.

However, practitioners should not get overwhelmed in this aspect and they should make wise decisions.

Before outsourcing their medical billing processes, practitioners should look for the following traits in a medical billing agency.

1. Suitable Business Size

It is important that whenever physicians decide to outsource their medical billing processes then they should keenly observe the size of their organization. Just compare it to your partner’s company size and make a suitable decision.

Because if you have an upscale healthcare facility then you need sufficient staff to manage your revenue cycle management. Otherwise, if you are on a limited budget then you can go for a small-sized or home-based billing agency.

The only purpose of focusing on the size of any organization is that your partner should have sufficient resources and systems to manage your data. Also, providers should inquire about the perspective of a billing company regarding medical billing and coding services.

Even if you own a large enterprise then you should go for a medical billing company that has a well-equipped infrastructure and offers premium revenue cycle management services with advanced practice management systems.

2. Extensive Experience

If a less experienced medical staff would treat your patients then results will also be vulnerable, right? Then why would physicians prefer a newly developed medical billing company to outsource their medical billing processes?

Therefore, physicians should not rush towards a cheap or low-budget billing agency that hasn’t a noticeable industry experience. Despite this, they should prefer a billing company that has worked for a generous amount of time in the industry.

3. Sound Reputation

You should always evaluate a medical billing agency after analyzing its reputation. For this purpose, you can do simple internet research or you can also ask for some suggestions from your fellow healthcare providers.

It will help you to learn about the client’s feedback on a particular billing agency. Evaluation of a billing company on the behalf of their customer’s reviews would give better insights into the selection procedure.

4. Knowledge Of ICD-10 Codes

If you don’t want to leave a single dollar uncollected in return for your hard-earned services then you shouldn’t make any delay to shift towards innovative medical billing solutions. If physicians get a chance to outsource their medical billing processes to a professional billing collection agency that has great proficiency in the ICD-10 coding system then they’ve landed on a great opportunity.

Since it will successfully hold your practice back from revenue loss accidents that happen due to claim denials and rejections. Certainly, if you would use an outdated set of medical codes to prepare medical claims then you will definitely hit your business’ bottom line negatively.

Hence, instead of learning about the up-to-date medical coding system, implementing new technology and upgrading your data management system. It is better to consult with a professional medical billing company that has already in-depth industry experience.

5. Specialty-Specific Services

Every specialty in the medical field comprises unique features not only in terms of medical obligations but also in the operational concepts. Therefore, practitioners should look for a billing collection agency that provides customized services that best meet their specialty’s requirements.

If practitioners want a partner who can help you expand their healthcare business with multi-specialties. Then they should make a business growth plan in advance to outsource their medical billing processes.

It will help them to align their efforts and time in the direction of their business success. The right partner would understand your requirements and offer custom-tailored billing services.

6. Ask For The Cost Of Services

Usually, after purchasing a grocery item, we seldom read the bills. But do not make the same mistake while contracting with a medical billing company. Read the contract carefully and inquire about the cost of services.

More often, practitioners think that it is not a thrifty decision to outsource their medical billing process to a third party. And they can save more money by keeping their medical billing system in-house.

Although, when you’ll ask about the actual cost of billing services of an offshore billing company and then compare it with the in-house billing expenditures then you’ll definitely get surprised.


Let’s do some calculations here;

An outsourced billing team would only charge a fraction of the revenue they collect on your behalf. On the other hand, just some up the following expenditures of the in-house billing department;

  • Annual appraisals.
  • System’s maintenance costs.
  • Resource management expenditures.
  • Paid holidays.
  • Paid leaves.

Now you’ve got a clear picture of how practitioners can prevent these cost overheads when they decide to outsource their medical billing processes.

7. Ensure HIPAA Compliance

Healthcare providers are highly responsible to keep their patient’s healthcare information safe from unauthorized access. Therefore, whenever you partner with a medical billing company then you should only prefer an ISO-certified company that is compliant with HIPAA policies.

You can also ask for the HIPAA certification of that company. If you’re 100% sure that a company will transit PHI/ ePHI through the HIPAA-certified network then you are in safe hands.

Are you determined to scale up your organizational growth at higher levels? Medicare MSO has been helping hundreds of healthcare providers to make leaps in their business growth for more than 12 years. Request a free demo of our reliable, efficient, and streamlined medical billing services.

Ajeet Sharma, the founder of Financegab and a well-known name in the field of financial blogging. Blogging since 2017, he has the expertise and excellent knowledge about personal finance. Financegab is all about personal finance which aims to create awareness among people about personal finance and help them to make smart, well-informed financial decisions.


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