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Third-Party Billing

First-off, let’s understand what third-party billing is in medical billing. Third-party billing services are a type of billing where the 3rd party medical billing companies perform as an intermediary that manages all types of billing and invoicing between healthcare practitioners, patients, or even hospitals. As it is evident, mistakes are entirely possible, even in the most professional environments. However, by outsourcing medical billing operations, you can effectively reduce most of these mistakes.

But before we go into the detailed benefits of hiring third party billing companies, we must understand:

What are Third-Party Billing Services?

Third-party billing companies such as Physicians Revenue Group, Inc., are the best billing outsourcing solution. Solutions for effectively managing medical billing and in-house payments for healthcare practices. Instead of your in-house staff dealing with complicated billing procedures, our experts with access to your EMR systems can handle all your claim submissions. Furthermore, our team also continuously follows up on all unpaid or denied claims. By outsourcing medical billing operations, healthcare practices can cut down on billing errors. Furthermore, we take care of the entire financial facet of your practice, so you can solely focus more on offering exceptional medical care.

Benefits of Third-Party Medical Billing Services

There are many reasons why most medical practitioners, hospitalists, clinicians, and small practices prefer incredible prospects of third party billing companies. In addition to saving resources, including energy and money, the 3rd party medical billing services facilitate patients and land them hassle-free billing experience.

1. Increased Revenue and Financials

Outsourcing billing operations to third party billing services providers improves revenue generation by sharply cutting overheads. These include expenditures such as office assets, salaries, equipment, electricity, and spending on billing software. Furthermore, this reduction in overall overheads will ensure on-time claims submission and facilitate enhanced reimbursements.

2. Ensuring Compliance

The healthcare industry in the USA is massively regulated, and it can become quite challenging to stay on top of all federal/state regulations. If a practice is not following the latest rules concerning patient data/information privacy, then they stand to lose out on compensation from both Medicaid and Medicare. Third-party or hospital billing companies will handle all compliance-related issues, as they carry a dedicated staff, including full-time compliance officers. These services can help your practice to get claims reimbursements efficiently and timely.

3. Cost Optimizations for Normalizing Billing Activities

It takes a lot of work, time, and effort to track who has paid and settled accounts and who needs to catch up. However, when you outsource to a billing company, you can enjoy a substantial reduction in efforts, and cost. Outsourcing your billing operations means you spend less money overseeing payments. This starts from the time of service to between reminders and finally being compensated. All of this means that your practice can allocate resources to higher-priority items, including enhanced patient care.

4. Amplified Safety Measures

All top and leading billing services providers comply with the HIPAA (Health Insurance Portability and Accountability Act of 1996). Most providers offer encrypted and top-level secure layered billing processes. The layered and encrypted billing process protects your systems from malware attacks or hackers.

  • What Is HIPAA?​

HIPAA (Health Insurance Portability and Accountability Act of 1996) is a federal law that necessitated the introduction and creation of national standards for protecting sensitive patient data. This data is kept from disclosure without attaining a patient’s knowledge or formal consent. Their third-party billing and coding service providers must maintain top-quality data centers for safeguarding and protecting confidential pieces of data while also keeping data safe by maintaining backups on multiple servers.

5. Ensuring Patient Satisfaction and Boosting Engagement

When visiting a hospital, a patient must complete and partake in many formalities, which takes a lot of time. This is due to the need to understand various medical jargon/terms and the costs of treatments involved. Thus, involving a third-party billing company is imperative, as such companies offer friendly and knowledgeable staff. The billing staff makes the entire patient experience hassle-free and offers happier patient outcomes.

What’s more, patients feel more relaxed regarding their visits to the doctor if they receive more personalized care right when they walk into your practice premises.

6. Unreliable Data/Information

When a claim has incorrect data, it often results in claim denials for the services rendered. It is advisable that medical practices invest in an alert system, so they are alerted whenever an inconstancy or error occurs. When an alert system is put to use, flagging the errors will keep the particular claims from getting processed and denied. Overall, this shall save providers more resources, including time and money.


Third-party billing in medical billing is an intermediary to manage billing and invoicing between patients and medical practitioners. Outsourcing your billing operations to a third-party billing company increases your practice’s overall revenue. Additionally, your finances get much better. Third party medical billing companies also ensure compliance while working to optimize costs for normalizing billing operations. What’s more, your practice can enjoy amplified safety measures.

Frequently Asked Questions

It is a process where an intermediary billing company handles the entire invoicing and payment processes of a medical practice and its patients.
The billing errors can cause delays in payments, loss of revenue, in addition to legal troubles. Medical practices and practitioners stand to face massive consequences owing to improper billing. These consequences include damaged reputation, regulatory penalties, and, most of all, loss of patients.
The top reason for claim denials is services not meeting the insurance company’s guidelines or policies. Denials in medical billing are when an insurance company decides not to pay for the services rendered by a practitioner to patients.



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