Hiring a medical billing company makes sense for many practices, but it’s important to ask the right questions so your practice makes the right choices. Here are some essential questions to ask the companies you’re considering.
Here are some essential questions to ask the companies you’re considering.
1. How long have you been working in this field and how many years of experience do your billers have?
Experts in this field tell us there’s no substitute for experience, not even certification. There’s no harm in having certified billers, of course, but experience and common sense are what counts. A majority of claims are straightforward; but the rest require understanding the physician’s coding habits and billing accordingly. Although a great coder can be successful with any specialty, if you can find a company with billers experienced in your specialty, it should weigh heavily in your decision.
2. How HIPAA compliant are you?
Simply getting a “yes, we’re HIPAA compliant” is not enough. Experts know that no practice or business is 100% HIPAA compliant; there’s always a continuum when it comes to compliance. That is why every healthcare provider or service is required to do an initial assessment, designate a compliance officer, designate a HIPAA security officer, and do ongoing periodic assessments, and then record compliance progress.
No physician wants claims and patient data being handled by a novice. Ask specific questions about the company’s business associate agreements, email security, fax security, data security, document destruction, and equipment destruction (those computer hard drives may still have your patients’ PHI on them!).
3. What types of reports will I receive?
Find out everything you can about the types of reports you’ll be getting and their frequency. Ask to see a sample of daily, monthly and quarterly reports to determine if they’ll work for your operation.
4. Can you guarantee transparency?
Transparency is the key. Some medical billing services will offer you a username and password so you can log into the system remotely and run practice management and financial reports at your convenience. Some billing systems can produce special reports or have the ability to adjust existing reports to suit—others will not. Now is the time to establish a comprehensive understanding of what you and your accountant will need by way of financial reports and make sure they’ll be available.
5. How willing are you to adjust to my processes?
You have systems in place, and although you should not be adamantly against all change, neither should you have to entirely revamp for your medical biller.
6. Will your operation alert me about contract issues?
Not all billing companies provide this service, and you probably want one that does. You want to know if one of your payers is reimbursing at 75% when you’re contracted at 120%, right?
7. What happens when the people on my account go on vacation or get sick?
Make sure you’ll receive the same level of service every day, even if the people who usually work on your account are out. Ask if the billing company cross trains employees and guarantees consistent service levels.
8. Which local, state and national associations are you affiliated with?
You want a billing company that stays informed about regulatory and industry changes.
9. Who can I call for references?
Just as you would with a new hire, take the time to call each company’s references, asking how long they’ve worked with the biller and what their experience has been.
10. What is the pricing breakdown for your services?
Finally, of course, you must ask about cost. The important thing is to ensure you’re comparing apples to apples. If a company’s fees are low, make certain they provide everything the higher priced companies do. Here are some examples of services often skimped on by less expensive companies:
- Sending out patient statements in a timely fashion
- Following up on low-ticket claims
- Working accounts receivable (what percentage of their bills are presently over 90 days?)
- Following up on denied claims (do these get worked regularly or shunted into a pile until there’s a slow period?)
- Being proactive about pursuing incomplete information sent by the provider
With the answers to these questions in hand, you’ll be more than ready to choose the best medical billing company for your practice.
Last Updated on August 4, 2022
I think when it comes to medical billing, it is great to have people who have experience in the field. I remember once I received a bill from a medical billing company that made no sense and I had to go through the headache of making sense of it through numerous phone calls. You want a company that will do it right the first time!
This had some great information on how to choose a medical billing company. I think you’re right that a good place to begin in by establishing an understanding of what you and your accountant’s needs are. I figure that’s a great way to eliminate some of the options that might not offer the services you need.
It’s interesting that you mentioned asking about how often you will be receiving reports. I will be starting medical school soon, and I was planning on going into private practice after that. I can see how it would be smart to find a billing office that will give you frequent reports, that way you won’t have to worry about missing any information.
I like that you talked about asking to see a sample of daily, monthly, and quarterly reports. If my dad were looking to hire an billing service I think he would find great value in that tip. I think I will talk to him about seeing a sample of their work before hiring.
In addition to considering how many years of experience a medical billing company has, checking with a service like the BBB to make sure that they are trustworthy and well-liked would be really helpful.
You made a great point about finding a company that is up to date on any changes in the industry. It would be smart to choose an up to date billing company because they would use the most recent best practices available.
What you mentioned about getting references is a great way to make sure you are getting the best of the best. Picking a company would be really hard without good references.