Legion Healthcare Solutions

Outsourcing your Medical Billing: What questions should ask before selecting a Medical Billing Company?

Outsourcing your Medical Billing: What questions should ask before selecting a Medical Billing Company?

Medical practitioners in the country see a steady drop in revenue; with a pandemic, the situation became grave with reduced volume. According to a survey conducted by AMA, medical practices have seen an average revenue drop of one-third. The revenue drop is putting pressure on practices to find ways to cut costs or innovate patient care.

Smaller healthcare providers are facing a bigger brunt with the complicated RCM process. Unable to identify and hire resources, providers are losing their reimbursement even during the billing process. The stop this falling revenue graph, outsource Medical Billing is the option. With providers managing the patient care; billing and denials can be handled by professionals who can manage the insurance company.

Outsource medical billing isn’t a new concept, only the definition has changed over the years. With patient volume, technology, and increased coding, you need to be aware of what are your practice requirements.

Complete Support for Medical Billing

If you chose a Medical Billing Company, you need to be sure what services they provide. Ask for the list of services provided to get a complete view of how your billing process will look, if you chose them. Outsource Medical Billing companies that cover the entire Revenue Cycle Management (RCM) process- from patients’ appointments to final reimbursement are always going to excel that part billing service provider.

Legion Healthcare Solutions cover each step of RCM process, starting with Patient Appointments, Medical Coding, Billing Audits, Claim Submission, AR follow-up, and Payment Posting. On the payer side, we cover Prior Authorization and Physician Credentialing.

Company with Specialty Experience

Whether you are a General Physician, specialty doctor, or equipment provider, each of them will come with a unique set of coding and billing requirements. The guideline doesn’t end here, even the payers have specialized billing guidelines for each specialty. Before selecting a billing company, always look for a company that has good coding experience in your specialty. The familiarity will help in documentation, coding, audits, and fulfil all the compliance requirements.

Check Coding Certifications

One of the biggest reasons why claims are denied is upcoding and down coding, leading to scrutiny by insurance payers. The billing company must have a team of coders who are proficient with ICD—10, the coders should be certified under the AAPC’s Certified Professional Coder (CPC).

Check the EMR Technology

Electronic Medical Record (EMR) is a bridge between providers and payer to electronically transfer data. Changing EMR with Medical Billing Company would mean that more resources need to be invested before you could make a move. EMR and EHR are an imperative part of growing technology transformation in Medical Billing to make patient care synched with facilities in the region. LHS covers all the EMR’s: athenaOne, TheraNest, NextGen healthcare, NueMD, DrChrono, WebPT, AdvancedMD EHR, Practice Fusion, Kareo Logic, eClinicalWorks, EpicCare EMR, and many more EMRs are added monthly to the list we support.

Practice Technology

Outsource Medical Billing Companies are moving away from traditional billing services and providing technology hubs for the providers. Here at Legion Healthcare Solutions (LHS), we work on API-led technology to improve the patient experience across the appointment booking and post-visit information. LHS even developed RPM technology for the providers to make the healthcare experience patient-centered. Practice technology is in the role of leading patient care for improved practice.

Responsiveness to Queries

Having a 24/7 chat and call facility can be imperative for many of the specialties dealing with emergency responses. Physicians will need to convey with billing service providers about all the requirements they will have when dealing with patients. If dealing with documentation, coding changes or reimbursement billing company should be conveyed about the need of response for all.

Compliance

Outsource Billing Company need to comply with regulations as they deal on first-hand scale with patients’ sensitive data. You need to know if the billing company is HIPAA compliant and knows the regulations when dealing with patient data. Providers will need to ensure that security features are implemented by the billing service company. LHS Billing Company has a team of data security who regularly conduct system audit to find loopholes in the system and upgrade the current technology.

Complete Transparency in Cost of Services

Charge based on the service is one thing every provider must look into before approaching a billing company. Outsource billing company may offer several packages that may even include the trial period or incubation period, what will be the benefits provided during that period should be the question. What is the service charge for each claim process? Will you charge based on the volume or is it fixed? Are there any hidden charges for claim processing? Asking several questions about cost of service will reduce the surprise costs during the actual period. Payment matters can become complicated; hence having an official agreement will reduce the friction points.

Conclusion

For providers who are already dealing with whirlwind of patient care and billing, LHS provides a simple and cautious plan. For each speciality, we understand which are the most vulnerable part in the RCM process and focus on them building a complete billing process. For providers, we offer a transparent and analyzed billing process where they can identify each claim and payment posting for them.

LHS Medical Billing Company uses cloud-based systems offering complete security in case of malware attacks and live updates on claims. Each provider can access various stages that the claim has gone through, even compare the rate of denials with industry average.
We even provide a complete billing quote for different practices taking into account patient volume, specialty and monthly reimbursement. To know more about our billing quote, please contact our experts.