The two most integral positions in the success of any healthcare practice are the physician and the medical biller. While the physicians work hard to provide the best care to the patient, it is expected of the biller to ensure optimal reimbursement for the physicians. We continuously speak to independent physician practices and are often told that their practice is consistently losing money! Some would say too many claim denials are rocking their boat. Others would say the AR is so out of control. This is certainly not acceptable, but the real question is... Why does this happen?
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It all comes down to what kind of medical billing company are you working with. If the goals of your billing arrangement are not aligned with your healthcare practice’s financial goals, chances are you will not be able to meet your own goals and eventually will run into a cash flow issue. Cash flow is the lifeline of any business, and your medical practice is no different. Therefore, if you are losing money, let’s take a deeper look at your current billing arrangement and what to expect.National Medical Billing Companies-
Almost all large national billing companies are chasing big Wall Street payouts. These private equity-backed companies are REQUIRED to hit growth and profitability targets, or the C-suite gets replaced. This has created a highly competitive environment, triggering a race to the bottom on prices to hit growth expectations. As a result, the majority of these set ups are now simply working like a middleman– their sales team will reach out and show you a pleasant picture, offer you prices that will be hard to resist, and once you sign on the dotted line, the whole project will be outsourced to someone else at a cheaper price. From that point on you will continue chasing them without receiving the effective billing service you were once promised. These billing companies have just one focus: to improve their EBITDA (Earnings Before Interest, Taxes, Depreciation and Amortization). They are not worried about optimizing your coding, clean claims submission, or conducting follow-ups with the insurance provider to collect outstanding bills. These aspects are missing from their agenda and part of the other set up that really does your work. The real set up doing your work is not paid well enough by the middleman, causing a severe breakdown in quality and service. In the end, their goals are being met but yours are not!
Now if this is your arrangement, think again– do you really deserve this?
Local “Mom and Pop” Shop –
These homegrown billing companies are available to you locally and if you want to meet with them once or twice a month, that is fine. However apart from this, what do you really receive? Honestly– not much.
These set ups generally lack the expertise and the ability to scale up. Because of this, it is not fair to expect them to leverage technology and domain expertise and optimize your billing to maximize revenue. Their lack of expertise should not stop you from expecting what is best for your practice. In fact, the whole reason you outsourced your billing was to get away from the business of billing and focus on what you do best–patient care.
If this is your current arrangement and you believe you are losing money, this is not a trend that is going to stop anytime soon. You would have felt this yourself and now you need to make an important decision by moving on to improve your cashflow and injecting some much-needed life into your practice before it is too late.
Software Companies Pretending To Be Medical Billing Services –
This is a new trend that has developed in the last 5 years or so. It is very easy to fall into this trap. You are not alone if you have made this mistake due to how common it is. You can find these folks everywhere. If you go to a seminar, they will have the biggest booths. Online, you will see their ads over and over, and it is quite difficult to miss them. They will offer you great billing rates. Why? Their main goal is to sell their software, and they will pick up your billing as a side project. They are not the ones who actually conduct the billing, which is often outsourced. The same cost prohibition applies and creates a similar lack of service and quality, resulting in your practice losing money. Yes, their software may be high in quality and they may also have the correct technology, but at the end of a day, you do not want a software developer doing your coding and billing because that is not their job.
As a matter of fact, these companies sign the most of number of new clients per year, yet they also lose the most clients per year once the physicians realize the predicament they’ve got themselves into and why it is not going to work.
Check out: 6 Top Medical Billing Mistakes That Cause Denials
In-house Billing –
You may be tempted to bring it all back in-house, but why did you outsource in the first place? It is because you went to medical school to learn medicine. You were never taught how to code or how to be a biller and you do not want to be a biller, do you? The only things you can achieve by bringing it back in-house are creating a huge human resource headache and many of the same issues as a “mom & pop” company. You definitely deserve better than that.
Why should You Create a Partnership with Cosentus !
To ensure you create the best chance for your medical practice to succeed, you need to develop a true partnership with an experienced and trusted team that has the ability to provide a highly optimized and customized solution. You want a partner who is willing to align their focus with your goals. This is someone with deep domain expertise and technology who can optimize your billing in a significant way and demonstrate sustained results. Moreover, this is a partner who is free from the influence of venture capital and can actually align incentives with you. Meet Cosentus!
We are the most effective revenue cycle operation in the nation with two decades of deep domain expertise focused on quality, execution, consistency, and transparency. Tight interdepartmental integration ensures that the highest quality of service never becomes cost prohibitive for us. We own your goals and deliver beyond your expectations because we apply highly qualified, well-trained, and skillful people to your account. Here is what to expect in terms of results:
- 48 hours service to submission
- 99% clean claims submission
- 100% payer contract enforcement
- 80:20 Model: our 80% effort goes into resolving 20% of claims that do not get paid automatically
- 100% AR touch every 30 days
- Denial Tracking and Preventive Denial Management
- Client service that will delight you: we always answer your calls, and take pride in being a no-voicemail business
- We are a special kind of billing company because we never your money on the table. We continuously and consistently strive to drive your revenue up.
- Documentation improvement support for physicians
If you want to stop losing money and increase your revenue by 20-30%, choose a billing partner that knows what they are doing and knows how to do it most effectively.
Choose well - Choose Cosentus!
We offer a FREE comprehensive analysis of your billing and coding, with zero obligations! This is so that you can see for yourself where your healthcare revenue cycle stand in this present moment and what improvements can be made. We provide you with a road-map to increase your revenue, be it with us or another partner of your liking. Obtain your free analysis today! If nothing else, you will obtain the valuable knowledge of what questions to ask your Medical Billing Company and how to demand proper performance! Once again, it is FREE and with no obligations!
Why Settle When More Awaits?
