The world of healthcare is complex and far-reaching, and managing the financial end of any practice can be a challenge. One of the most common questions that healthcare providers often ask is: “How much do medical billing companies charge?” At AMS Solutions, we believe in peak transparency, so we’re here to talk about that very subject. We’re going to take an in-depth look at the costs involved with partnering with a medical billing company. 

The Cost Variation

The first thing that is critical to understand is that not all companies charge the same rates, or even similar rates in many cases. Not only that, but some don’t even have the same pricing structure, so one company might charge or bill you in a completely different way for their time or services than another. Other factors should be considered when looking at the variance between what one company charges and what other charges. 

Percentage-Based Charges

One of the most common pricing structures for medical billing companies is the percentage-based structure. This means that when they need to figure out how much to charge for billing services, they simply look at the gross revenue for the practice, and charge a percentage of that. In most cases, percentage-based medical billing services will charge between 3% and 7% of the practice’s gross revenue. 

This model makes it easy for the billing company to align its interests with those of your practice. But it also leads back to the question: how much do medical billing companies charge in real terms? For example, let’s say your practice generates roughly $720,000 each month in revenue, and your medical billing service charges 5% of the gross revenue. You’ll be paying about $36,000 in billing service costs each month.

Flat-Fee Model

While less common, many medical billing services operate on the flat-fee model. AMS Solutions offers some flat-fee service plans, which can offer a far more predictable, fixed monthly cost for your practice. This is often a far more cost-effective solution, particularly with small and mid-sized practices, since it doesn’t fluctuate with the monthly revenue levels. This gives more stability and consistency to practices that need them the most. 

How Much to Charge for Billing Services?

Another question that frequently pops up is how billing service providers determine how much to charge for billing services. The answer to this can vary quite a bit, depending on factors like the total number of patients in a billing cycle, the complexity of the billing process, and the level of administrative support that’s needed to complement the billing. In most cases, billing service providers will charge anywhere between $1 and $10 per claim handled, with most averaging right in the middle of that range. 

Why Choose AMS Solutions?

With the constantly shifting healthcare landscape, and the often changing demands of small to midsize healthcare provider practices, choosing AMS can be one of the smartest moves you can make for your organization. We provide comprehensive coding and billing expertise which means you can focus on what matters for your practice, providing top-tier attention and care for your patients. Our competitive pricing and exceptional service and client satisfaction level mean you’ll always be getting the best value for your billing with AMS.

Trust AMS With Cost-Effective Management of Your Medical Billing Needs

Understanding how much medical billing companies charge can be a relatively complex process. However, with the right information and a trusted billing partner like AMS Solutions, it doesn’t need to be overwhelming. Reach out to AMS Solutions today for more information, or to get started discussing your organization’s needs.

Do you run a healthcare provider practice and find yourself wondering, “What do medical billing companies do?” The good news is, you are not alone. With the continual expansion and growing complexity of the healthcare industry, the need for specialized services like medical billing and coding has risen dramatically over the past few years. 

But, what exactly do these companies do, and how do they function in our modern healthcare system? Let’s take a look at those questions, as well as why you should consider outsourcing your billing needs to one and what kind of benefits it may be able to offer.

The Basic Role of a Medical Billing Company

In the most basic sense, a medical billing company acts as a middleman between healthcare providers, their patients, and the insurance companies. They ensure that medical procedures that are performed are coded correctly in the records, the claims are submitted accurately and on time, and that the payments are collected promptly. 

This process might seem simple and relatively straightforward, but in reality, there is a substantial amount of attention that is paid to the detail and the understanding of the assorted medical and insurance protocols.

What Does a Medical Billing Company Do On A Daily Basis?

While this may not reflect the typical day at all medical billing companies, it will give you a general overview of the various tasks that are involved. The first step is patient registration, where essential personal patient information, along with insurance information, is recorded and checked for eligibility and coverage. 

Next, comes the medical coding. In this step, the medical billing company translates the diagnoses and various procedures or treatments into the standardized codes that insurance company computers understand. This step is critical since any errors at all can lead to claim denials. 

The next step is claim submission, where the medical billing company will submit the claims to insurance companies to be reimbursed for the services they’ve rendered. This step has the potential for claim rejection, and if a claim is rejected, the billing company will often simply correct the error and resubmit the claim automatically. 

Finally, the last step is the payment posting and any follow-up that’s needed. The billing company will post payments received and will follow up on claims that are unpaid and extend the revenue cycle. They will also usually handle the usual patient billing inquiries, which can range from simple to highly complex, given the intricacies of insurance coverage and individual policy specifics.

Why You Should Consider Outsourcing Medical Billing

Now that you know what a medical billing company does, in general, and on a daily basis, you might be starting to wonder what the benefits are of outsourcing that particular workload. One of the biggest advantages is that it frees up your staff and healthcare provider partners to focus on what they do best: providing industry-leading care for your patients. 

Additionally, specialized medical billing companies like AMS are uniquely qualified to maximize your practice’s revenue and reduce overall error rates for claims. They keep their teams up-to-date on all of the constantly-changing industry regulations and compliance requirements, which helps ensure that your practice will never face penalties for violations or non-compliance. 

Finally, outsourcing your medical billing services can lead to substantial cost savings. By eliminating the need to spend in-house staff time and payroll dollars to manage billing needs, practices can save on salaries, benefits, and even hiring, training, and onboarding. 

Partner With AMS Solutions for Your Medical Billing Needs

AMS Solutions is one of the leading providers of medical billing services and can help you streamline your organization’s billing operations. For more information on the benefits your practice can see, or to get started making the switch, reach out to AMS Solutions today.

