Outsourcing Medical Billing - Questions and Answers for Doctors

Outsourcing Medical Billing - Questions and Answers for Doctors

Whether you are a physician with a one-doctor practice or a multi-doctor practice, the question of outsourcing your medical billing services must have come to your mind more than once. When a decision has been made to outsource, it is imperative to choose the right partner as billing could make or break a practice. In a previous article, I had specified the questions a doctor must ask while choosing the outsourcing partner. In this article, we will look at the answers to these questions and how that influences the decision.

1. Process

Does the billing company have a well-defined process for delivery? What are the artifacts available? How does escalation work? Do they have clear lines of responsibility? What are the SLAs? Are there safeguards for poor performance and termination plans?

Check on how the medical billing company would perform a specific operation and have them walk you through the various steps. Look for process documentation to ensure consistency. Interview the medical billing company on some real-life scenarios when a critical decision has to be taken and identify their escalation process and who the decision maker is. Analyze the SLAs and keep them within reach when a crisis develops. Make sure that SLAs carry a clear penalty clause for poor performance and contract can be terminated without complications.

2. Service Portfolio

What services does the medical billing company offer? Does it include a broad range across multiple functional areas or do they have deep knowledge in a narrow vertical? Can they offer other related services?

Evaluate the physician billing services offered by different vendors and ensure that they demonstrate the knowledge as well as the confidence to take up additional tasks. Interview the actual team and validate the knowledge of the team members.

3. References

Who are their customers? Can you talk to a current customer in your functional area to gain insight on the current delivery processes of the company? Are customers truly happy or satisfied with the billing company? Does the customer size match with your size?

Get a list of existing customers and interview one or two to get honest feedback on their working relation and performance. Check for signs of frustration, despair, happiness and contentment. Verify if the customers would renew their contract with the medical billing company.

4. People

Do you trust the folks running the company? Do you have enough information on the top management people? What kind of pedigree and experience do the people in the billing company have?

It would be great to strike a chord with at least one person at the top management team of the billing company. Verify the top team's credentials and experience and develop the confidence that they will deliver to your expectations.

5. Intangibles

Do you feel confident about the execution plan? Can you visualize a positive and growing partnership with the billing company? Are you fearful? Are you a micro-manager and would you require hourly and daily reports or weekly and monthly reports?

Ultimately, a well experienced, process-driven company can fail you and an inexperienced startup medical billing company might delight you as the former might be complacent and latter might be hungry and sincere. Based on the 4 points above, you should feel confident that the billing company will execute on the plan and you should be able to visualize a positive working partnership. It is imperative that you specify your expectations clearly to the billing company and let them know how they would be evaluated. Micro-managing an outsourced operation might not be pragmatic and it would be prudent to demand weekly reports along with specific details on any escalations.

Outsourcing medical billing operations is a practical and almost essential exercise for many small and medium doctor offices. The success of such an exercise will depend on both parties vetting each other and doing a thorough evaluation as mentioned above. A financially rewarding and mentally relieving experience awaits those doctors that find the right partner.

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