OutSourcing Your Medical Billing To 3rd Party Services

These days, sophisticated online medical billing services are coming out of the woodwork to cash in on the growing market for their skills and know how.

Who Hires Medical Billing And Coding Professionals?

The market is composed of physicians and medical practitioners of various sorts who are having a lot of difficulty in today’s complicated world of HMOs, Medicaid restructuring, and general health plan diversification. Doctors without expert assistance can have a tough time receiving the monies due them for their work. And when they finally do get paid, it often takes much longer than they would like.

Medical billing services go after business by promising to eliminate these and other billing hassles. Let’s take a look at some of the claims made by these companies on their websites.

Claim Care Medical Billing And Coding

A company called Claim Care offers some of the following service highlights on their home page: allowing doctors to receive payment within 24 hours of seeing an emergency room patient, complete remote billing (promising that no office staff at a medical practice will have to get involved in the billing paperwork), the ability to “pre-adjudicate” claims (i.e. tell what will and will not be paid and disputed by insurance companies), the system wide prevention of any and all billing/coding errors that could delay processing of a claim, easy to read “dashboard” reports that are available from any internet connection at any time, and claims of increasing the profits of clients who use them by 10- 20% while being lower cost that in-house billing services.

One thing that is clear from this website is that they are catering to the feeling that physicians and insurance companies are essentially on opposite sides in a kind of war, and that they as a billing service provide the necessary reinforcements. Toward the end of their home page sales pitch they assure the potential customer that: “ClaimCare Medical Billing Services has the caliber of people you need on your team when doing battle with insurance companies.” This may well not be too far from the truth, especially given today’s troubled economic conditions.


Another company called Medclaims makes it sound even worse: “…we fight the nasty battles with insurance carriers on behalf of our clients.” This same website goes on to make the following statistical claims, as if to underline that if you’re going to fight those “nasty battles” with insurance companies, you might as well not waste time and money while doing it, and get some professional assistance:

  • Up to 24 cents out of every dollar (or in excess of $6 billion annually) are wasted on administrative and billing cost.
  • The average doctor has more than $150,000 in outstanding accounts receivables.
  • Coding errors cost doctors over $6 billion annually.
  • Only 70% of all insurance claims initially submitted on paper are ever paid by insurance carriers.
  • Six billion insurance claims are filed each year or around 500 million claims per month.

Quite sobering indeed, if it’s not too far from the truth.

MBTC Billing

The MBTC billing company promises to be able to offer medical transcription (which is the transference of doctors’ voice recorded notes into printed form) for 4 cents a line as part of the overall billing package. The physician simply records his notes and then sends them into the company to be transcribed. This is one of the “value added” type features that these companies are offering more and more of. They put transcription, billing, coding, claims follow up and other features all together in one program, hoping to sell their service to doctors on the basis of simple efficiency.

Should you trust every claim, fact, and guarantee you read on these sites?

Of course not. Not right off the bat anyway. These are sales “pitches”. You need to do your own due dilligence, to ensure they offer the quality service they claim.

You should get references from other customers, research any medical billing company you consider either using or working for, and even check with the Better Business Bureau. But these websites give an interesting look into both the somewhat complicated and embattled state of health care billing as well as its growing induction into the information age. There is the everpresent specter of the greedy insurance carriers which comes through strongly in the literature on these sites. But above and beyond this, they show the emphasis on time economy, hands off comprehensiveness, monetary efficiency, and high standards of accuracy. All of these are new ideal norms congruent with the digital ethic. It will pay for both physicians and medical information professionals to familiarize themselves with these new standards in coming times.

ClaimCare Net



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