How to Choose an Infusion Billing Company

Infusion therapy in the US is growing at a rapid pace. The infusion market size was about $11 billion in 2024. It is expected to grow at a compound annual growth rate of 7-9% over the next years. But why is there so much growth in the infusion companies? It is because more and more people in the US need therapies. That's where the requirement for an efficient billing process also comes and so do the billing companies.

Here, there's one issue. The healthcare staff performs almost all the healthcare processes. That's why they cannot give an ample amount of time for patient care. So, what can be done in that case? That's where the infusion billing company comes into the picture. The dedicated experts know the CPT, ICD, and HCPCS codes. These codes are helpful to streamline the claim submission process. Apart from that, these experts also know how to correctly submit the PA process.

Advantages of an Infusion Billing Company

As there are so many infusion companies out there, how can one choose the best company? What are the factors you should consider while choosing a billing company? That's what this blog will discuss. So, let's begin one by one.

They Have Enormous Coding Knowledge

Healthcare regulations are in a constant state of flux. It is because new diseases are coming every single time. The healthcare staff stay busy with almost all the healthcare operations. That's why they don't get adequate time to improve patient focus. So, check if the outsourced infusion billing company have the latest coding knowledge. These experts also have thorough knowledge of the HIPAA law to make sure no claim denial occurs. Hence, you can streamline your claim submission process with the help of these dedicated experts.

They Help With Prior Authorization

Prior authorization takes a lot of time to perform. It is because first, the staff need to verify patient eligibility. Then they collect important patient documents. Finally, they submit the correct PA request. Now, most of the outsourced companies don't have knowledge of the latest changes in the prior authorization process. That's why you need to check whether these outsourced infusion billing companies know the latest electronic prior authorization procedures or not. Apart from that, these experts should also have knowledge of working with the specific EHR system to carefully store patient data.

These Companies are Highly Cost-effective

Cost-effectiveness is one of the major reasons for hiring an infusion billing company. You have to pay salaries, software, and separate office space to the in-house teams. That's why these in-house teams incur a large amount of cost. At the same time, the outsourced experts don't need any separate office space. Hence, they charge a lower cost compared to the in-house billing team. Apart from that, these outsourced experts are highly trained so that they know all the little details of the claim submission process. Hence, that's one of the main reasons for choosing these outsourced experts.

Providing Dedicated Resources

Healthcare staff juggle almost all healthcare operations. These operations start with patient care and end with administrative tasks. But the staff cannot focus on one single task. They have to focus on multiple tasks at the same time. That's why none of their tasks are perfect. That's where the infusion billing company can be highly beneficial. These companies have trained resources who are available 24/7. These dedicated resources know all the intricate details of the billing process.

So, What Can be Done?

There are many benefits that the infusion company provides. But as there are so many companies, it's a little difficult to choose one. It has been observed that there are several challenges healthcare providers face. These challenges include coding and drug documentation issues, complex coding guidelines, and complexity in the documentation process.

Check if the companies provide help with the billing process of IV, epidural, subcutaneous, and intramuscular infusion. These companies help with billing for all the relevant medicines such as biologics. The analgesics, ketamine and lidocaine, require accurate knowledge of coding. So, check if the infusion companies have this vast coding knowledge. It will help you to choose the correct company for your clinic.

Check if the infusion billing company provides timely charge sheet delivery within the specified turnaround time. Moreover, check if the coders hold ICD-10 certification. It shows their proficiency and expertise. Furthermore, these companies have a 99.9% accuracy rate in coding, and they are 100% HIPAA compliant. These services also provide several pre- and post-billing solutions. These include eligibility verification, prior authorization, medical coding, re-authorization, delivery schedule, claims creation, payment posting, and AR management. Moreover, these companies can reduce your operational costs by a whopping 80%. So, if you are planning to streamline your billing process, you may consider hiring an infusion billing company.