According to the AMGA 2017 Medical Group Operations and Finance Survey, operating costs losses per physician increased from a 10% loss of net revenue in 2016 to a 17.5% loss the following year. As a result, the overall losses per physician increased from $95,138 to $140,856 for the two-year period.

With increasing revenue losses, more and more healthcare providers are choosing to outsource their medical billing rather than maintain it in-house to decrease operational expenses. If you are thinking about outsourcing your billing, you should be aware of the three types of medical billing businesses. This fundamental understanding will assist you in determining which type best meets your requirements, allowing you to concentrate on your main operations.

A Medical billing company differs in the services they provide and are classified as follows:

Type1: Medical Billing Service Providers with Limited Services

These are Medical Billing companies that sell billing software. They handle code validation as well as functioning rejections owing to authorizations, eligibility, and patient demographics. Due to the restricted services provided by such organizations, which include completing the front end billing process and processing your claims, they are intended for clinics that have a skilled in-house medical billing staff.

Type2: Companies that provide full-service medical billing

These are the classic medical billing companies that begin providing services at the beginning of your revenue cycle. They are equipped and trained to do the following:

  • Give your practice technological tools and training for demographics, card issue information, and eligibility verification, which will be especially useful during the check-in process.
  • Work with rejected claims and advise you on how to avoid this in the future.
  • Communicate with practices on how to deal with rejections.

They are capable of handling all of your medical billing difficulties. As a result, they are an excellent alternative for medium to big firms who want to concentrate on their core operations.

Type3: Niche Medical Billing Firms

A medical billing company that can provide more customized support to your specialized practice is sometimes required. This is when the services of boutique medical billing companies come in handy.

Niche medical billing firms can provide tailored services to specialized practices and facilities that want to go beyond the standard payment posts, claim submissions, and account receivables follow-up. However, due of their unique personalized approach to medical billing; this also involves a greater service price.

Key points

Which medical billing business is best suited to your practice or facility?

It is determined by your needs. If your in-house billing personnel is limited, a full-service or boutique billing business might be suitable. However, if you have the capacity to handle the majority of this on your own and only need software to aid you, a light service medical billing company may be able to assist you.