What Do Medical Billing Companies Do?

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.

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