Transitioning to a New Billing Company for Your Medical Practice

January 21, 2012

How to manage the transition to your practice’s new billing company effectively, while maintaining your cash flow.

Congratulations on choosing a new billing company. It’s time to prep your staff, slow your spending, and make the difficult decision as to what you are going to do with all of that 120 and more “noncollectable” A/R.

There are companies and services available that for a nice fee will clean that up for you. If you are willing to walk away from a majority of that A/R to make a clean sweep, this might be the easiest way to get it over with and out of your life. They will still contact your office for missing or requested information to appeal originally denied claims, so your business will still be somewhat involved, and tasked with that gathering information.

You can ask your new billing company very nicely if they want to take it over. Many prefer to not take on some other billing company’s mistakes, but most will. A higher fee will be incurred since it involves a lot of resources on their end. They, too, will be contacting your staff for missing or requested information to appeal those originally denied claims.

There is a third option. It takes some guts to walk out on this limb, but if there is someone on your staff that you can pull away from some of their tasks, that you trust, find them today. Really believe that they have your company’s best interest at heart and ask them if they are interested in a challenge for a few months for a special project. Then turn them loose.

They will need to have access to the database of patients sitting in the 120+ A/R (from the old billing company), and will have to learn how to fill out a HCFA form per insurance (Your new billing company might be able to give them some pointers, or if you are still on semi-good terms, your old billing company.) I know this seems like a stretch, but it is possible. I did this for a company that I've been working with for several years. I called it “Billing Boot Camp.” I was pretty green at the whole billing process, but worked with the old billing company, and we managed to collect quite a bit of what was said to be noncollectable. You will pay much, much less in fees if you bring this portion of the transition in house. This in house person will have access to the chart notes, DX, authorizations, payment history, etc. That way the rest of your staff will not be bothered with phone calls and faxes coming in from other services requesting this information. You can also reward this person with a commission-type bonus based upon how much was collected each month.

It all really depends on how much cash flow you need to operate over the next several months while the new billing company steps in and up for you.

As you are transitioning, this is a great time for reflection on how you managed to get into a situation with a high 120+ A/R. I've heard and spoken with a lot of staff who claim they just don't have time to call on benefits, obtain the necessary authorization, collect copays / coinsurance / deductibles, etc. These are the first things you need to fix internally or you will most certainly find yourself sitting back in the 120+ wondering what just happened. You are ultimately responsible for your business, and no billing company - I don't care how good they are - can collect on your accounts if you do not provide them with the required documentation for claims submission.

The operations or business manager of your new billing company can sit down with you or your office manager and provide some necessary guidelines that will assist your staff with this compliance. It is a growing pain, and change is difficult, but considering your alternative, this is most certainly the lesser of two evils.

In my next blog post: I've made the move, now where's my money? Taking off the rose-colored glasses and looking at your new billing company as a colleague / partner.

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