Can Medical Billing Services for Small Practices Improve the Revenue Cycle?

As getting paid for services rendered becomes more complex, physician practices can streamline processes in the revenue cycle with the right support. Small organizations feel the pinch of being understaffed and overwhelmed, which creates friction in realizing earned reimbursement. Medical billing services for small practices could be the solution you’re seeking.

But how does it actually improve the revenue cycle?

What Are Medical Billing Services for Small Practices?

Small practices can engage medical billing service companies to outsource all or part of this phase in the revenue cycle. In most scenarios, experienced teams can do just about any task relating to medical billing, including:

• Handling all medical coding
• Claims submissions
• Clinical documentation review and attachment to claims
• Providing analytics and reporting on your financial performance
• Scrubbing claims for errors
• Denial management, including monitoring, appealing, and resubmission
• Patient billing collections

By relying on experts in the space, your practice can refocus on care and growth versus being mired in the economics of healthcare. The outcomes can boost cash flow, ensure more timely submission, and reduce denials.

Engaging with specialists can address the common root causes of revenue loss.

Revenue Loss for Small Practices: The Biggest Triggers

Without a healthy revenue stream, small practices can face financial uncertainty. The most common reasons for revenue loss include the following pain points

Coding Errors

The American Medical Association (AMA) cites the growth of coding errors. The organization classified these into three main buckets:

• Unbundling codes
• Upcoding
• Failure to update codes as they change
• Inappropriate modifiers
• Overuse of modifiers
• Unlisted codes without documentation

When claims have coding mistakes, payers kick them back, which becomes a new cycle of denial management. While it’s impossible to eliminate all errors, medical billing service providers use advanced technology and certified coders to minimize these.

Inefficient Denial Management

Denials caused by coding issues or lack of documentation are on the rise. Payers denied nearly 17% of in-network claims in 2021. Additionally, a State of Claims Report revealed that 30% of healthcare leaders experienced denial increases.

Denials reset the revenue cycle, requiring correction and resubmitting. This makes the payment cycle longer and puts your practice in financial jeopardy.

The best way to avoid denials is to prevent them, and medical billing service providers often have robust technology and processes to do this. They may be able to uncover the root causes of denials and correct them upstream by applying machine learning to historical data.

When denials occur, these organizations can quickly append and resubmit to ensure you aren’t losing earned revenue.

Payment Collections Stay in the Red

With the rise of high-deductible insurance plans, patients are shouldering more financial responsibility. When practices don’t review this with patients before services, there can be confusion on their part about what they owe and when. If payment doesn’t occur, this becomes bad debt, requiring continuous follow-up.

Solving this problem is twofold. First, streamlining patient registration ensures you receive all the information to determine eligibility and responsibility. Medical billing service experts can recommend technology-enabled solutions to achieve this. From here, patients can receive an accurate review of what they will owe.

On the back end of the revenue cycle, you can use medical billing services to support patient collection. They may even be able to prioritize certain debts over others with predictive modeling for propensity to pay.

Stop Revenue Leakage by Seeking Medical Billing Services Designed for Small Practices

Small practices have unique challenges in medical billing. You’re short-staffed and see patients with many types of diseases and illnesses. Partnering with a company to help fill these gaps should include due diligence. There are many options but look for an organization that specializes in small practices.

Here are some criteria for you to consider:

• Ensure they can recommend and help implement any new technology.
• Assess their medical coding capabilities in terms of expertise and breadth of knowledge.
• Discuss how customized their services are in terms of your specific needs, specialty, or regulatory requirements.
• Understand how their team will collaborate with your staff. Make sure they are removing strain from your employees.
• Request information about their pricing structure and fees. Keep in mind that there could be additional expenses in some scenarios.
• Look at the company’s reviews and references.
• Ask about their onboarding, training, and ongoing support models.
• Confirm that all their operations meet the compliance requirements of HIPAA.

A careful analysis of options can give you peace of mind when choosing a partner. It’s a critical relationship in terms of financial stability. Your provider should be an extension of your team that improves efficiency and removes obstacles.

Cost-Effective, Comprehensive Medical Billing Services for Small Practices

Outsourcing medical billing can deliver so many benefits. You can experience cleaner claims rates, fewer denials, and faster payments. When your financial performance improves, you can plan for the future of your practice without the constant worries about the revenue cycle.

If you’re ready to evaluate providers, explore our list of medical billing companies to get started.