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5 Things to Consider When Selecting the Right Medical Billing Service

I do understand this is a very difficult for anyone to do, but here are is a way to do it. Choosing the right Medical Billing Company from all the Medical Billing providers available is one of the most crucial business decisions a physician, practice manager or facility administrator must make. In practice, with over 7,000 Medical Billing Companies in the US, the decision making process can be rather difficult. Therefore a number of factors are important to consider:
  1. Experience: Spend time analyzing the company website for information on processes, track record and scope of the organization.
  2. Data Protection: Bills submitted by a reliable medical billing company should have full audit trial without a delete option. This will protect data in the submitted bill and reduce the possibility of fraud or mismanagement.
  3. Performance and Service: All companies claim to provide higher reimbursement levels and shorter lead times on reimbursement. Select a company that highlights an institutionalized process model. Additionally select a company that manages the billing process from A to Z. Companies responsible for the entire process chain are generally more accountable than companies that only handle one aspect of the billing process. The process includes, Data entry and submission (The importance of a fast and accurate process management cannot be overestimated; a good service provider will submit the bills within 48 hours of receiving claims), Payment Posting, Patient Billing, and Denial Follow-up.
  4. Location: In today's global economy the possibility of providing billing services on a cross boarder basis is now a reality. While many overseas companies are more than adequate to perform the task, keep in mind that your patient population will frequently interact with your medical billing company.
  5. Reporting: Select a medical billing company that provides frequent reports to help track both practice and the billing company's performance. Ideally select a company that provides internet access to their practice management system. This live interface will help you monitor the how the company is working for you in real time.
Based on these 'must haves', the following list provides a good process template for running your search process. Remember hiring a medical billing company is no different than hiring an employee or any other service provider. The same attention to process and detail should be given.
  • Shortlist: Create a shortlist of possible Billing Companies. Given the number of such companies in the US, finding candidates won't be an issue; start with 5 to 10 candidates based on the high-level criteria listed above.
  • Criteria List: Develop a criteria list that defines your key concerns and primary issues which have caused you to seek third party services; identify your needs, wants and have nots.
  • Interview: Contact and interview the Medical Billing Companies on your list. Use your needs and have not criteria to refine your short list to a handful of companies. Ask for a reference list and take time to thoroughly check all references.
  • Negotiate: Review Contracts and negotiate deal terms with your top selection. Key terms include contract duration, termination triggers and procedures, services you may desire that are not part of the core price, and mutually agreed performance standards (average days in AR etc.), as well as price. Keep in mind that price should not be your defining decision maker. A good company charging a higher percentage is always better than a poor company charging a lower percentage.

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