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 in this area has witnessed significant growth. According to the Healthcare Business Process Outsourcing Market report for 2022–2025, the market size for these services is expected to increase by USD 7.43 billion between 2022 and 2025. Amidst the growing needs of healthcare organizations during the pandemic and the scarcity of staff, RCM companies have become increasingly important.
Choosing the right partner from the multitude of options available in the market can be quite challenging. To achieve the best results, it’s crucial to consider the various pros and cons while balancing them with your financial budget. Since the RCM company will be handling sensitive data for your organization, checking its credibility is paramount. This article will guide you through 10 easy steps to evaluate and select the correct medical billing and coding company.
Determine the size of your account:
Identify the scale of your practice and accounts to understand what type of revenue cycle management company is suitable for your needs. Factors such as the estimated budget, the number of physicians, and the accepted insurance companies will help you decide whether to hire a small-scale billing service, focus on specific billing steps, or opt for an end-to-end revenue cycle management service.
Take stock of past experience:
Partner with a revenue cycle management company that possesses years of experience in managing the evolving healthcare billing ecosystem. Verify the company’s track record, credentials, and success stories with other healthcare systems. Request testimonials from their clients and read reviews from real healthcare providers to gauge their effectiveness.
Professional experience:
Look for companies that have demonstrated their expertise in providing services for the specific medical specialties you require. If your organization has multiple specialties or plans to expand into new areas, ensure that the outsourcing partner can accommodate your growth and stay up-to-date with the latest practices.
Number of employees:
Ensure that your medical billing provider has sufficient staff to handle your account effectively. Having an adequate number of trained professionals is crucial to manage the workload and provide emergency support during non-peak times.
Estimated costs:
Consider your budget when selecting a medical billing and coding company. Compare multiple quotes from different vendors, taking into account the quality of services offered. Evaluate the pricing options, such as flat fees or a percentage of revenues collected, and choose a reasonable and cost-effective solution.
Measures to ensure compliance and security:
Validate the credibility of RCM companies based on their compliance and security measures. As billing professionals will have access to sensitive patient information, it’s essential to verify the company’s IT systems for multiple layers of security and adherence to HIPAA compliance.
Management of claim denials:
Inquire about the company’s approach to handling claim denials. Gain insights into their denial rates and their strategies for editing or resubmitting denied claims within specified deadlines. A proactive approach to resolving claim denials is vital for optimizing revenue.
Advancements in technology:
Ensure that your medical billing company utilizes appropriate software solutions to minimize errors in billing, such as typographical mistakes or outdated insurance information. The right technological tools are essential for maintaining revenue integrity and accuracy.
Services and support:
Look for medical billing and coding companies that prioritize excellent customer service. Effective communication channels, such as chat, email, and phone calls, should be available for seamless interaction with the billing team. A responsive staff enhances organizational efficiency.
Additional services offered:
Explore if the RCM company provides additional services beyond billing and coding, such as EHR integration, provider credentialing, or customer service. Having a comprehensive solution provider can streamline your back-office operations and enhance your overall business efficiency.
With several options to choose from, selecting a vendor can be overwhelming for a business. However, by following these 10 steps, you can narrow down your choices and find a medical billing and coding company that aligns with your specific needs. Make an informed decision to optimize your revenue cycle management and ensure the success of your healthcare organization. “Finding the best medical billing and coding company is like finding a needle in a haystack, but the right choice is worth the search”. The article provides guidance on selecting the most suitable medical billing and coding company from a range of choices. If you have any questions or concerns, please don’t hesitate to reach out to us.
