Medical practices have to take advantage of every initiative that will make them perform better, and outsourcing there billing activities is one of the most practical things they can do. However, finding the right service provider can be quite cumbersome. The following are some of the most essential questions that you ought to ask any billing company you are considering.
1. For how long have they been working in this field and how many years of experience do they have under their belt?
You are probably aware that medical billing can be a complex process to go through, particularly with the introduction of ICD-10. Experts working in the field have clearly stated that there is no substitute for experience. Even though there is no harm in having certified billers work for you, experience and common sense will ultimately have an impact on your bottom line. Most of the claims that are filed tend to be straightforward, but there are those that require the understanding of a physician’s coding habits and billing procedures. Despite the fact that a good coder can provide optimal results with any specialty, if you can secure the services of an experienced billing company in your particular field, it will help to make your decision much easier.
2. Just how HIPAA compliant do you happen to be?
A billing company simply telling you they are HIPAA compliant is not enough. Most experts will tell you that no business or medical practice is 100% HIPAA compliant. This is because there is always a continuum when it comes to matters of compliance. This is one of the main reasons why every healthcare provider is required to conduct an initial assessment, pick a compliance officer, appoint a HIPAA security officer, perform ongoing periodic assessments, and finally record compliance progress.
No physician wants patient data and claims being handled by a novice company. As a result, you should ask the about the company’s email security, business associate agreements, data security, fax security, and equipment and data destruction.
3. What kinds of reports will I get?
It’s important that you try to find out about the kind of reports you will get and their frequency. You can request for a daily, monthly or quarterly report to establish if it can work for your operation. Keeping transparency in mind, some medical billing services will provide you with a username and password so you can access the system remotely at your convenience.
There are certain billing systems that can provide you with special reports, or have the ability to adjust existing ones.
4. How open are you to the idea of adjusting to my processes?
Since you have your won systems in place, you can be open to the idea of minor changes, but not a total revamping for the benefit of your medical biller.
5. Will I be informed about contract issues when need be?
Not every billing company offers this service, so you should look for one that does. For instance, it’s important to know if your payers are reimbursing at 75% when in fact you contracted them at 120%.
6. What are the procedures in case people on my account get sick or go on vacation?
You should ensure that you receive the same level of service each day, even when the people who normally work on your account are out. Inquire whether the billing company cross train employees and can guarantee consistent service levels.
7. Which national, state or local associations are you connected to?
You should hire a billing company that stays up-to-date with regulatory and industry changes.
8. Who can contact for references?
In the same way you would do with any other employee, make sure you take the time to call each company’s references. Ask how long they have worked with the biller, and what was their overall experience.
Finally, you must look at the aspect of cost. In case a billing company fees are low, make sure they provide all the elements that higher priced companies do. The following are some of the services that tend to excluded by less expensive companies.
• Handing out patients statements in the appropriate time frame
• Following up on any ticket claims
• Working all accounts receivable (this usually includes what percentage of their presently over 90 days)
• Doing follow ups on denied claims (you have to establish if the get work out regularly or are simply shoved into a periods until things get slow)
• Taking the initiative on pursuing incomplete information sent in by the provider.
With the answers to the above questions in hand, you will be more than capable of choosing the best medical billing company.