01 Apr When Should You Switch Your Medical Billing Company?
The Warning Signs It’s Time to Ditch and Switch
The truth is, if you’re outsourcing your medical billing services, the financial health of your practice depends on how well your vendor is processing claims and capturing revenue. If your vendor falls short on performance, your bank account will be hurt, and your practice will suffer. What are the warning signs that tell you it’s time to start looking for another medical billing provider?
Your accounts receivable (A/R) balances are growing.
If your total accounts receivable balances are rising month after month, your billing company isn’t doing its job. Here’s the industry benchmark:
Good
Average
Poor
Here are some other key A/R facts:
- Your practice only has a 15% to 25% chance of collecting accounts once they’re past due for more than 90 days.
- 10% or less of your practice’s A/R should be more than 60 days past due.
- 3% or less of your practice’s A/R should be past 90 days due.
The Solution: Improve Your A/R
Ideally your billing provider should offer a RCM platform that combines comprehensive practice management software with a powerful RCM toolset. Its robust reporting capability will deliver on-demand insights into your revenue cycle, and the platform can make it easier to manage your practice’s performance by identifying your problem A/R pool and working to shrink it. (By the way, according to MGMA metrics, 53 days is A/R is considered best in class, but thanks to our proprietary MedClarity RCM platform, Medusind’s best-in-class performance beats that with only 35 days in A/R.)
Denials are piling up, and it’s taking longer to resubmit and appeal denied claims.
Medical revenue cycle management (RCM) is about one thing and one thing only: getting claims paid. And if your claims are being consistently denied under your current billing provider, that’s a serious problem.
Denials are often the result of incorrect coding or insufficient documentation. Are your denials increasing? Is it taking longer to appeal or resubmit them? Maybe it’s time to look elsewhere.
The Solution: Maximize Collections
Like Medusind, your provider should uphold a philosophy of No Charge Left Behind to tackle this problem. It should review 100% of all scheduled/documented patient encounters. Then it should drill down:
- Audit all patient appointment and registration lists and compare them to billed charges.
- Use automation to audit patient hospital or triage statuses across various hospital settings.
- Determine whether a patient was treated or left the site before treatment.
- Verify that the census rounding report lists the correct provider of service.
- Perform coding audits to capture all charges.
- Report write-offs and outstanding (AR) balances.
You’re not getting the level of service you require.
When you need help from your billing company, it takes ages for them to get back to you. You have to chase after people for answers. Sometimes you never hear back at all.
When you’ve got questions, your billing company should respond quickly. In fact, it should be proactive and reach out to you if it detects a possible problem. Ideally it should schedule standing appointments with you to check in and report on your revenue performance.
The Solution: Your Billing Provider Should Offer High-touch Service and Customization
You should get a team focused on your success, with a dedicated Practice Consultant/Account Manager assigned to your account.
Your Operations team should tackle:
Credentialing: It should offer a comprehensive provider credentialing and enrollment process to prevent a lag in payment.
Coding: It should be staffed by a large contingent of AAPC-certified coders.
Charge Entry and Billing: It should ensure that every billable charge is accounted for and claims are submitted promptly
A/R/Denial Management; Your billing team should focus on:
- Speed to cash
- Denial analysis, root causes, and fixes
- Underpayment analysis
Patient Services: Your patient-first customer service team should create a positive experience for your patients.
Meanwhile, your dedicated Practice Consultant should deploy a comprehensive playbook of revenue cycle best practices focused on KPIs and identify where your revenue cycle performance can be improved.
Adopting your provider’s RCM platform and using their software in general is causing you glitches and problems.
Are you having problems integrating your current computer systems with the offerings of your current medical billing provider? Are features not coordinating properly? Are you having consistent software glitches and hiccups? Then it’s time to consider someone new.
The Solution: Your Outsourced Billing Provider Should Offer Ease of Implementation When You Switch to It
It should make transitioning to its solutions a painless and efficient process. A dedicated Implementation Specialist should act as your point of contact throughout the implementation process, and they should always be available and responsive to ensure a seamless transition.
Your provider should:
- Evaluate your current RCM methods and policies
- Recommend best practices to improve your operational processes
- Train your staff on practice-specific nuances
- Provide workflow recommendation and SOP documentation to guarantee processing accuracy
You should be able to go live with your new provider in less than 6 weeks.
Listen to Your Bottom Line
Is your bank account suffering? Are unpaid claims and days in A/R piling up? Has your contact person at your medical billing provider turned into the Invisible Man (or Woman)?
You’ll be happy to hear that Medusind provides all of the solutions to your problems listed above. Medusind created its MedClarity RCM platform to implement its No Charge Left Behind philosophy, and our Coding Center of Excellence is staffed by with over 300 U.S. and global AAPC-certified coders.
If you want to improve your practice’s profitability, consider contacting Medusind, a national leader in medical billing, and let us show how we can transform your bottom line.
