Using digital records, billing and communications in healthcare helps streamline internal workflow and effective communications. But with layers of regulation designed to protect patient information, the environment is complex. It is vital to adequately evaluate potential medical billing companies to ensure data protection.
There are two levels of outsource medical billing businesses. The first provides medical billing services only by submitting and tracking claims. With the growth of the industry, a second category has emerged: revenue cycle management. These companies offer a large user platform including the administration of financial transactions. But in the end, they encompass every interaction between the patient and the healthcare provider from the first appointment until the last bill is paid. The range of services may include:
Estimation of patient liability
Demographic and Insurance Verification
The basic goal of medical billing or revenue cycle management is to ensure that the provider is paid for their service. Outsourcing medical billing can help care practice manage revenues and reduce overheads, such as equipment, software, personnel and personnel costs.
Key players in 2022
There is a potential danger in choosing the cheapest outsourcing option as it can really cost more in the long run. Some companies lack data protection security, technology compatibility with current systems, or may not provide efficient service, negatively impacting cash flow. IMARC identified five of the key players in the medical billing landscape as part of a global industry trend and forecast for 2021-2025.
Over the past decade, the industry has seen strong growth as the interface with healthcare practices improves the complex revenue-generating process and reduces the practice’s workload. Since no company is immune to fraudulent activity and data breaches, it remains the responsibility of the health practice to closely monitor and continue to monitor every company they entrust with patient data.
1. All scripts
Allscripts Healthcare Solutions was founded in 1986 as a medical management company in Chicago, IL. They switched to information technology in 1997. The company currently offers electronic health records, practice management, and revenue cycle management. The products and services are offered through a strong network distribution.
The company was founded in 2004 by the founder of Scour, a multimedia Internet search engine. The company is headquartered in Irvine, California. Acquisitions between 2013 and 2015 have given the company a strong foundation to provide a broad technology platform for independent practices. Its growth has seen the company recognized as one of the fastest growing companies for four years in a row in 2016.
3. R1 RCM
The company was founded in 2003 as Accretive Health. In 2017 they were rebranded as R1 RCM. The company provides revenue cycle management services to healthcare practices, private physician groups, hospitals and other health systems. In 2018, R1 acquired RCM Intermedix Corporation, another revenue cycle management and practice management company. In June 2020, R1 RCM announced that they are expected to complete the acquisition of Cerner RevWorks in the third quarter of 2020.
4. Experian Information Solutions
Experian was founded in 1968 in the US in the field of data management. The company has been providing revenue cycle management for 25 years, providing a frictionless experience between payers and providers, and using artificial intelligence and machine learning to automate productivity and match data. Their platform manages financial solutions and guidance.
5. Quest Diagnosis
The company started in 1967 as a pathology laboratory. After several rebrands and acquisitions by Corning Glass Works, Quest Diagnostics became an independent company in 1996. Their revenue cycle management product, Quanum, provides services to hospitals and private physician groups. They provide electronic health records, practice management software, and medical billing service using their financial solutions platform.
How COVID-19 Affected Medical Billing Companies
Small healthcare practices have been disproportionately affected by the COVID-19 pandemic, which in turn is impacting the businesses that serve them in the areas of medical billing or revenue cycle management. Big companies have not been immune, but are weathering the storm with more resources. As medical practices reduce the cost of survival, they also evaluate their overheads that can be eliminated. A survey found it:
85% of medical practices taking steps to reduce the financial burden
Nearly 37% of practices automate workflow
33% create new payment plans for patients
28% use remote payment options
It’s important to choose a medical billing or revenue cycle management company that fits the immediate needs of the practice and can grow with the healthcare provider in the future. In these unprecedented times, it is important to keep an eye on the future and pay close attention to the current circumstances. A strong medical billing or revenue cycle management company can partner with healthcare providers to offer their resources as changes in the healthcare system unfold.
Gail Morris is a freelance health and wellness writer. She worked as a nurse and nurse practitioner for over 20 years before hanging up her stethoscope and picking up the pen. She started her writing career 10 years ago and has since written 2 non-fiction books and is working on her third. Health and wellness is her passion and she loves to turn complex studies into actionable strategies that help improve health.