Navigating the Complexities of Private Practices Billing Services

Private practices are those that are not affiliated with the health system and work independently. Operating a private practice means being an entrepreneur, which comes with a variety of challenges resulting in burnout, especially in smaller practices where physicians have additional responsibilities such as payroll management, billing, vendor accounts, and patient information. In a study by AMA and Mathematica researchers, respondent physicians expressed some issues.

Administrative burden: Physicians found it difficult to balance clinical responsibilities and administrative functions like pre-authorization requirements and coding. One doctor said that the administrative burden of the private practice overwhelmed them to the extent that they opted to sell the practice.

Unfavorable contracts: Respondent physicians also showed frustration while negotiating contracts due to a lack of resources for contract negotiation, or their issues were ignored and not heard. Several individuals attempted to negotiate contracts independently but still could not overcome this challenge, so they partnered with a third party to deal with contracts.

Less reimbursement: The gradual decrease in reimbursement rates from Medicare, Medicaid, and private insurance companies over the years was also reported as a great concern. Doctors affiliated with health systems receive higher reimbursement than independent doctors.

Expenses of technology: Moreover, the constant influx of new technologies, compliance regulations, security measures, and fluctuating patient needs exacerbates the challenge. The high cost of implementing and maintaining Electronic Health Records (EHRs) for collecting and analyzing essential records and the lack of IT department support after purchasing posed a significant challenge.

Documentation issues: In another place, the AMA stated that documentation and staffing shortages are common workflow issues impacting patient care and revenue in small practices.

All these issues collectively, if they persist continuously, result in physician burnout, high turnover, high overhead expenses, increased possibilities of errors and claim denial, and lack of patient trust due to reduced patient care, and many more consequences, eventually causing disrupted cash flow. Physicians can successfully navigate these challenges without compromising patient care by outsourcing private healthcare facilities to a leading medical billing company to stay ahead.

Minimize errors and maximize reimbursement of your private practice through MedsIT Nexus!

We have a proven track record of providing billing services tailored to small- to medium-sized independent medical practices' unique needs, including private practices, small clinics, and specialty practices. By offering a lot of perks, MedsIT stands out as the top outsourced medical billing company in the USA.

Negotiation with payers

In the healthcare industry, securing beneficial contracts is a cornerstone for your private practice's sustainability. Many practitioners overlook the significance of negotiation or lack clarity on what aspects are negotiable, resulting in missed opportunities for fair compensation. Our expert negotiators do thorough preparation, clear communication of expectations, and leverage available data and insights to advocate for equitable rates and terms from Medicare, Medicaid, and MCOs and negotiate out-of-network reimbursement.

Private practice specific

We are all about personalized solutions. That is, we adjust our services to perfectly suit your practice, identifying the loopholes to guarantee top-notch outcomes.

Technology-driven efficiency and accuracy

Our dynamic clearinghouse integrates with leading insurers effortlessly, facilitating swift claim submissions and accelerating reimbursement processes. Our knowledge-based automation system absorbs the delicate rules and regulations governing medical billing practices. Through EHR and EMR systems, we accurately record PHI in an organized way and share it securely while adhering to HIPAA rules. Similarly, our AI system automatically verifies insurance eligibility within no time and swiftly pinpoints any discrepancies—missing details or inaccuracies—before the bills are even sent to the payer, preventing medical fraud and abuse. Our robust billing software tailored to the specific needs of your private facility reduces administrative burden, streamlines billing, and helps increase profit.

Clean claim

Detecting errors is paramount as they can result in denials, financial penalties, and legal consequences, ultimately impeding revenue generation. A robust revenue cycle demands a comprehensive claim tracking and follow-up system throughout the billing process. MedsIT monitors your claims throughout their lifecycle using our automated claim scrubber integrated software, which scrubs your claim promptly, ensuring smooth operations.

Auditing and reporting

Our auditing process is like a finely tuned scanner, pinpointing any inaccuracies that could otherwise result in decreased reimbursement and higher costs. By conducting thorough audits and providing detailed reports, we empower you to optimize your private facility’s revenue cycle management effectively.

Seamless cash flow

Reimbursement represents the pivotal step of our process. Therefore, we guarantee precise documentation, coding, timely resolutions, and overcoming hurdles through our meticulous attention to denial management. By digging into your list of outstanding payments, we uncover outstanding payment cases, figure out the lagging aspect, find ways to eliminate issues, and help you get reimbursed. After designing strategies, we implement an action plan and then refine the pricing structure and method to ensure that you get paid for what you rendered, thereby fostering a 10% increase in cash inflow.

Stand out against large healthcare practices

Highlight yourself against larger healthcare practices by prioritizing unparalleled patient care while seamlessly managing administrative tasks through expert billing services. MedsIT Nexus makes it possible

Healthcare providers and independent practices to whom we serve

MedsIT Nexus makes itself competitive by catering to medical facilities of multiple sizes, including private practices and healthcare systems. We are dedicated to providing premier medical billing coding services. Our experience extends across a diverse spectrum of independent medical specialties or clinics, including but not limited to:

Outsource with MedsIT Nexus, and let us help you thrive!

MedsIT Nexus has been providing valuable services across the USA since its inception and is the best-managed billing vendor, increasing your revenue by up to 30%. Avail the opportunity of short-term contracts we offer to gain medical billing services that are like expert navigators for your revenue journey, equipped with all the tools and strategies needed to succeed and excel, ensuring every step of the revenue cycle is optimized for maximum returns. With no onboarding fee, hidden charges, technology, or operational costs, we have emerged as the most economical billing firm with a minimum price of 2.69%. Book an appointment and let us help you with your field.