How To Choose The Right Medical BIlling Company For Your Practice

How to choose a medical billing company for your practice ultimately comes down to a practical decision: whether the company can reliably improve collections, reduce denials, and maintain compliance for your specific practice type without increasing operational risk. 

At OmniMD, we see this decision play out everyday. Practices that align billing with documentation, coding and clinical workflows achieve more predictable revenue and fewer denials. Practices that don’t often struggle with avoidable rework and delayed payments. 

This guide acknowledges how to evaluate medical billing companies using practical, decision level criteria and reflects how much we approach billing at OmniMD. 

What Is A Medical Billing Company? 

A medical billing company is a service provider that manages the revenue cycle from claim creation through payment posting. 

This typically includes:

• Insurance eligibility verification
• Coding validation using Current Procedural Terminology and ICD-10 standards
• Claim submission to commercial payers and government programs 
• Denial management and appeals 
• Payment posting and patient billing 
• Financial and operational reports  

At OmniMD, billing is not treated as a separate function. It gets operated within the same environment as clinical documentation and electronic health records, which minimises gaps in between care delivery and reimbursements. 

Why Choosing The Right Medical Billing Matters 

Illing performance directly impacts cash flow, compliance and operational confidence. 

Across outpatient practices, generally accepted benchmark includes: 

• Claim denial rates between 5% to 10% 
• Clean claim rates above 90%
• Days in accounts receivable under 40 days 

Many billing problems originate before a claim is even submitted, often in documentation inconsistencies or coding delays. These issues are identified earlier and resolved faster when billing is closely aligned with clinical workflows.  

Who Should Use an Outsourced Medical Billing Company?

Outsourced medical billing is most effective when internal capacity or specialization is limited. 

It is often appreciated for: 

• Small to mid sized practices without dedicated billing teams
• Multi location clinics managing high clam volume 
• Specialty practices with complex payer requirements
• Organizations seeking predictable billing operations 

What Performance Metrics Should You Require?

Any billing company should be evaluated using an objective performance benchmark. 

Key metrics we recommend reviewing: 

• Clean claim rate of 90% or higher 
• Denial rate below 8%
• Claim submission within 24 to 48 hours 
• Days in accounts receivable under 40 to 45 days 
• Regular, payer level reporting 

OmniMD supports these benchmarks by connecting billing activity directly to real time clinical documentation.

How Do Medical Billing Pricing Models Compare?

Pricing models influence both predictability and accountability.

Pricing Model	Typical Range	Best Fit	Trade Off
Percentage of collection	4% to 9%	Growing practices	Costs rise with revenue
Per claim fee	$3 to $12 per claim	Low volume clinics	Limited scalability
Monthly flat fee	$500 to $2,500	Stable volumes	Performance risk
Hybrid model	Variable	Scaling practices	Contract complexity

At OmniMD, we often see indirect costs, manual reconciliation, reporting gaps, duplicated systems, have a major financial impact than the billing fee. 

What Services Must Be Included? 

Billing support should cover the full revenue cycle, not isolated tasks. 

At a minimum: 

• Eligibility verification 
• Coding validation 
• Claim submission and tracking 
• Denial management and appeals 
• Payment posting 
• Patient statement 
• Compliance oversight 
• Financial and operational reporting 

OmniMD blends these services into a single workflow so billing teams and clinical teams operate from the same source of truth.

How Important Is EHR Integration? 

EHR – Electronic Health Records Integration is mandatory for accurate billing. 

When billing is embedded within the EHR: 

• Documentation related denials decrease by 15% to 25% 
• Clean claim rates improve 
• Reimbursement timelights shorten 

OmniMD’s medical workflows are designed to function directly within the clinical environment, reducing handoffs, and manual corrections.

How To Compare Medical Billing Companies Step by Step?

A well structured evaluation leads to better long term outcomes. 

Recommended evaluation steps: 

• Confirm compliance with HIPAA and payer requirements 
• Validate specialty specific billing experience 
• Review real performance data 
• Understand pricing inclusions and exclusions 
• Confirm EHR compatibility 
• Review reporting cadence and escalation paths 
• Assess contract flexibility 

This framework mirrors how we guide billing decisions at OmniMD.

How OmniMD Approaches Medical Billing 

At OmniMD, medical billing is designed as part of care delivery, not as an afterthought. 

By aligning documentation, coding, billing and analytics within one system, teams gain clearer visibility into revenue performance, fewer preventable denials, and more consistent reimbursement outcomes, without maximising administrative burden.