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How Much Do Primary Care Physician Billing Services Cost?


Covering perhaps the widest demographic in all of healthcare, primary care physicians provide care to patients across a broad spectrum of ages and socioeconomic groups and administer treatment for a variety of behavioral, mental, and physical health issues. Because of the amount of medical knowledge required across multiple areas, primary care physicians have a lot on their plate, and worrying about billing isn't necessarily a top priority. Instead, you can hire a primary care physician billing service to manage the billing process, ensuring that finances are handled by dedicated professionals and physicians can focus on their patients.

Why You Need a Primary Care Physician Billing Service

Whether you operate a large facility with multiple practitioners or a small one with a single doctor, billing is an important and necessary aspect of healthcare. Being a primary care physician is a busy job that requires a lot of attention and focus to a diverse group of patients; for some, a primary care physician is the only doctor they see. With such a high focus on so many different types of patients and procedures or treatments, adding billing to your workload may cause things to be forgotten or mistakes to be made. If you hire dedicated staff to handle billing, you have the added expense of salary, benefits, and resources to do the job (desk, computer, etc.).

A primary care physician billing service takes away some of that stress by managing all aspects of medical billing and leaving you and your staff free to perform other tasks. Many billing services also have certified staff to ensure the process is as accurate as possible.

Primary Care Physician Billing Features

Primary care physician billing services manage all aspects of the medical billing cycle and offer several different features to help your practice. Some features include:
  • Accounts receivable management: Billing services work to solve any claim issues in order to secure fair and proper payments from insurance companies.
  • Appeal filing: In addition to handling claim issues, billing services will also handle any appeals with the insurance company on your behalf.
  • Data entry: Services gather information from physicians to be entered into the system. If a medical coder is being utilized by the service, they verify that all the correct codes have been used to ensure proper payment is received.
  • Payment posting: Payments from insurance companies are posted in real time to keep account statuses up to date.
  • Primary care EHR consulting: Some billing services will make recommendations on different EHR (electronic health record) solutions to provide you with the complete package.

What Will I Pay for Primary Care Physician Billing Services?

Costs vary widely based on numerous factors, including the size and location of your practice, the number of providers, and the billing method employed by the service. The two main options are a flat rate and as a percentage of the amount collected.

Billing services that charge a flat fee per claim usually cost $1 to $8 per claim, with the typical practice paying between $4 and $6 per claim. If a service uses this fee structure, ask whether they separate the cost of inpatient and outpatient claims.

Other billing services will charge a percentage of collections. These fees tend to cost between 5% and 10%, though some companies may cost as much as 15%. Typically, companies charging higher percentages only get paid if you do, so you may be better off with this structure.

While cost is a major factor in deciding which billing service to hire, it is not the only factor that needs to be considered. A company that charges more may increase your total collections and make up for the steeper fees. Make sure to ask for all available references. In addition, request a full breakdown of all associated costs and read any available reviews before making any final purchasing decisions.

Benefits of a Billing Service

There are several benefits that come from hiring a primary care physician billing service that go beyond just taking the billing process out of your hands. Utilizing a billing service greatly reduces the amount of errors, operational costs, and time spent keeping up with codes and laws that occur when medical billing is performed by the practice itself. Billing services also take care of any possible issues with insurance claims and perform checks on insurance forms to ensure appropriate and timely payments.

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