9 Characteristics of 2019’s Best Medical Billing and Coding Companies

If one of your New Year’s resolutions is to improve your practice’s financial performance through better revenue cycle management (RCM), you’ll need to decide between an in-house or outsourced medical billing solution. If you choose the latter—a wise option for many—it’s imperative that you closely evaluate the best medical billing and coding companies. Doing so and selecting a top medical billing company can dramatically increase the likelihood of achieving your bottom-line goals in 2019 and beyond.

As with any business investment in today’s environment, you’re faced with a myriad of options when it comes to evaluating and selecting medical billing services. And, quite frankly, some are better than others. So what are the critical factors you should look for when assessing medical billing and coding companies? Let’s take a look:

Specialty Expertise

It’s often best to partner with an RCM company that specializes in your type of practice, as they tend to have more intimate knowledge of your specific requirements for medical coding, documentation, compliance, etc.

Comprehensive Medical Revenue Service

Successful revenue cycle management encompasses the entire medical billing cycle, from before the appointment through final reimbursement and payment. Your chosen billing vendor should particularly excel at claim generation and submission, carrier follow-up, payment posting and processing, patient invoicing and support, and accounts receivable follow-up, among other related functions.

Innovative Healthcare Technology

The days of manual medical billing processing are gone, replaced by software solutions that drive more efficient, cost-effective and high-quality revenue cycle management. Make sure that your medical billing and coding vendor offers a scalable, state-of-the-art RCM solution that incorporates powerful software such as practice management and EMR systems. Depending on your practice’s individual needs, you may want to seek out a billing company that also offers other integrated software, such as inventory management and analytics.

Proven Performance

Beyond client references, seek detailed information on an RCM vendor’s billing and collections performance. Ask about specific metrics, including net collection ratio, days sales outstanding, denial/rejection rate and average number of days in accounts receivable (AR). The best medical billing and coding companies perform above the industry average.

Security and Compliance

You’ll be trusting your medical billing company with extremely sensitive patient and financial data. Top RCM outsourcing companies have HIPAA-compliant and secure medical billing processes in place to help keep your data confidential. They also stay current with rules and regulations, helping your practice keep up with changing conditions, particularly those related to your specialty—whether it’s dermatology, ophthalmology, orthopedics or gastroenterology.

Pricing

You shouldn’t choose an RCM vendor on cost alone. You should analyze a vendor’s pricing compared to the services and results they deliver. Whether offering a percentage-based, fee-based, or hybrid pricing model, the best medical billing and coding company should be affordable but high-quality.

Client Capacity

Ensure your chosen medical billing company has the capacity to not just bring you on as a new client, but also help you consistently achieve better financial results for your practice. Effective revenue cycle management requires dedicated medical claims processing and follow-up, which is largely what you’re paying the vendor for, so don’t settle for less.

Transparency, Communication and Reporting

Though you should have full confidence in your RCM vendor, you’ll still want a level of control and visibility into your healthcare revenue cycle. The best medical billing and coding companies foster transparency with regular communication. They also provide comprehensive near-real-time reports on your billing performance and facilitate a personal, open relationship.

Available Support and Resources

As with any vendor, you’ll want timely responsiveness, training and support whenever you need it. This is particularly critical during the transition from in-house operations or a previous outsourced medical billing company, but also important throughout the vendor relationship. The best medical billing and coding companies have strong customer support and resources to help you be successful.

Not all medical billing and coding companies are created equal. When choosing an RCM solution, request specific information related to the above characteristics, because it’s one of the most important practice management and financial decisions you’ll make.

Additionally, check out our “Guide to Outsourcing Gastroenterology Billing Services” for questions to ask when evaluating medical billing and coding companies. Though it’s written for gastroenterology, the basic ideas are applicable to any practice specialty.

About Veronica A. Diaz, MD

MEDICAL DIRECTOR OF ORTHOPEDICS AT MODMED