9 Best Medical Billing Services for Small Practices

Medical billing and coding are the most complicated components of the healthcare industry. They provide the framework for revenue cycle management services that are essential to proceed with payment collection management.

Therefore, medical providers should ensure well-managed medical billing services to create a strengthening financial policy. Despite this fact, medical providers rely on manual billing procedures that lead to several issues like; miscoding, overcharging, and less efficient revenue cycle practices. 

Thus, it is necessary to have a steady and efficient way to execute the whole billing procedure that leads to successful revenue collection goals. It includes patient appointment registration, double-checking the documentation, accurate medical codes, clear and timely submission of claims, and keeping an eye on adjudication issues. 

In the United States, healthcare practitioners have to follow federal guidelines and comply with the current changes in medical billing and coding protocols. If providers fail to follow these regulations and stay at the disposal of billing mistakes. Then these mistakes can take a hefty toll on the doctors providing quality care to patients.

According to a recent survey, it is revealed that 80 percent of medical providers submit erroneous medical bills. A single slipup can drastically change the final medical bills. It has led to a growing need for accurate and efficient medical billing services.

How to Get the Best Medical Billing Services

In this article, I have highlighted the key factors that affect reimbursement cycles for medical services positively and help you collect more revenue. 

1. Reduce Medical Billing Mistakes

A thorough study of the healthcare financial industry has revealed that most medical practitioners lose billions of dollars due to medical billing pricing inaccuracies each year.

Therefore, practitioners should ensure the accurate information flow from the initial appointment with a medical provider to the final payments. They should implement the right medical billing solutions that help you analyze, catch, and remove errors from medical claims.

Only “clean claims” can empower your revenue cycle management services that drive maximum revenue on return. 

Otherwise, incorrect medical claims and delayed claim submission would lead you to failure while collecting payments. It will cause delayed payments which are one of the primary concerns of most healthcare providers. Therefore, catching small errors related to medical billing services can help reduce denied bills.

Preparing and reviewing medical bills for completeness and following up on unpaid claims is extremely crucial to ensure steady workflow and maximum revenue.

The front desk staff should also not ignore the significance of verifying the insurance eligibility of patients. They should double-check the prior authorization and insurance coverage of the patient right at the moment when they come to visit their doctors. 

Any mistake during this initial step leads to a multitude of errors in information flow and documentation. It causes incorrect use of medical codes. If the front desk staff has not properly verified patient eligibility then the payers will also deny paying for out-of-network services. In addition to this, 

Delayed payments are one of the primary concerns of most healthcare providers. Catching small errors related to medical billing and coding services can help reduce denied bills.

Preparing and reviewing bills for completeness and following up on unpaid claims is extremely crucial to ensure steady workflow and revenue. The incorrect use of coding, along with patient eligibility verification and a lack of knowledge about preparing billing statements are the most frequent causes of medical billing mistakes today.

2. Document Electronically

Medical providers should shift towards Electronic healthcare records (EHRs) to maintain the accuracy of information flow. It helps providers maintain, use, and secure patient health information at a central location. It also helps to prepare correct documentation.

Accurate documentation is the fundamental requirement of the medical billing and coding system. In this way, innovative medical billing solutions help to streamline revenue cycle management services with precision and accuracy. 

Medical coding is a crucial step that is required to translate medical and diagnostic procedures into standard medical codes. These codes are used to prepare billable medical claims that are submitted to the payers. If medical billers have submitted error-free or clean claims to the payers then they succeed in collecting payments for their services.

Medical coding allows for the efficient transfer of a huge amount of information with precision. It helps to measure and relay personal health information to help control costs and make healthcare services affordable for patients.

3. Implement the Denial Management System

Explanation of Benefits (EOB) is the statement that is used by payers and government healthcare programs to notify their beneficiaries. It helps patients learn how an individual healthcare claim was processed for the payment of services they have received from their doctor. 

Filing clean claims is the safest way to ensure accurate payments. As it reduces the need for claim resubmission and claims denials.  An EOB outlines very important information that tracks all health expenditures of a patient.

An individual can learn about the dates of service, claim numbers, provider information, and types of services provided by the healthcare facility. This information also allows healthcare practitioners to get a thorough knowledge of claim denials.

In that case, they will better be able to appeal claims promptly. This practice is essential for revenue recovery and reliable medical billing practices today.

4. Qualified Billing Staff

It is important to stay on top of the latest changes in the medical billing and coding field. To streamline medical billing services, it is important to produce timely submission of medical claims. It requires a specific set of skills and knowledge to execute this task properly.

