For medical practices of all types and sizes, implementing the best medical billing and coding system is crucial for success. Not only does your medical billing and coding process influence your office’s day to day operations, but it also determines your revenue cycle and overall profit. Leaving the responsibility of medical billing and coding to an under qualified in-house staff can end up being a nightmare, costing you tons of wasted time and money. At the same time, outsourcing to the wrong medical billing and coding company can be equally frustrating! That’s why we recommend outsourcing medical billing and coding needs to the best medical billing and coding service. Ultimately, finding the best service for your practice’s particular needs will maximize your revenue and save you the stress of managing billing in-house.
360Connect is here to help! Check out the benefits of outsourcing medical billing and coding as well as what to consider before choosing service. Then, consider our list of the top 5 medical billing and coding services.
Why Outsource Medical Billing?
Nowadays, there are tons of benefits to outsourcing medical billing and coding needs. In fact, partnering with a professional, credentialed, and experienced medical billing service is a go-to choice in the healthcare industry. It can relieve a tremendous amount of stress and complicated responsibilities from your in-house staff as well as ensure maximum reimbursements from each patient visit and get you paid more quickly. Keep in mind that hiring a third-party medical biller and coder is much more cost-efficient than hiring an in-house staff. An in-house biller can cost you at least $50,000 per year in salary, plus the cost of software and training. An outsourced company will charge a fraction of that cost.
What to Consider before Choosing a Medical Billing and Coding Service
There are several factors that determine what makes the best medical billing and coding service for your needs. While reading online reviews can be useful, remember that your medical practice has its own set of unique needs. The best medical billing and coding service for one practice may not be the same as another! We recommend brainstorming your practice’s top priorities before comparing your options. To help you get started with this, consider these questions that practices commonly ask when choosing a billing service suited to their needs.
1. Do you prefer a local company?
You will generally have two options when it comes to outsourced medical billing and coding services. You can hire a local company or choose an off-shore biller. We recommend choosing a local company for several reasons. Many off-shore billers can cause challenges when they don’t fully understand the U.S. insurance system. Additionally, many times the only way to contact them is through their support center, which can mean sitting on hold when important issues arise. When going local, you benefit from more direct assistance, on-site support, and more.
2. Do they have experience in your specialty?
Be careful of medical billing services that are not transparent about their years of experience billing and coding for your industry. A big priority is finding medical billing and coding service that has expertise in your field. The last thing you want is to sign a long-term contract with a company that assigns novice billers and coders to your account.
3. What is their payment structure?
Pay close attention to how the medical billing and coding service plans to charge you. There are many different payment structures in the medical billing and coding industry. You will want to become familiar with what payment structures are common and make sure that it will fit into your budget.
4. Is the price too low?
Be skeptical of medical billing and coding services whose prices seem too good to be true. With medical billing services, you get what you pay for. That means that if you see a company that is marketing their very low rates, it probably means the quality is subpar or there’s a “fine print” catch. Both of these can cause serious issues with your revenue cycle management down the road. While you don’t want to pay too much for a service, it can be even worse to sign up for a low cost service. You can expect to pay around 4-7% of your practice’s net revenue to a billing partner.
5. Is the contract duration too long?
Be careful of medical billing and coding contracts that will lock you into using their service for a very long period of time. Avoid this especially if you haven’t tried the service yet! Standard contract lengths are usually 1-3 years with annual renewal contingent on the billing company performing well for your practice (aka a “performance guarantee”). Many companies also offer a free trial so you can make sure you’re satisfied with the service quality.
5 Best Medical Billing and Coding Services
Finding the best medical billing and coding service can be tricky because there are tons to choose from. Additionally, they can all seem very similar at a glance! However, there are certain factors that determine the best services – including reliability, experience, cost for quality, client reviews, and more. Here are 5 high-quality medical billing and coding services that we recommend considering.
Kareo is becoming a more well-known and commonly used medical billing and coding services company year over year. In addition to having great client reviews, Kareo has developed a trustworthy billing program that trains their staff to get quicker reimbursements, as well as develops ways to improve their system. They will also run one-on-one training sessions with your practice to ensure your understanding and success. Kareo works with over 65,000 practices, generating $25 billion in claim revenue per year.
- Years of experience: 16 years in business
- Pricing: 4%-7% of net collections
- Pros: Robust training, quick reimbursements, great price for quality of service
- Cons: Limited EHR software and integrations
AthenaHealth is known as a very reliable medical billing and coding service. They are a robust program who have been in business a long time, understand the industry, and take HIPAA compliance very seriously. In turn, they offer terrific and professional customer support. Keep in mind that they tend to be a better fit for larger practices and hospitals due to the comprehensiveness of the billing platform.
- Years of experience: 23 years in business
- Pricing: Either flat rate per insurance provider or a percentage of annual collections, whichever is greater
- Pros: Comprehensive service, 90-day minimum contract, best HIPAA compliant system
- Cons: May be overly complicated for small practices, can be pricey
CureMD tends to be a favorite billing service among medical practices because it is flexible and customizable to fit your needs and is relatively easy to use. Clients report that CureMD’s EHR software is easy to navigate compared to their competitors, not to mention it is free when you sign up for their service. They also provide lots of options when it comes to client support and is relatively cost-efficient for what they offer. However, keep in mind that CureMD does not support every medical specialty, so be sure to ask about your field when speaking with them.
- Years of experience: 20+ years in business
- Pricing: About 5% of net collections
- Pros: Great for small practices, easy to use, included EHR software and patient portal
- Cons: Not the best solution for large practices and hospitals, some add-on fees, some specialities not supported
AdvancedMD is one of the most widely flexible medical billing and coding services because they support so many specialties. Their clients also enjoy their very high “first pass” success rate when it comes to claim submissions. This means that they are known as a service that gets physicians reimbursed more quickly. They also have a meticulous process for billing and coding, and resubmits any denied claims quickly and efficiently.
- Years of experience: 20+ years in business
- Pricing: About $729 per provider per month
- Pros: Many specialties supported, highest success rates in industry, easy to use interface, helps you avoid error
- Cons: Does not automatically code for you, which means you may need an in-house coder
Cerner is a highly credentialed medical billing and coding service structured to help larger practices with complex billing needs. They typically handle the entirety of the medical billing and coding process start to finish, which can take a huge weight off your in-house operations. However, since they offer a robust platform, there may be some training requirements and a learning curve that comes with it. Also keep in mind that it is pricier than other services, but you get what you pay for!
- Years of experience: 40 years in business
- Pricing: Higher than average. Exact pricing unavailable online.
- Pros: Tons of useful features, great for large practices, handles entire billing process
- Cons: Longer training period, higher pricing
If you are ready to outsource your medical billing and coding needs be sure to check out this article before deciding:
Ready to compare prices? 360Connect's free service helps you compare up to 5 quotes from top-notch medical billing companies. The services are catered to your practices needs, and you'll save up to 30%! Get started here.