Medical Billing Services for Small Practices

Medical billing is an essential part of RCM to gain correct reimbursement. Operating a small medical practice can be expensive, demanding constant adaptation to maintain financial stability. The responsibilities can be overwhelming when you do it all on your own, from delivering quality care to overcoming administrative hurdles, managing billing and coding, and ensuring precision across the board. At MedsIT Nexus, a medical billing company, we overcome the challenges you face through a team of experts that offers sophisticated solutions tailored to your needs, all at an accessible rate. With our support, you can concentrate on delivering exceptional care while we handle the intricacies of billing and administrative tasks.

The Importance of Effective & Efficient Medical Billing for Small Practices

Reduced manual tasks and errors

In the modern era of technology, efficient billing encompasses automating administrative tasks. Hence, repetitive tasks such as claims submission, payment posting, and follow-ups are automatically automated to reduce manual burden and increase staff accuracy and productivity.

Increased financial stability

Accurate coding and timely billing are necessary for reimbursement because insurers mandate claim submission within a specific time limit. Different insurers provide different time limits for claim submission; otherwise, claims will be rejected. Efficient medical billing is pivotal in the healthcare revenue department, as it ensures accurate documentation and coding and timely submission of claims to insurance entities or patients to receive proper reimbursement.
Moreover, it also enables immediate identification and resolution of billing errors or compliance issues, mitigating the risk of audits, penalties, and legal issues, thereby safeguarding the organization's financial integrity and the overall success of medical practitioners.

Better patient satisfaction

Streamlined billing procedures offer patients accurate and easily understandable invoices, hence no confusion and frustration. Moreover, an efficient process boosts the delivery of statements to patients, facilitating prompt settlement of financial obligations. This professional billing facilitates clear communication channels and timely resolution of any billing inquiries, further enhancing the patient experience and fostering a sense of trust and reliability in healthcare providers.

Compliance to updated rules

Mitigating complex billing necessitates strict adherence to a myriad of industry regulations, guidelines, and insurer rules. Efficient healthcare billing ensures adherence to modern coding standards and documentation protocols and thoroughly follows insurance policies and regulations, safeguarding the organization and upholding the principles of ethical billing.

Common Challenges Faced by Small Medical Practices

Running a small medical practice comes with many challenges, including resource deficiencies, limited staff, shortage of time, and lack of automation. Some other issues bothering the medical industry are coding errors, poor employee training, poor tracking of claims, Compliance headaches, ever-changing confidentiality rules, administrative load, information gaps, account receivables, and lack of insurance coverage. These issues lead to claim denial, a significant challenge because it hinders revenue growth and is a barrier to RCM (delayed payment); hence, considerable profit loss occurs. According to the latest estimate, the claim denial rate ranges between 5-10%; however, some specialties face a denial rate of 20-30%, a significant revenue loss. Becker’s Hospital Review states that claim denials cost nearly $20 Billion annually, which is a huge loss.

Outsourcing is the proven solution!

For healthcare providers working in small facilities, it's always challenging to perform professional billing in each task because they are always busy with patient care, and hence, they have less time to stay updated with changing rules. Therefore, working with 3rd party healthcare billing providers ensures a comprehensive administrative process. These companies offer myriad services such as errorless patient enrollment, insurance verification, credentialing, updated coding, claim processing, claim submission, denial management, appeal, payment posting, and all other aspects for accurate billing. For providing these services, the 2024 cost of external billing services ranges from 4% to 10% depending upon several factors such as geographic location, size of the practice, complexity, and volume of the services, the level of technology, etc. Along with cost, it's necessary to know the billing companies' payment model. In the USA, percentage-based structure and fee-for-service are the most commonly implemented fee structures.
Now, how do you contact billing organizations? Each billing facility mentions its contact number on its website, so you can easily access it. Many doctors and medical practitioners find financial partnerships with billing companies helpful. For instance, research provides reviews about outsourcing in a way that it reduces cost, increases productivity & profit, provides flexibility, access to skilled resources, risk management, and better services. Moreover, client reviews are always stated on the company's website for your trust.

Streamlining the Revenue Cycle for Small Practices with MedsIT Nexus:

MedsIT Nexus is considered a leading medical billing platform renowned for its top-notch services and the diligent revenue cycle management process it follows to guarantee perfection in your administrative section. Let’s take a panoramic view of our billing process, which is designed to accelerate revenue generation.