Well-experienced and qualified medical billing specialists are well-versed in the dynamics of insurance companies and medical billing guidelines. Therefore, they always succeed in sustaining the proficiency of revenue cycle management. 

Practitioners must have a well-trained staff who is able to decipher medical reports, be adept in medical coding, understand claim denials, and accurately provide viable medical billing solutions. If practitioners find it hard to maintain, hire, and train a proficient staff to manage their in-house medical billing department then should consider outsourcing.

Outsourcing medical billing services would help providers reach out to industry experts who have core competencies for quality medical billing services. It will help providers run their administration through the help of commercial medical billing specialists who are well-versed in all medical coding, health record management, and medical terminologies for various treatments. 

Best medical billing services for small practices

For small medical practices, finding the right medical billing service can be a game-changer. Here are some best medical billing services for small practices to consider:

1. Medesk

Medesk is an all-in-one practice management solution designed for small to medium-sized medical practices. Its medical billing service streamlines claims submission, tracking, and payment processing. Key features include:

• Automated billing and claims submission
• Real-time insurance verification
• Customizable billing workflows
• Patient Portal for online payments and billing information
• Comprehensive financial reporting and analytics
• Integration with EHR systems
• HIPAA compliance

2. Kareo

Kareo’s medical billing service focuses on maximizing revenue and reducing claim denials. Its features include:

• Claims management with real-time tracking
• Automated insurance verification
• Customizable billing rules and workflows
• Electronic claims submission
• Patient billing and payment portal
• Detailed financial reporting and analytics
• Dedicated customer support
• Integration with Kareo EHR

3. DrChrono

DrChrono’s medical billing service integrates seamlessly with its EHR platform, reducing billing errors and increasing efficiency. Features include:

• Automated claims submission and tracking
• Real-time insurance eligibility verification
• Customizable billing workflows
• Electronic remittance processing
• Patient billing and payment portal
• Comprehensive financial reporting
• Integration with DrChrono EHR
• HIPAA compliance

4. AdvancedMD

AdvancedMD’s medical billing service caters to growing practices, offering scalable solutions and advanced features:

• Automated claims submission and tracking
• Real-time insurance verification
• Customizable billing workflows
• Electronic remittance processing
• Patient billing and payment portal
• Detailed financial reporting and analytics
• Integration with AdvancedMD EHR
• Dedicated customer support

5. TheraNest

TheraNest specializes in mental health billing, offering batch invoicing, client portals, and claims eligibility verification. Features include:

• Automated billing and claims submission
• Customizable billing workflows
• Electronic remittance processing
• Patient billing and payment portal
• Comprehensive financial reporting
• Integration with TheraNest EHR
• HIPAA compliance

6. NextGen

NextGen’s medical billing service focuses on maximizing revenue and streamlining billing processes. Features include:

• Automated claims submission and tracking
• Real-time insurance verification
• Customizable billing workflows
• Electronic remittance processing
• Patient billing and payment portal
• Detailed financial reporting and analytics
• Integration with NextGen EHR
• Dedicated customer support

7. AthenaCollector

AthenaCollector’s automated medical billing service boasts a 93% first-pass resolve rate, reducing claim denials and increasing revenue. Features include:

• Automated claims submission and tracking
• Real-time insurance verification
• Customizable billing workflows
• Electronic remittance processing
• Patient billing and payment portal
• Comprehensive financial reporting
• Integration with Athenahealth EHR
• HIPAA compliance

8. CareCloud

CareCloud’s full-service revenue cycle management includes medical billing, coding, and patient engagement. Features include:

• Automated claims submission and tracking
• Real-time insurance verification
• Customizable billing workflows
• Electronic remittance processing
• Patient billing and payment portal
• Comprehensive financial reporting
• Integration with CareCloud EHR
• Dedicated customer support

9. Cerner Medical Billing

Cerner Medical Billing caters to small to medium-sized practices, offering clean claims and improved communication with clinical teams. Features include:

• Automated claims submission and tracking
• Real-time insurance verification
• Customizable billing workflows
• Electronic remittance processing
• Patient billing and payment portal
• Comprehensive financial reporting
• Integration with Cerner EHR
• HIPAA compliance

When selecting a medical billing service, consider factors such as pricing, features, customer support, and integration with your existing EHR system to find the best fit for your practice.

Conclusion

Doctors face an influx of patients with major healthcare challenges that require detailed research. It includes several factors i.e. providing life-saving health emergency treatments, managing business operations, and controlling revenue flow across the organization.

As for doctors, it is a rather strenuous task to constantly seek a way to submit claims on time and receive reimbursements. Thus, they should only rely on professional medical billing service providers to maintain a healthier bottom line and achieve revenue goals.