Selecting a Billing Company

September 1, 2008

I am in the process of breaking away from a six-physician practice to open my own office. While together, we amassed quite a bit of hardware, software, and other electronic gadgets. I am realizing that the price of upgrades and maintenance for all this may be more of a luxury than a necessity. For one thing, as a large group we had in-house billing. As a soon-to-be solo doc, I am strongly considering outsourcing this service. What should I take into consideration when deciding among outside billing services? Should I look for one that would work off the same software I use? Should I abandon what I have and use whatever system they offer?

Question: I am in the process of breaking away from a six-physician practice to open my own office. While together, we amassed quite a bit of hardware, software, and other electronic gadgets. I am realizing that the price of upgrades and maintenance for all this may be more of a luxury than a necessity. For one thing, as a large group we had in-house billing. As a soon-to-be solo doc, I am strongly considering outsourcing this service. What should I take into consideration when deciding among outside billing services? Should I look for one that would work off the same software I use? Should I abandon what I have and use whatever system they offer?

Answer: The key factor to consider with outsourced billing is vendor accountability. You need to understand how much they are collecting, whether and how they are working denials, what their cut is, and what you can do in the practice to improve collections. For example, if you lose money because of eligibility problems, that’s something your office needs to fix, not the billing company. It is worth paying more for better outcomes.

You also should look at software such as that from Navicure or athenahealth, which essentially do both billing and full revenue-cycle management. Think of these and other similar products as online management software aimed at billing and collections. It’s a step above outsourcing billing with lots of knowledge of payer contracts built in. This may or may not be a better option for you; investigate and decide.

Generally, I’d focus less on technology and more on how to retain as much of the money you’ve earned as possible.