Why Do Providers Choose a Medical Billing Partner, & How?
Hiring an expert team can make all the difference.
The Top 20 Medical Billing & Coding Problems Providers Face
In today's complex healthcare market, providers face numerous challenges that can severely impact their practice’s efficiency, financial profitability, and operational success. By partnering with an experienced medical billing company, optimizing your billing process and reimbursements is easier than you might think!
Are You Struggling With These Same Medical Billing and Coding Issues?
Most providers encounter the same problems:
🚫 Inaccurate or Incomplete Coding – Coding errors result in claim denials, lost productivity to working resubmittals, and even lost reimbursements.
🚫 Underbilling – Missing billable services or misinterpretation of clinical notes leads to unnecessary revenue loss.
🚫 Underpayments – Receiving less than what you are owed from payers directly reduces profitability.
🚫 Delayed Claim Filings – Delayed claim filings causes work to pile up, internal frustations, and cash flow disruptions.
🚫 Untimely Claim Filings – Entirely missing payer deadlines is automatic claim denials and lost revenue that could have been reimbursed.
🚫 Passive Accounts Receivable Collections – Lack of proactive follow-up on unpaid balances makes aging balances expenentially harder to collect.
🚫 Passive Pursuit of Reimbursements – Insufficient engagement with insurance companies causes delays in standard payment timelines.
🚫 Duplicate or Overlapping Claims – Submitting multiple claims for the same service can cause payment delays and potential audits.
🚫 Lack of Compliance with Changing Regulations – Constant updates to medical billing codes, payer policies, and federal regulations can lead to non-compliance, resulting in claim denials, fines, or audits that disrupt cash flow.
🚫 Inconsistent Charge Capture – Missing or inaccurately documenting billable services leads to lost revenue, reimbursement shortfalls, or improper revenue tracking.
🚫 Writing Off Denied Claims – Failing to appeal denied claims leads to unnecessary financial losses.
🚫 Employee Turnover – High billing staff turnover disrupts cash flow, causes frustration, loss of training investment, and inconsistency of workflows.
🚫 Poor Claims Tracking – Inefficient claim monitoring results in lost revenue opportunities.
🚫 Credentialing Tediousness – Complicated credentialing processes delay provider enrollment and reimbursements.
🚫 Patient Collections Problems – Difficulty collecting patient balances weakens financial stability.
🚫 Challenges with Prior Authorizations and Insurance Verifications – Time-consuming tasks delay patient care and reimbursements.
🚫 Complex Payer Mix – Navigating intricate, unique payer requirements can lead to confusion and costly mistakes.
🚫 Incorrect Patient Data – Submitting claims with incorrect patient data or modifiers means denials, payment delays, and compliance risks.
🚫 Employee Overhead Costs – Maintaining an in-house billing team significantly increases expenses with employer taxes, payroll, training, benefits, vacation, and equipment.
🚫 Insufficient Documentation for Medical Necessity – Lacking enough clinical notes to support medical necessity can lead to claim denials and increased scrutiny from payers.
Take back control. Use our form to reach top medical billing experts you can trust.
Every missed claim, denied payment, or inefficient process adds up to lost revenue and operational strain. Without a streamlined revenue cycle, your practice could be losing tens of thousands every year. Get a professional medical billing team and/or medical coding team to eliminate these headaches, maximize your profitability, reduce administrative burdens, and get you back to what matters - patients!
The Medical Billing & Coding Experts We Refer
Best Billing Professionals
✅ Nationwide Reach – Trusted medical billing and coding experts serving providers across the U.S.
✅ Industry Experts – Extensive experience optimizing billing for healthcare practices.
✅ Proven Performance – Only top-rated billers and coders with a strong track record of maximizing revenue for myriad providers.
✅ All Specialties Covered – Experts in every medical field, from primary care to complex specialties.
✅ Tech-Savvy Users – Flexible teams that work within your EHR & PMS software platforms.
✅ Comprehensive Solutions – Beyond billing, they offer credentialing, patient scheduling, prior authorizations, and more!
How To Choose A Great Medical Billing & Coding Partner
🏥 Industry Experience – How many years do they have?
📍 Proactive Calling and Electronic Inquiries – Do they use both methods to track claim status and push for resolution with insurance payers?
🎓 Staff Expertise – Are their billers and coders experienced in your specialty?
🔒 HIPAA Compliance – Will they sign a Business Associate Agreement (BAA)?
⚖️ Appeals & Follow-Ups – Do they handle denials assertively and use all levels of appeals for reimbursements?
🔄 Software Expertise – Discuss your PMS, Clearinghouse, and EHR billing platform. Can they use those systems?
📊 Accounting & Reporting – How often do they provide revenue reports, what details are included, can reports be customized?
💰 Payment Reconciliation – Will they help enforce payers to honor contracted rates?
📖 Industry Knowledge – How do they stay updated on billing regulations and coding changes?
💳 Collections Approach – How does your medical billing partner prioritize and manage AR collections to maximize recoveries?
📑 Credentialing Support – Do they assist with provider credentialing, payer contracting, and compliance management?
💼 Fee Structure – Are service fees based on claims volumes, collections, or a flat rate? Are there setup costs or long-term contracts?
📞 Account Management – Will you have a dedicated account manager or main contact for your practice?
👥 Backup Coverage – What hours do they operate? Is there backup staffing provided for your account?
⏳Onboarding and Start Date – How soon can they start? What are the next steps?
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