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Before You Hire a Medical Billing Company Ask About These 10 Points

If you have never worked with a medical billing company before, it can be difficult to know what to ask about when you are trying to decide who you want to hire.

On the other hand, if you have previously outsourced your medical billing, but find that you need to change billing companies, you already know how important it is to get the right information up front, but you may not know exactly what to ask to get the full picture of what it will be like to work with that company.

Slick sales people can give you an answer that sounds good, without actually telling you what you need to know, so in addition to knowing what to ask, you need to know what to look for.

Over the years, we’ve heard a lot of horror stories from our clients who have had bad experiences with other medical billing companies, so we’ve put together this list to help you avoid the same problems. Before you make any agreements with a company, be sure the answers to these questions match your needs.

Top 10 Things to Look for in a Medical Billing Company

  • Proven System for Claims ManagementOne of the most important aspects of medical billing is having an efficient system in place for managing claims. Getting them filled out and sent in isn’t a problem for most billers; however, an enormous amount of money is lost every year because rejected and denied claims aren’t addressed—and inexperienced (or ineffective) billing companies will have a lot more rejections and denials.It is critical for the medical billing company to have a system in place for tracking and managing claims until they are paid so none fall through the cracks (or get ignored because dealing with them would be “too much work”).
  • Experience and Company Stability, Familiarity with Coding in Your FieldEven though billers have training classes, it still takes years of experience to master the complexities of medical billing. Every field of medicine has its own set of codes in addition to the general coding, so your medical billing company should also have experience billing in your field.In addition to individual billers being experienced, the company itself should have a track record that goes back several years, at least. You need to know that the company has a record of success and will be around for a while.
  • Fees for Medical Billing and Any Additional Charges, Including Packaged ServicesOf course you need to know how much the medical billing company will charge for their services, but be sure to also find out about any additional fees they charge. For example, is there a setup fee? Minimum monthly charge?Some companies include additional services with their medical billing and charge you for them whether you use them or not. It is important to only pay for services that you want, so make sure the fees for medical billing and anything else you will be charged for are clearly defined.
  • Implementation Time and Integration with Existing Software:  Changing medical billers involves a lot of work, but an experienced medical billing company should be able to make the transition very efficiently. Get confirmation that your system will not be offline, and your payments will not be delayed for an extended period of time during the switch.The right software is an important part of managing a practice and is critical for medical billing. Find out if the medical biller’s software will work with your existing software, and if not, how the two systems will work together.
  • Security and Data BackupHackers are constantly trying to access personal data, and medical records are a prime target, so your company must use data transmission with high security protocols in addition to being HIPPA compliant.Make sure they have a data backup plan so that your records won’t be lost if there is a fire or storm that damages their offices.
  • Old Accounts Receivable (AR)When the new medical billing company takes over, all the existing unpaid claims will be considered old AR. You certainly don’t want to lose all that revenue, so make sure a plan is in place to get those claims paid. Will the new company take them over? What will they charge for that?
  • Access to SupportWhen you have questions or problems, how can you reach the billing company? It’s important to find out who you will talk to. Some businesses use an automated “ticket” system, and you may not get called back for a few days. Make sure your new medical billing company recognizes you as an important customer and makes it easy for you to communicate with someone who knows your account.
  • Transparency and ReportingTo a large degree, the company providing your medical billing services has control over your revenue. That means the process needs to be transparent, so you can see how the process is working and see the status of claims and payments at any time. Reports are one of the main ways you can stay informed. What kind of reports will the billing service provide to you? You should be able to confirm that payments match actual bank deposits and that the time it takes to get claims paid is gradually decreasing over time (meaning the system is getting more efficient and there are fewer problems with rejections and denials). There are many more useful statistics that the medical billing company can provide. Will they give you updated reports as often as you would like? Some providers are happy with monthly updates, but most would like to have more frequent access to their numbers, especially when starting to work with a new billing service.
  • Additional ServicesIf all you want is claims management, additional services may not be important to you, but many clients find that once a billing relationship is established, they would like to have more aspects of medical revenue cycle management (RCM) taken care of. Being able to do this with a company they already have a working relationship with saves a lot of time and effort. Some of the most popular additional services provided by RCM companies include patient billing, payer credentialing and compliance audits.
  • TestimonialsAn established medical billing company should have happy clients who will attest to the success of working with them. These may be published on the company’s website, but you can also ask for referrals and may be able to speak to their clients directly, so you can feel confident you are getting the whole story.Medcare MSO provides revenue cycle management services to medical providers of all sizes. Our innovative system has proven to increase our clients’ revenue (up to 30% in three months!). Call Medcare MSO at 800-640-6409 to find out how we can help your practice make more money and run more smoothly.
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