How pediatric insurance billing services will benefit your practice

Medical billing is complex. From submitting claims to managing rejections and denials to payment posting to reporting, all of the processes involved in billing can be overwhelming for small pediatric therapy practices. Imagine being able to focus on patient care with confidence that all of these processes are taken care of. With the right pediatric insurance billing service, you can experience this ideal scenario. 

How a billing service works

Medical billing services fill in the gaps that many small practices experience because they can’t hire staff dedicated to billing. These services allow you to focus on revenue-earning tasks and client care, handling claims processing, submission, and more. All you need to do is send the data, and they take care of the rest.

Many companies also offer additional services, including verifying insurance coverage for new and existing clients, keeping track of unpaid client balances, assisting with plan applications and credentialing, following up on lost or unpaid claims from payers, and tracking claim authorizations. 

6 benefits of using a billing service in your pediatric practice

Your practice’s cash flow depends on billing for services. You must send accurate and timely claims to insurance carriers. But with a billing service, the benefits go beyond improved claims processing. Here are six reasons you may want to consider using a pediatric billing service.

1. Greater staff efficiency and more time for serving patients

Therapists need to focus on providing patient care. When they have to also handle the financial aspects of running a practice, they can easily become overwhelmed. But, for small offices with minimal office staff,  there simply may not be enough resources to have a dedicated person handling billing. By contracting out this work, your practice can focus on what it does best and leave the billing tasks to someone else.

2. Reduction in submission errors

Pediatric billing service companies focus on making sure that claims are submitted accurately and in a timely manner. They’re familiar with the medical codes and payer processes and requirements that must be followed to reduce the rate of claim denials. Billing companies can also navigate the denial appeal process and can help to provide feedback to maximize reimbursements.

3. Faster claims processing

By using a billing company dedicated to this task, claims can be submitted and processed faster. If you’re trying to handle claims submission yourself, chances are this task gets relegated to the end of the week or month — whenever you can make time. With a billing service, you have someone dedicated to ensuring claims are sent regularly and promptly.

4. Improved cash flow

By contracting with a medical billing company, your practice will have a reliable claims submission process. Because of this, you can depend on a steadier cash flow, which directly impacts your practice’s ability to pay salaries and bills in a timely manner. 

5. Improved profitability

In addition to a higher claims acceptance rate, greater profitability also results from being able to focus on patient satisfaction. Patients are becoming more educated on healthcare, and many practices are shifting to be more patient-centric. Quality of care expectations have increased. High levels of patient satisfaction ensures that patients will choose to work with you and happily recommend your practice to their friends.

6. Reduced per-patient costs

Lowering overhead drives down per-patient costs as practices become more efficient in providing quality care. Without having to pay a full-time salary to keep a billing specialist on staff, you will reduce the cost of care — which can benefit everyone.

What to look for in a billing service

It can be challenging to choose a billing service because there are so many, each with a slightly different service offering and specialization. Here’s what to look for as you’re evaluating your options.

Offers the services you need

Different companies offer different types of services — some offer only basic support while others offer a broad array of services. Make a list of the services you need, and look for billing companies that offer those specific services. This exercise will help narrow down your options.

Specializes in pediatric therapy

Though billing companies can work with any medical specialty, it’s always a good idea to find one that specializes in pediatric therapy. Team members will have specific coding expertise and will be familiar with any requirements for compliance and documentation relevant to pediatric therapy. Choosing a more general company that doesn’t have experience with your specialty may lead to coding inaccuracies and unnecessary claims denials. 

Has experience working with local insurance carriers

Every insurance carrier has its own way of doing things, from submission requirements to denial appeals. You want to find a billing company that not only has expertise with your area of specialization, but one that also has extensive experience working with your local insurance carriers. 

Has a clear and simple fee structure

Though it’s not wise to make a decision based on cost alone, it would be naive to think that cost won’t be a factor in the decision. You should be very clear about what you are paying for when working with a billing service. The fee structure should be simple and easy to understand. Ideally, it will offer different options for you to consider as you grow. Look for billing services that won’t leave you worrying about hidden fees. 

Has excellent reviews and recommendations

Ask for input from other pediatric therapists who use billing services. Find out which billing services colleagues enjoy working with and which they recommend you avoid. Read reviews to see what people say they like or don’t like about each billing service you’re considering. 

Billing services can be a lifesaver for small pediatric therapy clinics, reducing stress and allowing therapists to focus on providing quality patient care. And often, they provide a streamlined path to growth. Ultimately, they can help you have a healthier business, happier staff, and more satisfied patients. 

In need of a pediatric billing service? Look no further than Ensora Rehab Suite’s revenue cycle management solution!