Partnering with a medical billing company is a big decision. There are a lot of choices out there. You may have some questions that are specific to your needs, but the following questions should apply to any practice.
Do they have an accredited compliance plan in place? Are they HIPAA compliant? What are their security protocols?
What will it cost? This is always the main thing on everyone’s mind. Ask about start-up fees, termination fees, data conversion fees, and any other additional costs. Some companies charge extra for patient collections to follow up and other services.
What kind of training does the staff have? Are they certified and what type of ongoing training do they receive? They should be using the most up-to-date resources and guidebooks (i.e., CPT, HCPCS, etc.)?
Can they provide references? Have they worked with practices that are like yours in size, scope, and/or specialty? Do they have testimonials, or can you call someone directly for a reference?
Who owns your billing data? Your billing data should belong to you, and you should be able to take it with you if you choose to change services or bring your billing in-house.
Do they have any professional affiliations? Do the employees, maintain any professional affiliations such as HBMA?
Can you get a guarantee of transparency? They should share the financial state of your business and the billing service’s progress.
Are most of their services electronic? Most of the processes should be electronic from eligibility verification to remittances.
Are there billing follow up items that they don’t handle? Don’t assume that a billing service will do everything or that everything is included in your rate. Ask up front and be sure you know if there are services that they don’t offer.
How does the billing company stay informed on coding changes? ICD-10 and CPT codes are updated annually and when needed, as with COVID-19 related updates. How does your billing company keep up? The medical billing company have enough resources to participate in industry seminars and association meetings covering all your specialties.
Does the billing company offer customized support to clients? Partnering with a company that can help providers introduce new services and procedures is extremely valuable, including coding guidelines. In challenging, or experimental procedures, does the company help providers with coding requirements to enable them to be properly reimbursed? Your billing or coding company should be equipped with the necessary coding expertise and technology to help client’s revenue cycle management.
It is worth taking your time to evaluate and ask the right questions as you make the important decision to partner with a billing company that will be crucial in your overall success. Use these questions to help guide your decision when selecting a medical billing service