Emergency medicine advances everyday and, as a result, the cost of maintaining a high-performance, community-based service has dramatically increased. Ambulance providers face many unique financial challenges, foremost being the downward trend in ambulance transport reimbursement. Consequently, researching and finding the best billing method to maximize your cash flow is of utmost importance.
Billing companies can offer a wide range of services from basic claims submission and tracking, to provider enrollment and continuing education opportunities. Generally, billing companies have the specialized knowledge and resources to focus on the reimbursement issues that emergency medical providers confront. The best billing companies offer services such as electronic trip sheet import, federal program enrollment and compliance, educational workshops and electronic payment reconciliation which will save you thousands of dollars a year. Some companies offer these additional services at no cost to their clients, while some charge for any services extending beyond simple claims submission.
Clearly, one of the most important items to consider is the cost involved in out-sourcing your billing. It is imperative to evaluate billing companies based on end result value, rather than price. Like in most businesses, billing companies offer various fee structures and pricing scenarios. These fees can range from a fixed percent of the collected amount, to a standard per claim rate, or even a monthly fee. You must decide which works best for your company.
For instance, let’s say that your company runs 1,000 billable calls a year. Billing Company A proposes that they can collect an average of $250 per claim. Their fee is a low $10 per claim. You would pay $10,000 in billing fees. Company B proposes that they can collect $300 per claim and they charge 10% of the collected amount. This adds up to $30,000 in billing fees. On the surface, Billing Company A has a lower fee, but your bottom-line may suffer because they may not have a vested interest in the amount collected (they get their fee up front.) So, who would you choose? Billing Company A would collect $250,000 and you would pay $10,000 in fees, leaving you with a net income of $240,000. Company B collects $300,000 and you would pay $30,000 in billing fees, leaving you with a bottom line of $270,000. By focusing on the end result value, the answer is obvious.
This example shows how important it is to assess the cost/value ratio of prospective billing companies. Most billing companies should be able to calculate your company’s estimated future revenue in conjunction with the cost involved in collection. This estimate should take into account your call volume, payer mix and carrier reimbursement rates. Researching this information up front will allow you to make an educated decision when choosing the right company for you. You also want to be sure to look at the additional services each company offers, as this may save you money in other areas. As always, reputation does matter. Check with your neighboring companies to see who takes care of their billing.