A medical practice needs strong medical billing processes to stay financially healthy—especially in today’s challenging environment, where 69% of respondents to a recent Medical Group Management Association (MGMA) Stat poll reported increased overhead expenses over the previous year.

Managing medical billing is a challenge in today’s financial and regulatory environment. It requires practices to keep up with ever-changing payer and regulatory mandates, as well as updates in medical billing processes. However, failing to stay current with evolving billing requirements invariably results in information gaps that can lead to billing inaccuracies. Regardless of their magnitude, billing errors have the potential to cause claim denials.

These and other medical billing challenges place a tremendous burden on staff during a time when medical practices are frequently short-staffed and existing staff are chronically overworked.

Outsourcing medical billing can be a valuable solution to both the financial and time constraints and demands on your practice. If you decide to outsource, it’s critical to choose a vendor that offers the features that best suit your needs. Evaluating Billing Service vendors and selecting the best one for your practice can be difficult. This article is designed to help. Keep reading to learn the essential features and qualities to look for when selecting a Billing Service for your practice.

Feature #1: Streamlines and Simplifies Your Medical Billing Process

One of the most critical features to look for when evaluating Billing Services options is a vendor that will work to streamline and simplify your medical billing processes. Look for a vendor that will collaborate with your practice to handle medical billing processes from start to finish.

This also means finding a vendor that will simplify and expedite the many steps in the medical billing process, either by taking over or automating those steps. For example, look for a vendor capable of supporting automation in steps such as:

  • Eligibility verification—by electronically checking insurance eligibility and patient copays
  • Creation of superbills—by electronically pulling required data from EHR chart notes, which can reduce double entry and increase billing accuracy

Feature #2: Stays Up-To-Date With Evolving Rules & Regulations

You will also want to ensure your vendor will keep abreast of evolving government and payer requirements. Medical billing professionals need to undergo regular training to stay informed of updates to coding standards, compliance regulations, and healthcare policies. Find a vendor that keeps up with the very latest from official sources such as CMS, AMA, HIPAA, and professional groups like MGMA.

Also ensure that the vendor can keep up with the changing technology available for medical billing, which is evolving rapidly.

Feature #3: Provides Trained, Experienced Support

The third essential feature to look for in a Billing Services vendor: They need to offer easily accessible support to help when problems or questions arise. Here are some key considerations as you evaluate potential vendors:

  1. When is support available?
  2. How do practices using a Billing Service vendor reach support? Is support easily accessible?
  3. Do support services extend to patients as well as practice staff and providers?
  4. How experienced is the support team?
  5. Will support services be able to address any practice-specific needs, such as billing questions related to your specific medical specialty?

Look beyond the Billing Service support staff to also assess other product support services and educational resources the vendor provides.

Practice Fusion’s Fully Integrated Billing Services

Practice Fusion is a cloud-based EHR platform, now with fully integrated billing services, that is made to help independent practices thrive. With no software to download and no hardware to manage, the Practice Fusion EHR helps practices stay current in a continuously changing clinical landscape.

Now, Practice Fusion offers integrated billing services as an add-on for Practice Fusion customers. Practice Fusion’s Billing Services team has over 30 years of experience providing services to over 45 different medical specialties. We currently serve over 27,000 providers and handle $3 billion in annual payments. Our clients report outcomes such as:1 

  • 98% first-pass clean-claims rate
  • 98% net collections
  • 2% to 5% average first-year revenue improvement

Practice Fusion Billing Services features include:

  • 30-day implementation and go-live, with a dedicated enrollment expert available at every step of the process
  • Real-time eligibility verification
  • Same-day electronic claim submission
  • Timely payment posting
  • Full denial and accounts receivable follow-up
  • Dedicated patient call center
  • In-depth financial reporting
  • In-product tasking to communicate with your billing team
  • BillerBot, an AI-driven chat feature designed to help locate answers to billing-related topics, such as questions about billing terminology, workflows, or products related to the Billing Service program

Schedule a call with a billing expert today!

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References:

  1. Veradigm 2024, Internal Data on File.