Keys to choosing a medical billing company for your practice

Sure, all billing services say they will maximize revenues, but how confident are you that the companies you are considering can actually do it? Take every function of the billing process as well as the people who perform the work into consideration.

This may seem similar to the above, but it is so important (in our opinion) that it deserves its own category. How do they perform insurance and patient follow-up functions, and how in-line are these processes with your ideal expectations?

Look at the entire spectrum and everything in between. Are you dealing with a “mom and pop” shop and the associated risks? Does the opposite end of the spectrum better suit you? Is the company subject to the whims of venture capitalists and investors? Are they profitable? Are they going to be around to serve you in the long term? No answer is right or wrong, but they need to be compared to your expectations and desires.

While the ability to maximize revenue is most important, you should also choose a company that provides you with a practice management system that comfortably suits your needs in a variety of ways such as appointment scheduling, data transfer, patient tracking, and reporting. Systems should be highly accessible, user-friendly, and have extremely high-level functionality. You may also want to make sure that the system provided can seamlessly work hand-in-hand with Electronic Medical Records (EMR) systems both now and in the future.

The internal structure of the organization should be conducive to both maximizing reimbursement and to customer service.  Determine if they use billing “assembly lines”, or if they have a one-on-one or small team approach. Make sure the company structure makes sense to you and meets your expectations.

It is important to note not only the experience of the company, but also the experience levels of the actual specialists, supervisors, and managers who will work on your account.

You can often tell a lot about a billing company by their internal procedures and protocols. Believe it or not, many don’t have any. Ask what type of quality control initiatives they have in place. See if these initiatives are formalized.

There is not a salesperson in the world who won’t tell you that the company they represent has the best customer service. So dig deeper. Ask about policies. Speak to references. Most importantly, make sure the structure of the company does not hinder your access to the specialists who actually perform work on your behalf.

Make sure that data regarding billing is available to you at all times. That means charge data, payments, outstanding claims, user notes and follow-up detail should only be a few clicks away. This level of transparency ensures that you can audit your billing service and maintain complete control over your practice.

Make sure that your billing service has a formal and correct HIPAA and OIG compliance policy. This is essential in ensuring security for both you and your patients.

Different billing companies treat patient billing and calls in different ways. Check into the procedures and tactics used to collect payment from your valued patients. They should not only be effective, but should also reflect the manner in which you want your patients treated.

Many billing companies have their back office (actual billing) performed overseas. Are you comfortable that overseas billers directly control your future earnings? Are you comfortable with them speaking with your patients? There is no right or wrong answer, but just make certain that what is offered is consistent with your expectations. Want to know where we stand on the topic?

Ask yourself if your practice is going to have to completely change the way you function just to accommodate your billing service, or if they are willing to work with the way you operate. A billing company should have options, which integrate seamlessly with your practice’s processes and not require significant change or realignment.

What is the overall cost? Look at the details. What is included and what is buried in the fine print? Are things like software, training and postage included? Are there startup fees or any hidden costs? Do fees seem exorbitant or perhaps even too good to be true? Sometimes you get what you pay for (good or bad). Make sure to compare apples to apples. What good is it if you pay a billing service 2% less, but collect 10% less in revenue?