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Finding the right medical billing company can be challenging, especially when there are nearly 2,000 active companies in the US alone. Coupled with over 130,000 hospital and non-hospital facilities across the US and over 900 health insurance companies, the medical billing and healthcare industry is constantly changing and evolving. If healthcare practices are behind on the latest billing and market trends, they can find themselves struggling to meet patient needs and stay operational.
Medical billing companies help hospitals, ambulatory surgery centers, and behavioral health facilities track and send bills to patients, insurance providers, and other payers. Otherwise, physicians, admins, and other healthcare staff must split their time between caring for patients and monitoring the billing process. This can overwhelm staff, leading to medical billing mistakes, upset or irritated patients, poor reputation with insurance providers, and revenue leakage.
These issues are very common and cost the US medical industry $125 billion annually. It’s estimated that almost 80% of medical bills contain errors that will cause them to be denied or rejected. Most of these denials and medical billing mistakes are due to human error, but they can quickly stack on top of each if there unrecognized or resolved.
Medical billing services are indispensable in California. In 2020, the state allocated $405 billion towards personal healthcare (PHC), making up 12% of the entire United States PHC spending. Additionally, California has the most active physicians in the US, totaling around 118,000, compared to the state population of 39 million. This means there is only one doctor for every 330 California residents.
The scope of the healthcare industry across the US is also vast and complex. Healthcare spending in the US remains significantly higher both on a per-person basis and as a share of the GDP compared to other countries. Mental health challenges are also apparent, as reflected by high rates of anxiety, depression, and suicide. US citizens have also reported seeing physicians less frequently than citizens of other countries due to rising and inconsistent medical costs. This leads to less preventive medical services and more expensive emergency services.
If medical billing isn’t done properly, these challenges can snowball and cause healthcare providers to fall behind in providing one of the most essential services.
Check out how Hansei Solutions helped a California pain management clinic.
Before you call a medical billing company, you should have a list of questions put together that’ll help you understand if they’re a right fit for your practice. Some medical billing companies only focus on billing or coding, while others focus on revenue cycle management and practice growth. Just as each medical practice is different, each medical billing company is unique, and you don’t want to partner with someone who doesn’t have your best interest in mind.
Here are seven things you should look for in medical billing companies in California.
Medical billing companies use various fee structures to charge their clients. These include percentage-based fees (a percentage of collections), flat fees per claim (fixed amount per claim), monthly retainers (fixed monthly fees), and hourly rates. The most common and effective approach is the percentage-based fee, where you’re charged a portion of the money collected, often with decreasing percentages as collections increase. Ensure that additional charges for services like patient follow-ups are clarified, as some lower-priced companies might exclude standard services to appear cheaper.
A reliable medical billing company should have a solid billing background for diverse healthcare providers, including specialties like behavioral health and ambulatory surgical centers. The company’s staff or founders should have relevant experience, even if the company itself is new. Ask about their experience in your field and specific needs. For instance, a pediatric clinic would require familiarity with codes for childhood vaccinations, growth assessments, and pediatric procedures, while a dermatology office would need expertise in coding for skin-related procedures like surgeries, biopsies, and laser treatments.
Always ask about staff training and certifications. Look for certifications from reputable organizations like the American Academy of Professional Coders (AAPC) or the Professional Association of Healthcare Coding Specialists (PAHCS).
When considering medical billing companies, you probably want to enhance client satisfaction and revenue. After all, a steady rate of happy clients and efficient billing services keep healthcare practices profitable. You might have effective processes already. When discussing with a company, inquire if they can incorporate your successful methods into their new system. If they propose significant changes, ensure they can train your staff on their system.
Before hiring a medical billing company, ensure your billing and patient data belong to you, are accessible, and remain secure and accurate. This grants you the flexibility to switch services or bring billing in-house. Medical billing firms like Hansei offer real-time data for treatment planning and business choices. Always inquire about a billing company’s full range of services and who owns your data. Assuming they offer standard options or that they won’t share your patient information can lead to issues later.
When looking at medical billing companies, ask them for references from other healthcare providers. It’s important to hear first-hand experiences about the company and its practices, especially if they’re unreliable, inexperienced, or unprofessional. It’s also helpful to check if they’re accredited or affiliated with reputable organizations, such as the Healthcare Business Management Association.
A good medical billing company is transparent and forward-thinking, and it’s important to build a partnership rather than just a contract. Accountable medical billing teams will have open lines of communication with their clients, so they can respond and update healthcare providers whenever needed. If your practice is assigned an account manager, ask the company who will oversee your billing while someone is out sick or on vacation. Ask them if they cross-train their billers and coders to handle different accounts to ensure uninterrupted service.
At Hansei Solutions, we take pride in our partnerships and company-wide transparency. Our behavioral and ambulatory surgery medical billing teams respond in real-time to provide uninterrupted service and support to all our clients. Our leaders and founder started Hansei to help expand mental and behavioral health treatment so that more individuals can access essential services. Partner with a medical billing company that understands and works toward meeting your needs and goals, rather than inconsistent and unprofessional organizations that just want to collect a fee.
If you’re looking for medical billing companies in California, contact Hansei Solutions. Our California and Tennessee offices, combined with team members across 13 other states, are dedicated to helping non-hospital and behavioral health facilities navigate their complex and unique medical billing and RCM challenges.
As the healthcare field changes, we stick close to our clients and partnerships, continuously finding new opportunities for growth and optimization. Call today to schedule a free demo of our services and find out how Hansei Solutions can help your practice focus on quality patient care rather than tedious billing tasks.
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