For smaller EMS agencies, difficulties with billing can have a multi-faceted effect on all areas of business. Small agencies may be dealing with billing struggles that stem from staffing shortages and high turnover rates. Considering the financial risks that go beyond significant resources required to maintain a dedicated billing team, these small agencies may be looking for a trusted, external resource to help with their billing needs.
Why then might small, struggling agencies reach out to a billing-as-a-service (BaaS) agency? On the other hand, why would larger agencies consider offering this service, and how can they optimize BaaS by leveraging software designed to handle it?
Billing teams need to stay on top of current, often complex rules, such as those related to Medicare, and not having experienced billers may cause trouble for small agencies. Inexperienced billers could over- or under-code, leading to major inconsistencies when reviewing revenue. This can cause compliance and liability concerns, leading to costly fines and/or delayed reimbursement due to claim rejections or denials. Therefore, having a third party handle billing could take the pressure off these small agencies and help prevent many of these risks.
Smaller agencies may seek out larger, more experienced EMS agencies with capable billing teams that offer multi-company BaaS. Relying on these larger agencies to provide the necessary industry knowledge and familiarity with local or regional regulatory environments can be a good option for small agencies looking to outsource their billing.
Large agencies considering undertaking multi-company billing should have a sizable, experienced billing team that has the resources in place to handle billing for smaller, “tenant” agencies. Once the right team is in place with the appropriate bandwidth, leadership can make the strategic decision to offer BaaS to diversify revenue sources beyond transport.
The experienced billers must be able to keep up with the constantly changing world of guidelines and regulatory updates. Agencies offering BaaS must also be able to manage the billing team so as to prevent liability (such as fraud) that could come about if billers incorrectly input data. Supervisors should assess the strengths and weaknesses of their billing team to decide whether or not they are capable of managing several agency accounts at once.
Multi-company billing management would not be possible without a simplified billing administration process. When managing multiple companies, each with individual national provider identifiers (NPIs), there is a risk of duplicated data when an automated process isn’t in place. Many provider’s payer requirements often feature unique rules and specific details that could potentially be billed in error if accessed manually.
With the right cloud-based billing software, billing teams can work from a single source of truth, through which configurable billing requirements and payer guidelines are referenced automatically and updated regularly. Certain data fields normally need to be re-entered manually, but with software solutions built to handle multi-company billing, this data can be saved within one configuration and easily passed between multiple companies for faster claim processing. With this, billers become more efficient, and the time savings in turn oftentimes positively impacts an agency’s bottom line.
A best-in-class software solution can also allow agencies to compare the performance of these tenant agencies in aggregate, tracking how much revenue is being collected on all claims. With these metrics in hand, billing agencies can then re-evaluate their team’s performance and decide if more training or education is needed on software, processes, best practices, etc. Overall, this leads to better revenue cycle management (RCM) and a clearer return on investment (ROI) when considering whether to continue multi-company BaaS as part of a much larger, long-term revenue plan.
Billing agencies should capitalize on the unique features of a best-in-class, cloud-based billing solution to make multi-company billing an attractive and viable option. Large agencies should look for a solution that provides:
Agencies that are interested in offering BaaS can transition more easily with a cloud-based software solution. This new potential revenue stream will save time and resources while assisting smaller agencies dealing with common staffing shortages and undeveloped teams. If your agency is thinking about diversifying revenue streams with BaaS, visit the ZOLL Billing web page to learn how our solution can help.