At AMS Solutions, we understand more than most that dealing with unpaid medical bills can be one of the most stressful, confusing, and even overwhelming tasks, particularly when there are problems with getting the bills paid by your insurer. You may even be at the point where you’re wondering, “Can you sue an insurance company for not paying medical bills?” This question is a lot more common than you may think, particularly when patients may find themselves stuck in a frustrating situation with their insurance providers. 

Understand Your Rights

First of all, you must understand your rights, however, the insurance landscape can be incredibly complex. In some cases, the answer to “Can I sue my medical insurance company” is a definite yes. That said, like many other things it is not as straightforward as it seems. 

Before rushing out to file a lawsuit, however, you’ll need to ensure that you’ve exhausted all of the other possible solutions or remedies. This can include filing an appeal directly with the insurance company, seeking the intervention of an insurance regulator, or even getting a patient advocate involved. 

When Can You Sue an Insurance Company?

If your insurance provider is not adhering to the terms of the contract that they hold with you, your insurance policy, then it is possible to sue for a breach of contract. This is often the case when a particular insurance company denies a claim without any reason, when they’re delaying payment intentionally, or when they refuse good-faith out-of-network rate negotiations as may be required by their policy. The biggest hurdle is that the legal process can be lengthy and quite costly to pursue in some situations. This is where the services AMS Solutions provides can be of incredible value.

The Value of Expert Assistance

When you’re dealing with an issue as serious as unpaid medical bills, expert assistance can make all of the difference in your case. If you’re asking “Can I sue my medical insurance company?”, it may be time to talk to a professional about it. AMS can offer you that much-needed assistance. We are well-versed in the intricacies of insurance policies and have a solid track record of helping to resolve complex billing issues. 

How AMS Solutions Can Help

The expert billing professionals at AMS have extensive expertise not only in coding and billing but in collections. This means we’re uniquely equipped to help you navigate the incredibly complex billing situations that have you wondering if you can sue your insurance company for not paying your medical bills. 

We can help you explore viable solutions, and our team of insurance experts can review your coverage, and help identify any potential inconsistencies in the denial issued by the insurer. For those trying to appeal insurer determinations, this can be invaluable. In many cases, it can even lead to a satisfactory resolution without resorting to legal action. 

The Best Course of Action – Partnering With AMS

Can you sue an insurance company for not paying medical bills? While the answer is yes, it’s important to remember that it should be the last resort. It’s often found to be more cost-effective and more efficient overall. This is generally because the more efficient and cost-effective option is to resolve these issues with the help of experienced and trusted professionals, like the ones at AMS Solutions. 
Instead of feeling overwhelmed by the prospect of legal action against your insurer, why not start with more manageable steps? First, reach out to AMS and let us help you explore your options and find the best solution together.

Every industry is rapidly moving toward complete digitization, and the healthcare industry is certainly no exception. Unfortunately, a world that is moving constantly toward more digital solutions will undoubtedly face mounting concerns over growing problems like medical billing fraud. 

We’re going to take a look at what exactly medical billing fraud is, as well as go over a step-by-step walkthrough of how to report it. We’ll also discuss how AMS Solutions is uniquely positioned to be an effective, ethical, and error-free partner in outsourced medical billing. 

What Is Medical Billing Fraud?

Medical billing fraud typically involves false claims or statements being made in relation to healthcare services. This means medical billing fraud can take many different potential forms, including billing for services not performed, double billing, or misrepresenting the services rendered. Fighting these unethical and illegal practices helps to be able to recognize and report instances of medical billing fraud.

How to Report Medical Billing Fraud: A Step-by-Step Approach

1. Document Everything: The first and most important step in billing fraud reporting is documentation. Keep a record of every detail related to the suspected fraudulent billing. This includes dates, service descriptions, amounts billed, and records of any conversations you had with providers or insurers.
2. Contact Your Insurance Company: Once you have gathered together all of the needed information and documentation, the next step is to contact your insurance company. They will generally have a dedicated fraud reporting hotline, and they will guide you in their specific fraud reporting process. 
3. Report To Authorities: If your insurance company doesn’t, or isn’t able to, resolve the issue, or if you suspect they may be involved in the fraud, it’s important to escalate the matter to the appropriate local, state, or federal authorities. This can include the state insurance commissioner’s office, the Federal Trade Commission (FTC), or even the Office of the Inspector General (OIG).
4. Get Legal Help & Representation: If the fraud has resulted in you suffering financial harm or other measurable damages, you may have the right to pursue compensation, but you’ll likely need to get an attorney involved. Consulting with a lawyer will often not only be able to get you answers to your questions, but it can get you guidance on the process, and may even result in the attorney taking the case on contingency.

Partner with AMS Solutions for a Fraud-Free Experience

Understanding how to report medical billing fraud is a critical skill in the modern highly digital healthcare landscape. By staying highly vigilant, you can help fight this unethical practice, ensuring that everyone pays their fair share for healthcare services. Remember, however, that prevention is the best strategy, and while understanding how to report medical billing fraud is essential, doing everything you can to prevent it is even better.

Partnering with one of the most trusted leaders in the medical billing services industry, like AMS Solutions, can go a long way toward providing you with peace of mind regarding your practice. Choosing a reliable billing partner like AMS means that you can count on your coding, billing, and collections to be handled in a professional, ethical, and legal manner that helps protect patient data integrity and security.
At AMS Solutions, we’re also committed to transparency and integrity in all aspects of our operations. We adhere to all local, state, and federal regulatory requirements, and ensure that all billing practices we engage in are accurate and compliant. We employ a robust checks and balances system to prevent any chance of fraudulent activity, providing a safe and reliable billing service for all of your organization’s needs. Reach out to AMS Solutions today to learn more or to get started making the switch.