Medical Billers- Nine Tips To Help You Select One

Often, medical practices decide to at least explore the idea of using a third party medical billing company

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Between new laws impacting the security of patient information and the difficulty of maintaining a billing staff, the idea of outsourcing this function might be good business.

When vendors are plentiful, the choices are greater but making a choice is tougher. Following are some factors you may want to consider when reviewing medical billing companies:

Determine Service Scope- Decide what you're seeking to outsource- appointment scheduling, EMR (electronic medical records), and/or billing. If it's billing alone, is it electronic submission, posting payments, reconciliation, second notices, patient billing or researching billing questions?

You might want to focus on a company who processes claims accurately and aggressively follows up on unpaid bills. And can prove it.

Billing Metrics- Determine what you want to have the billing service measure. You'll want to know the basics like what percentage of your money comes at certain checkpoints after billing. Can you obtain customized reports? Is 24/7 data available?

Laws and Regulations-Check if the firm is in compliance with the FTC's Red Flags rule being implemented in late 2009 and other HIPAA privacy measures designed to prevent identity theft. Make sure the firm stays current on all regulations.

Billing Timelines- Make sure the company is aware and complies stringently with patient, insurance and Medicare billing timelines.

Follow Up System- Ask to review the billing service firm's follow up schedule. Make sure it's aggressive and active especially with insurance companies. Make sure the company has a sound monitoring system in place to make sure government reimbursement programs pay on a timely basis.

Technology- Review the technology the company uses. See what platforms it supports. Inquire about the skill level of the staff. Are regular training seminars provided so the employees can process the bills with as few errors as possible?

Other Services- Inquire about the full scope of services the company offers. Medical billing services range from single work at home processors to large companies with several hundred or even thousands of employees.

You may want to think about what your practice might need down the road or even expand your scope to include more than billing.

References- Ask for references and contact them. If possible, you may even be able to go to a client of the firm and see the billing practice in action.

Troubleshooting- Find out how the company handles problems or disputes. Every company is great when all is going smoothly. The mark of a true partner is one who responds quickly when out of the ordinary situations arise

See if there is someone assigned to your account who will help you in those cases.

by: Ronald McLaughlin

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