Choosing a New Billing Partner for Your Medical Practice

January 14, 2012

How to choose your medical practice’s new billing company - what questions you should be asking.

Last week, we touched on the steps you need to take prior to making a switch between a poor performing billing company and a potential new one. Here are some questions you can use to “interview” a new company, and the areas you should focus on during this process.

There are so many reputable billing companies out there, and so many that are not. The most important thing to remember when going through this process is: “Will this be a good fit for my business?” By good fit, I mean: Does the company you are looking at manage businesses your size, well? You can be a single private practice, or have 30 locations throughout the country. If they are a small billing company, and you have many locations, chances are that's not the best fit. Once you have narrowed down your options, here are some other very important questions to ask yourself and your potential new billing company:

1. What is your rate? Although this is a very important question, and you must know this in order to move forward with the conversation, keep in mind that if a company is going to provide you with amazing service, that extra 1 percent might just get you to a much better place with your business, and well worth it. Keep an open mind.

2. If we collect the patient co-pays and co-insurance, or if a patient pays a cash rate, do you still collect your percent with those monies collected? The answer should be “No.” If you and your staff are taking the time and effort to collect this up front, that money should be 100 percent yours. There are no administrative costs incurred to the billing company (time, printing statements, mailing, etc.) so they should be not be adding that into your bill.

3. Do I have a designated representative that I can talk to and they work on my accounts, consistently? The answer should be “Yes.” With the insurance industry as volatile as it is, accounts get really messy and it’s important that you have the same people working on your accounts. If a patient calls in and asks to speak with your rep, they should be able to get them on the phone. Remember that this team is an extension of your business.

4. How do you handle payment denials and delays? This should be an easy one; the answer should be “quickly and efficiently.” They should be asking for items from your staff which might include: copy of health card, RX, DX, copy of initial evaluation, chart notes, etc., every week, if not more often. The quicker you can get these items to them, the quicker they can appeal. We know that some unsavory insurance companies will deny up front in order to delay payment. A good billing company knows who these insurance companies are and can help you get paid on those much quicker.

5. Who keeps track of my business statistics and analysis? This answer should be you. You are ultimately responsible for your bottom line. However, a good and reputable billing company will have this information available to you on a daily basis through a website or portal. It is very important to know how to access your daily A/R, and if this is not provided, I would certainly call this a red-flag. They should also have business analysis individuals who can help answer any questions you may have, and be happy to do so.

6. Can you help me integrate my EHR with your billing company? This should be yes, most definitely. However, some billing companies are scrambling to make sure their systems are “talking” with all of the new EHR systems coming out every day. Ask them up front which systems they are compatible with.

Ask around to your colleagues and see who they are using, if they are successful, and what they do and do not like about their billing company. But always be sure it is a good fit for you. If you do not feel they will get the job done the way you need it done, then move along.

Making the transition, you may be asking: What about my old A/R? Look forward to next week’s article on how this can go really smoothly, and how you can help make that happen.

Find out more about P.J. Cloud-Moulds and our other Practice Notes bloggers.