Submitted by Antonio Arias, MBA, CHBME on Tue, 10/28/2014 - 10:00

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Considering A Medical Billing Service? 5 Questions You Need To Ask!

As the end of the calendar year approaches, many practices perform self-audits to determine areas where their practice management systems and processes can improve.  Billing and compliance roles are often at the top of the list.  Is your practice overwhelmed with the multiple layers of non-clinical duties, such as reporting and compliance programs?  Are you considering outsourcing these tasks by partnering with a revenue cycle company?  If you answered “yes,” here are five important questions you need to ask any billing company to ensure a successful partnership and a return on your investment.

  1. How quickly will they be able to begin processing claims?  In a typical situation, 30-60 days provides enough time for the company to begin services.  Now, this is not an exact science and many factors will play into this timeline.  For example, if you do not need to change your practice management software and they are versed in the practice's software, this could be a very quick transition.  In this instance, the main focus would be on creating user credentials and providing software access to the medical billing company.  If this is not the case and the practice management software is not on the same system, the timing will be affected by whether data is going to be exported, imported or manually entered.  Also sufficient time will be required to set up electronic connections to the various payers, leading to a potentially longer implementation timeline.  The company that you are considering should be able to provide references for practices that had an implementation plan similar to yours.  Reach out to those references and if they had a positive experience, it will be proof that your partner has experience in this type of implementation. 
  1. What are the services that will be provided?  Revenue cycle management  is a complex process, which involves a variety of important tasks.  It is vital to clearly identify each of these tasks, and assign them to either the practice or the medical billing company.  Not every medical billing contract is the same.  For example, your practice might want to input charges on-site, while another practice might choose for the billing company to not only enter the charges, but also complete the coding for the encounters.  All steps need to be discussed and clear expectations set.
  1. What kind of training does the staff receive?  Proper training of a medical billing company's staff is essential to maintaining their core competency.  Before you engage in any agreements, confirm that the billing staff is certified and receives continuing education to maintain their certifications.
  1. Who will handle the current accounts receivable (A/R)?  It is important to determine who will be handling the current A/R before services begin.  To minimize the chances of old non-paid claims falling through the cracks, the best practice would be to start fresh, especially if you are changing practice management software.  Some companies will take on the current A/R and run the old claims out.  This is also something the practice can decide to keep in-house and manage themselves.  Either way, for about 90 days, depending on the total amount of A/R, there will be two different billing processes running concurrently.
  1. Will monthly financial reports be provided?  And how?  A strong medical billing company will not only provide you access to your monthly financial reports, but will also automate and interpret these results for you.  The reports will provide the practice with monthly financial summaries, highlight trends, and offer advice based on the practice's results.  Access to financial dashboards for 24/7 monitoring should be available, and will allow quick confirmation that key performance indicators are being met.  A good medical billing company will establish KPI’s and set standards for monitoring.

A reputable billing company should be willing and able to quickly answer each of these questions, and have processes in place to complement these key activities.  A strong medical billing services partner is a team player and excited to be an extended part of your practice...

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Topics: Picking a Medical Billing Company, Medical Billing, Revenue Cycle Management

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