Choosing a Billing Service

How Medical Billing Works

Medical billing is confusing, complicated, and constantly changing. Getting claims billed out accurately and performing prompt follow up for any problems is critical for the financial success of your practice. Falling short on any of these important tasks will have disastrous effects on your bottom line. However, good billing practices and follow up can simplify your life and greatly improve your cash flow and revenue.

Unfortunately, trends in the medical billing industry have been headed towards inexperienced billers providing services working out of their homes, or with many companies outsourcing work overseas. It is not uncommon to hear of unfortunate situations where medical practices hired an inexperienced biller only to discover their claims were not getting paid, or where their patient information had been breached due to non-HIPAA compliant companies sometimes located out of the country. It is unfortunate but by design, medical billing has been made very difficult by insurance companies. A good billing service knows how to correctly bill and submit clean claims, and how to properly follow up on any problem claims to ensure you get paid appropriately for your services. Make certain to thoroughly check out any billing service before you sign up!

In contrast, a competent and experienced billing service can have a tremendously positive effect on your practice and cash flow. Your time is best spent seeing patients and not managing billing staff or worrying about rejected and denied claims. A good billing service will pay for itself many times over both by reducing unpaid claims, maximizing reimbursement, and freeing up your time to build your practice and see patients.

AMB tailors its services to meet the needs of our clients. This allows us to offer specific services to help your practice run smoothly. Our highly experienced and professional staff can handle your billing needs regardless of specialty or complexity. You can rest easy when partnering with us for your medical billing needs, and be confident that the work we do will be done professionally, accurately, and thoroughly.

Should I Use a Billing Service?

Not every practice should use a billing service.

Practices that treat patients that are primarily self-pay, or that see only a few patients per day, may elect to do their billing themselves. If practices like this have someone that has the time and know how on staff, it might make sense to do the billing in-house.

However, if your practice or specialty is more complex, if you have limited time, if you are not especially good with keeping track of details, if you are losing money due to unpaid claims, or if you just don’t want to be bothered with the whole billing process, then perhaps you should consider a dedicated billing partner such as AMB. It can be very time consuming to keep up with all regulatory and procedural changes in an ever-evolving industry. A good billing company, such as AMB, can be instrumental in keeping you abreast of industry changes, and how they may impact your practice and bottom line.

Types of Billing Services and Fees

Medical billing companies range from one-person home-based services to larger companies servicing hundreds of customers. Some billing companies may specialize in billing for specific types of providers while others manage all types of specialties and clinical settings. Look for a company that has experienced billers that are familiar with your specialty and specific needs.

Most billing companies charge fees based on a percentage of monies collected, although some may charge a flat rate per claim. There may also be special pricing when restructuring a practice or tackling a large batch of existing, unpaid claims commonly referred to as “old A/R”. However, most of the time, you will pay a percentage of the amount you receive for a claim usually including from both insurance and patient payments. Shop around for pricing that fits your budget but be sure to look at other factors besides just who has the cheapest rates. Not all billing companies are the same. If a less expensive billing company charges 2% less than another company, but has a collection rate that is 5% worse, you would be losing 3% if you went with the cheaper company.

AMB has been in business since 2013 and we have a proven track record of effectively getting our clients paid for their services and in a timely fashion. We charge a percentage of monies collected (not billed). We don’t get paid until you get paid.

Typical Procedures

There are multiple ways in which billing companies work and communicate with their clients. A billing company will need certain information to bill for your services such as patient demographics, insurance information, etc. Many will request that information be sent to them via fax, HIPAA compliant email, or through a web-based system. Depending on your needs, and their level of service, some may give you the ability to enter that information directly into an on-site practice management system or EHR.

Most billing services have the capability to submit claims electronically, and this is now the norm in the industry. This allows for a speedier revenue cycle and better tracking of the whole process. If a billing service does not have the ability to send electronic claims, you may want to reconsider using their services. That said, not all insurances are set up to receive electronic submissions. This is common with smaller insurance companies and some HMOs. In that case, claims will need to be submitted via paper.

AMB uses one of the industry leading software systems. You can upload documents or enter information directly into the system. Alternatively, if you prefer, we can handle all the data entry. We submit claims electronically when possible, which speeds up the revenue cycle and gets you paid faster.

What to Look for in a Billing Service

One of the most important things to consider when looking for a billing service is cost to benefit. What type of service can you expect for what you are being charged? Some services will submit your claims and do very little more. A good billing service will also follow up on unpaid claims, track authorizations, mail statement to patients, track co-pays, etc.

Here are some important questions you should ask:

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