How to Determine Medical Billing Services Fees Rates and Quotes

Medical Billing Services Fees is basically the revenue of a physician that is dependent on the reimbursements of their medical bills. This is why, almost all practices, small or large; give immense importance to the efficient management of their finances, medical billing, account receivables, and overall revenue cycle management. Medical billing is a specialized field and hiring the right human resources to manage this burdensome task for your practice involves huge cost and management skills. Therefore, most of the physician practices outsource their billing management to a medical billing company.

How medical billing service fee is generally determined?

There are a lot of medical billing companies that offer their services at different scales. Some companies would charge a certain percentage of the overall collections and some may offer their services on a flat rate. An all-inclusive feature-rich medical billing service may cost you a higher percentage but eventually, the service provider would enhance your collections and give you peace of mind.

How to decide on what should be the medical services fee?

It can be as simple as getting price quotations from different medical billing service providers, compare their quotes, checks their experience, and reaching a medical billing service agreement. You can also decide by calculating the overall cost of your organization to manage to bill and choose an outsourced billing company that can best handle it but charging you the same. A full-service medical billing company should cover:

  • Medical coding
  • Entering patient demographics
  • Patient eligibility & benefit verification
  • Claims scrubbing
  • Claims submission
  • Payment follow-ups and appeals
  • Denial management
  • Monthly reports
  • Posting insurance and patient payments
  • Clearinghouse management
  • EOBS & ERAS

Medical companies also offer some additional services other than the base billing service. Such as, the billing service provider may also help you out in provider credentialing & contracting, manage your front office, and assist you in the handling of clinical technologies.

Why outsourcing medical billing is beneficial?

Outsourcing medical billing is beneficial in many ways. A full-service medical billing company would enter the clinical data and ICD/CPT codes would take care of all your billing data. Although it involves a small medical billing service fee over the course of time, you would learn about all those weighty tasks that only a medical billing company can perform well and that would ultimately save you a lot of energy and time to focus on improving the patient care. Similarly, if the same service provider manages your practice management system that would help to eliminate any redundancy in the process and would positively impact your collections.

The usual process of medical billing

This unilateral handling of clinical processes is also necessary to avoid any errors that can occur if managed by different resources. There are different types of contracts or medical billing service agreements. Some medical billing companies involve upfront setup fees and sign a renewable agreement for a few months or it can be for a longer-term ranging from 1 to 3 years. Sybrid MD is a leading medical billing company that is helping healthcare professionals and organizations get paid faster and easier. The billing company charges 4% to 7% of practice collection (based on volume & specialty). Medical billing experts working for the company have got years of experience working with a number of physician practices, managing their EHR, Practice Management, and Billing software applications.

What you will get for paying the medical billing service fee to another company?

Within 48-hours of receipt of patient encounter forms (either in paper or electronically), billing experts scrub the claims to ensure that all relevant information for processing is included and only then submit the claims to the insurance company. Periodically, the certified billing experts enter all explanation of benefits, patient payments, and insurance payments and maintain accurate accounts receivable.

What are the average medical billing service fees?

Medical billing service fees vary on the basis of your requirements but it can range from $870 to $10,000 a month but it’s entirely dependent on the size of the organization, their requirements and how much workload they want the company to manage. There are also various companies that can go down below $870 as this amount is just an average and not a base medical billing service fee. Again it will depend on your requirements and needs. But before deciding to select a company based on their medical billing fee structure, make sure to do your research and identify the expertise, the solution they can provide and what is the percentage of error. This you can find out by asking your colleagues or doing your own research online.

The first step of the process always starts with reaching out to various companies and get medical billing quotes. But make sure to also request medical billing rates by specialty to have a clear understanding how much you have to pay. Healthcare professionals often overlook the fact that their specialty might demand additional efforts from the medical billing company and they may charge extra for it. Therefore, it is ideal to sign a medical billing service agreement only after developing a clear understanding.

Average medical billing rates by specialty

It is a fact that some medical practices are more complicated than others when it comes to a medical billing service fee. If you are planning to outsource your medical billing services, then the company may give you a quote on the basis of your specialty after calculating the number of hours they are to put in to ensure accurate medical billing. As mentioned above, the average medical billing rates by specialty falls somewhere between $870 to $10,000, but it’s hard to calculate the average. For instance, a company like Sybrid MD may charge you lower than the other companies for a certain specialty as we have the latest technology and expertise to get the job done in less time with accuracy. Likewise, there may be other companies who must have developed their own systems to optimize the overall medical billing process and can give you a jaw-dropping medical billing quote.

When you should sign the medical billing service agreement?

Having learned about the average medical billing service fees and what factors affect medical billing rates by specialty, now is the time to get an answer to the question “when you should sign the agreement?” Let’s say that after doing some research you have shortlisted two medical billing companies. You have liked their medical billing quotations and are satisfied with their overall reputation. Now, ask both the companies to provide you with a medical billing service agreement. Learn how flexible they are in negotiating the terms and if there are any hidden clauses that might get you in trouble in the future. If a company has clearly mentioned each and every method to your satisfaction and are ready to discuss the proposed medical billing service agreement, then you have your answer. You should go for it.

Leave a Comment