Category/ Medical Billing

10 steps to find the Best Medical Billing and Coding Companies

Blog Main Image here

10 steps to find the Best Medical Billing and Coding Companies

Outsourcing revenue cycle management to medical billing and coding companies can be a beneficial experience for healthcare organizations. Over the last few years, the outsourcing market has grown in this area. The Healthcare Business Process Outsourcing Market report for 2022–2025 predicts that the market size for these services is expected to increase by USD 7.43 billion between 2022 and 2025. As a result of the scarcity of staff, With the growing needs of healthcare organizations during the pandemic, RCM companies have become increasingly important.


Although there are many options available on the market, it can be pretty challenging to choose the right partner. For the best results, you need to take into consideration the various pros and cons and then balance them with the financial budget. As the RCM company is going to handle sensitive data for your organization, you should also check out its credibility. This article walks you through 10 easy steps to evaluate and choose the correct medical billing and coding company.


Determine the size of your account:

Despite the fact that there are numerous medical billing and coding companies in the market, few are capable of handling all account sizes. Identify the scale of your practice and your accounts in order to know what revenue cycle management company to hire. A conclusion can be drawn by evaluating aspects like the estimated budget, the number of physicians, and the accepted insurance companies. The following steps will help you decide whether to hire a small-scale billing service, narrow down specific steps of billing, or hire an end-to-end revenue cycle management service.


Taking stock of past experience:

A revenue cycle management company with many years of experience has managed the changing healthcare billing ecosystem. Partnering with a company with strong credentials and proven experience dealing with accounts for another healthcare system can be useful. Make sure the company has been in business for a long time. Be sure to ask for testimonials from their clients. Consider reading reviews of real healthcare providers instead of generic ones to get a better sense of how their customers have been successful.


Professional Experience: 

Medical billing poses a unique set of challenges for every medical specialty. It is important to find companies that have demonstrated their ability to provide services for the specialties you are looking for. In the case of an organization with multiple specialties, ask the company if it is up-to-date with the latest practices. Even if you have a general practice right now, it may be a good idea to expand into specialties. It is important for your outsourcing partner to be able to grow with you.


Number of employees: 

Staff members in the billing department are ultimately responsible for doing the groundwork. It is important that your medical billing provider has enough staff to handle your account. The sheer number of bills you may receive at non-peak times might overwhelm you without the support of enough trained professionals. Determine the number of people who will manage your account and provide emergency support.


Estimated costs: 

One of the most important factors to consider when selecting a medical billing and coding company is the budget. You can choose between different types of costs. There are two types of fees: a flat fee and a percentage of the revenues collected. When it comes to getting a reasonable price, it is vital to compare multiple quotes from a few vendors. However, you should also consider the quality of the services being offered.


Measures to ensure compliance and security:

RCM companies’ credibility is based on compliance and security. Account billing professionals will have access to sensitive medical information about patients when dealing with your account. Verify that the IT systems are secure multiple times to ensure the safety of PHI. Medical billing and coding companies must maintain HIPAA compliance as a security building block.


Management of Claim Denials: 

Despite taking all the necessary steps, some insurance companies may reject your claim. Get an idea of the denial rate from the companies. A survey reported that more than 60% of billing professionals never edit or submit a denied claim within the given deadline. Thus, it is very important to know how your outsourcing provider plans to deal with these issues.


Advancements in technology:

Errors in medical billing can be a result of typographical mistakes or incorrect or outdated insurance information, among other things. In order to maintain revenue integrity, these issues must be handled with proper software solutions. Make sure your medical billing company is using the right tools to make sure there aren’t any mistakes with your bills.


Services and Support:

Medical billing and coding companies can benefit from maintaining a good customer service record. Companies that lead the way in RCM ensure that their internal counterparts are kept in the loop so that information does not lag. Discuss the different modes of communication you can expect from the billing team, including chat, email, and phone calls. The organization will become more effective if you have a responsive staff.


Additional Services Offered:

Many RCM companies offer more than just billing and coding. They can also provide EHR companies with additional services, such as provider credentialing and customer service. You can also ask them if they offer any additional services in these fields if you’re suffering from any other back-office issues. An RCM company that is well-known will help you run your business better when you work with them full-time.


A business may find it overwhelming to select a vendor from several options. If you follow the above steps, you will be able to narrow down your options to one that matches your needs.


The article above explains how you can choose a medical billing and coding company among a number of options. Please feel free to contact us if you have any queries.