Medical Billing Best Practices

Essential Questions to Pick a Medical Billing Company

Asking these questions will help you pick the right medical billing company for your practice

Needing to pick a medical billing company, or RCM partner, can be one of the most nerve-wracking tasks that has to be done for your practice. Whether you are switching billing companies or looking to outsource billing functions for the first time, this guide will help you find the right medical billing partner. So how do you find the right fit for your practice?

The process to pick a medical billing company that fits your needs

The answer to this question rests on an honest evaluation of your operations and establishing your goals. For example, if you are convinced that your current billing company is not capturing all charges, before making a final decision to change, be sure to examine your operations and confirm the issue is not within your organization. No outside party can fix problems within your practice.

Setting clear goals is also essential. If your sole purpose is to cut operating costs, there are many choices that will do just that. But for most healthcare organizations, there are additional reasons such as collecting more revenue, decreasing days in A/R and simplifying administrative tasks that weigh heavily in the decision. If your approach has solid goals, you will be better equipped to make the right decision.

Questions to pick the right medical billing company for your practice

Who owns the data?

It is essential to understand what happens to your information if you
and your billing company part ways. Will the company retain the files, or will the information be transferred to your organization?

How is your staff trained?

Do any of your staff hold industry certifications? Medical billing can be complicated and is always changing. If staff is regularly trained or holds current certifications, it is an indication that the billing organization has put a priority on staying current in the industry.

Do you regularly audit to confirm we are receiving the right contractual amounts?

The billing organization you choose should be your partner when it comes to making sure payers are fulfilling their obligations and ensuring you are receiving the reimbursements you deserve.

How will I be informed of performance?

Each billing company has its way of reporting. Some forward standardized paper reports monthly, while others give their clients access to analytic dashboards. Some companies meet with their clients regularly and others only meet when requested. The vetting process is the time to ask about any customized reporting you require.

What DON’T you handle?

This is a critical question! Think through all the responsibilities
you will expect your new billing organization to manage and confirm they actually do them. For instance, do you expect them to handle all patient billing questions? Send statements? Forward uncollected accounts to third parties? ERA/EDI enrollments? Credentialing? Process refunds back to patients? Establishing a service model that meets the needs of your practice is an essential step in selecting the right medical billing company.

What support will you need from our practice?

This question is perhaps the one that is most often overlooked. Billing companies will need someone in the medical practice’s office to act as the primary liaison responsible for making sure the agency gets the information it needs (for example, forwarding documentation requests to the provider and then returning them to the agency). For larger healthcare organizations, more than one support person may be needed to keep the revenue cycle running smoothly.

Wrap Up

The central concept to bear in mind when choosing a new billing partner is that neither side wants surprises. If you are prepared with a solid picture of what your practice needs, issues you are experiencing and ask the right questions you can then confirm everyone is on the same page with responsibilities and you are much more likely to create a successful partnership.

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