Medical Billing for Private Practices: Don’t You Want to Get Paid?

You know medical billing is a crucial part of your private practice, but why exactly, is it so vital? There are many reasons that all boil down to the same thing: it’s a matter of survival.

The majority of patients do not pay in full for private practice office visits with cash. Sure, some patients may pay copays by credit card before they leave your office but, in most cases, you must bill the individual’s insurance company for reimbursement for services rendered.

The majority of patients do not pay in full for private practice office visits with cash. Sure, some patients may pay copays by credit card before they leave your office but, in most cases, you must bill the individual’s insurance company for reimbursement for services rendered.

Solo practitioners rely heavily on revenue cycle management, timely submissions of claims, and reimbursement from insurance carriers for their very survival. Unfortunately, it’s not uncommon to find a private practice physician waiting weeks if not months for reimbursement.

Why do private practices struggle with billing tasks?

One of the main reasons why small private practice physicians struggle with medical billing is that a vast number of medical billing companies don’t typically work with small or solo practices. Why? Because these types of accounts are smaller.

The majority of medical billing companies charge a certain percentage of overall collections generated from the billing services they provide Smaller revenues equals smaller profits for the medical billing company.  Unfortunately, it’s as simple as that.

So why not hire someone in the practice to take care of the coding and billing? Many doctors do. However, today’s healthcare billing practices can be quite convoluted.

A number of rules and stipulations apply to claims submissions depending on whether you’re billing Medicare/Medicaid, veteran’s insurance providers such as Tricare, or one of the many private healthcare insurance companies in the United States.  Each of these carriers has different provisions and guidelines as well as time limits for filing claims.

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