1. Collection of patient data
We initiate our process by acquiring all appropriate patient records, including patient demographics (name, DOB, address, phone number, etc.) and insurers’ details (insurer name, insurance policy, and number, any secondary insurance, etc.), detailed encounter notes, and any other necessary documents for streamlining revenue.
2. Documentation analysis & charge entry
After gathering data, our experts implement the Clinical Documentation Improvement (CDI) System to ensure the correctness and effectiveness of documentation and charge entry.
3. Insurance verification
Our trustworthy services for eliminating your concerns integrate an electronic insurance verification system that automatically verifies financial responsibility in just one click.
4. Coding & append modifiers
We completely understand the importance of accurate coding in reimbursement, and that's why we dedicate a certified team tailored to deal with your case with precision and attention to detail. These coders perform a keen analysis of medical records, diagnosis, and treatment and then utilize the latest guidelines recommended by esteemed bodies such as AMA and AAPC to adeptly convert this information into specialized, up-to-date ICD, CPT, and HCPCS codes. If a healthcare professional renders any additional service, our trained and knowledgeable coders implement modifiers by adhering to professional standards.
5. Auditing
Our healthcare auditing services encompass three main components for auditing your claims: knowledgeable auditors, analytics technology, and authentic auditing procedures. Outsourcing your claim auditing with MedsIT Nexus means processing your claim through software or scrubbing tools that automatically identify errors according to set rules. First, we perform internal and external auditing, and then we conduct a prospective or retrospective review.
6. Claim submission and denial management
Correct and timely claim submission is an overwhelming task requiring skills and profound insights into technology. Therefore, we are a team experienced in optimizing your claim submission process electronically and following up on it. In case of claim denials, our systems immediately find the root cause of this and appeal/resubmit the claim accordingly within the given time limit.
7. Payment collection and posting
Immediately after the claim is accepted, we collect and post payment into the system for record-keeping and send patient statements if there is a copayment.
8. Reporting
Our financial services update you with all necessary information & feedback on claim denial analysis, reason code analysis, charge report, payment report, and AR follow-up report through our reliable reporting solution. Our dedicated team sends daily, weekly, bimonthly, and monthly reports to our customers. To meet clients' demands, we have integrated a customized practice dashboard providing in-depth analysis of metrics such as month-to-date charges, month-to-date collection, and month-to-date visits.

Advantages of Our Medical Billing Services for Small Practices:

Experience: With over ten years of industry expertise, we’ve emerged as a top outsourcing billing company in the USA whose professionals provide invaluable insights that propel our small practice clients to achieve heights of success.
Advanced technology: Our reliable technology, such as Electronic Medical Records (EMR), Cloud-based coding software, Electronic Health Records (EHR), Automated Coding Algorithms, Machine Learning, Computer-assisted ICD-10-PM, CPT, HCPCS, and ICD-10-PCS coding, and Practice Management Software, helps eliminate errors, streamline billing, and generate profits for your small practices.
HIPAA-compliance: In healthcare, regulatory compliance is mandatory for the overall integrity of medical organizations; hence, medical billing organizations are supposed to follow HIPAA rules for the safety of PHI because they deal with patient records. No compliance results in severe consequences such as fines, legal penalties, a bad reputation, suspension of license, and revenue loss. MedsIT Nexus understands this intricacy; hence, each step while handling PHI is performed by sticking to HIPAA guidelines and ensuring privacy at all costs.
Increased revenue: MedsIT Nexus ensures accuracy and, hence, increased revenue for your small organization by conducting auditing, using experience, professionalism, and technology, and adhering to security guidelines.
Free cloud access: We provide free access to the cloud so that you have full control over your administrative cycle and can monitor it, ensuring transparency and building trust.
Cost-effective: We don't charge staff fees, operational and technology expenses, or hidden expenses. So, when you compare your in-house billing cost with our cost, our advanced services are always economical for your small facility.
Affordable pricing: MedsIT Nexus offers its competitively priced services at a minimum rate of 2.69% of your revenue; however, this rate varies depending on the size of the practice, ensuring affordability without compromising quality.

Tailored Solutions for your Small Practices:

Short-term contracts: While outsourcing healthcare billing for the first time, no one wants long-term contracts; thereby, we offer flexibility by offering short-term as well as long-term contracts.
Flexible pricing options: To suit your small healthcare firm, we provide flexible pricing, such as price alternatives within your budget.
Personalized support: We pay attention to the importance of communication in billing. Therefore, we prioritize fostering solid client relationships through different communication channels. We have a customized customer support team for your small practice that addresses any questions or clears any confusion that might be exhausting you. Moreover, we provide our contact for your patient so they can clear their confusion regarding their financial responsibility.
California-based services: We serve different states of the USA, including Texas, California, New York, and Florida; however, our California-based healthcare RCM services specialize in assisting small medical practices all across the state. Our presence in California ensures you can easily approach our representative at your nearest location in case of any query.
Some other customized services include

• Payer-specific decreased AR days
• Meeting Payer-specific coding requirements
• Negotiating contracts from HMO, PPO, Medicare, etc

Specialties We Cover:

We cover 90+ specialties, such as OB-GYN, gastroenterology, Neuro-Spine surgery, acupuncture, podiatry, ASC billing, surgery, physiotherapy, orthopedics, prosthetics and orthotics, ER and radiology billing, and many more.
However, we have specialized in billing for primary care, including family medicine, internal medicine, pediatrics, and general practitioners, for many years. Moreover, our services have broad experience in cardiology billing, including procedures such as ECG interpretation, stress tests, echocardiograms, and cardiac catheterizations. We specialize in urgent care billing by implementing S, CPT, and HCPCS codes and serving our clients professionally. Our expertise encompasses dental billing using CDT codes and physician and institutional billing using CMS-1500 and UB-04 claim forms.
Whether your practice is small or large, trust our team to generate perks in every area. We aim to provide more than we receive to help you stay ahead of the curve.