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If you're a medical billing company, your main point of operation is doing just that, sending out bills for services rendered to the various patients that you represent. And while this may seem like a simple decision to make, deciding what method of billing you're going to use is sometimes not as easy as some people would think. In this installment, we're going to discuss your various choices and what factors are involved in making your decision.

First of all, one thing a company has to understand when it comes to billing is that it's not simply a matter of what method you use to send the bill itself. After that part is done, the next part involves posting the money that is paid to you by the insurance carrier itself. How you get paid and how you post those payments, unfortunately has a lot to do with how you bill in the first place. So payment issues must be kept in mind when making your decision.

For example. If you're going to send paper claims, meaning that you are sending a HCFA form, then you automatically make it so that you can't be paid via batch billing methods. Batch billing is when the insurance carrier, supported by the software itself, sends you a file, which you usually download from their site, that contains all your payments. Once you download this file and run it through the batch billing system, the payments will automatically be posted to the patient accounts. However, in order to use this system, you have to batch bill, which means you have to bill electronically.

This is where we run into a cost effectiveness problem. Electronic billing is more costly than paper billing if you don't have a lot of patients to bill. In other words, if you're a small billing company, the cost of an electronic billing system will probably eat into your profits more than what it is worth to use. So the first thing you have to do is a cost analysis of what your electronic package will cost as compared to what kind of revenue you'll be bringing in. Most medical billing companies don't know how to do this and end up having to bring financial analysts in to compute this. That too costs money.

You also have to figure in the cost of the forms you're going to need. If you're doing a lot of DME billing, which is billing of durable medical equipment, a lot of this equipment is going to require more than just a HCFA form. You're also going to need a printed CMN or Certificate Of Medical Necessity form. This is going to add to the cost of your billing expenses.

Another thing to consider when choosing a billing method is the experience of your billing staff. If none of your staff has ever done electronic billing, even if it is cost effective, you may not want to use it because of all the problems you may run into because of inexperience.

When in doubt, it is best to consult with the software company itself. They will be able to give you a pretty good idea of the best medical billing method for you to use.

Michael Russell Your Independent guide to Medical Billing

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