10 points to consider when hiring a Medical Billing Company

Medical practitioners have to provide quality care to the patients while administering strenuous tasks for the smooth functioning of their offices and clinics. Amongst many such routine tasks, coping with finances can be especially burdensome and time consuming. To overcome the difficulties in handling the finances, medical practitioners prefer to outsource the medical billing & collection services of their practices to external medical billing companies. As much as these medical billing companies can buttress the clinic’s functioning, choosing an unparalleled resource amongst hundreds of such companies, holds a great deal of importance.

Here below, we provide you a list of top 10 points to help you evaluate a medical billing company on, before outsourcing your medical billing & collection services:

1. Experience: The presence in the market for quite some time and having withstood multiple changes related to insurance claims and other finances within the medical domain, bolsters the capabilities of a medical billing company and speaks volumes about its experience in handling billing services for similar practices. A medical company with such experience possesses valuable insights on handling tricky claims, fluctuations, and other complicated financial hurdles. Thus, putting faith in a company with substantial experience in providing medical billing and collection services can prove to be beneficial in the long run.
2. Client Testimonials: Checking client testimonials are a great way to know about the depth of the quality of services provided by the medical billing company. Researching and asking for such testimonials from the company itself is always a good idea when evaluating the worth of the company. You can even reach out to the company’s clients directly, to get answers of various questions related to the company’s service standards, such as clean claims, customer support, risk prevention, problem handling, response time and management, etc. which will further help you in making the right decision for your firm.
3. Knowledge Evaluation: A medical billing company needs to be well-versed with the financial knowledge related to the medical field in order to maintain the proper functioning of the clinics and avoid unwanted obstacles. Up-to-date knowledge of information such as the International Classification of Disease(ICD) codes, enables faultless coding for insurance claims. Thus, evaluating the cognizance of the person handling the billing of your practice becomes an important factor when choosing a medical billing company.
4. Versatility: Rules and regulations related to medical billing change as per the speciality of medical practices. Thus, the approach for handling billing for a gynecologist will differ from that of an ophthalmologist, and the same applies to other specialists. Therefore, a medical billing company that can offer its services to versatile medical firms becomes a more reliable option.
5. Extensive Support: A medical billing cycle is an extensive process that starts right from a patient’s appointment and ends at the reimbursement of the insurance claims. Meticulous management of each part of the revenue cycle is of utmost importance in order to avoid any hindrances in cash flow. Therefore, opting for a medical billing company that can efficiently handle each step of the billing cycle and provides end-to-end support including claim submissions, follow-up, payment processing, patient invoices, accounts receivable follow-up, etc. should always be amongst your top priorities.
6. Certifications: Another important factor that you should consider while choosing a medical billing company for your practice is the possession of certifications such as CMRS, AMBA, CMBS, ISO-certifications. These certifications offer reliability, and are an exemplar of service standards followed by the company. For example, a billing company that is Health Insurance Portability and Accountability Act (HIPAA) compliant is bound to keep your data confidential, thus facilitating security measures within the firm.
7. Transparency: Transparency in the working relationship between a medical practitioner and the medical billing company is vital for the smooth functioning of the practice. It is your undeniable right and responsibility to gather important data such as cost bifurcation, hidden costs (if any), service bifurcation, etc. which are necessary to uphold transparency between you and the company.
8. Staff Turnaround: Important information like staff turnaround can provide you with insights about the work environment of the company. You will be prone to inconsistent billing management when working with a medical billing company with a high staff turnaround time. Similarly, knowing about the staff strength will help in determining the capability of the company to withstand work pressure. Larger firms tend to provide better services, even when they are inundated with tasks.
9. Denial management: Reimbursement of medical insurance claims is a complicated and time consuming process that can offer a considerable amount of hurdles. Amongst all, claim rejection is an unavoidable scenario. Claims can be rejected for several reasons, which can be redressed by determining the cause and putting in preventive efforts and with timely follow-ups. However, denial management isn’t offered by all the medical billing companies. Therefore, outsourcing to a company that offers such services is bound to be propitious for your firm.
10. Contingency Management: It won’t be an exaggeration to say that the COVID-19 has shaken the entire medical industry. Because of the pandemic, major changes were made by the government in the rules and regulations related to medical billing. For a while, coping up with these changes became a strenuous task for almost every company. This situation has asserted the fact that such contingencies are inevitable, and one has to be always ready for such scenarios. Therefore, demanding contingency management from the medical billing company has become a necessity.