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Home » Practice Management

 

Choosing a New Billing Partner for Your Medical Practice

By P.J. Cloud-Moulds | January 14, 2012

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:

(MORE: Working with Workers' Compensation Medical Billing Codes)

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.

 

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More from P.J. Cloud-Moulds:

Medical Necessity: Physicians Need to Prove It to Payers

Smart Cards: An Intelligent Idea for Healthcare

Discussing Payment Options with Medicare Patients

Basic Medical Terms Your Practice Staff Should Know

Reviewing Policies and Procedures at Your Medical Practice

HIPAA Issues: Occurring Every Day in Medical Practices

Resolving Eligibility Issues at Your Medical Practice

Dealing with Patient Refunds at Your Practice

Working with Payers to Avoid Patient Visit Limit Bills

Making Benefits Verification Better at Your Medical Practice

Start Improving Your Medical Practice Operations Today

Diffusing Difficult Patient Interactions

Five Payer Pitfalls: Dealing with Patients and Their Insurance Plans

Three Ways to Improve the Claims Process at Your Medical Practice

Departing Medical Practice Staff: Be Prepared to Move on

Payer Success Starts with Empowered Medical Practice Staff

Addressing Problem Payers at Your Medical Practice

Telecommuting and Your Medical Practice: Could It Work?

Easy Steps to Improve Communication with Your Medical Billing Company

The Yearly Review: Measuring Physicians Practice Staff Performance

Payer Denials, Delays, and Managing Them at Your Practice

How Your Practice Can Overcome a 'Medical Necessity' Denial

How to Get What Your Practice is Owed in Payer Reimbursements

Reduce Unpaid Claims before Patients Visit Your Medical Practice

Motivating and Engaging Your Medical Practice Staff

Making the Most of Your Medical Practice Reports

Keeping Your Medical Practice’s Accounts Receivable on Track

Boosting Collections at Your Medical Practice: Whose Job Is It?

Transitioning to a New Billing Company for Your Medical Practice

Choosing a New Billing Partner for Your Medical Practice

Five Steps to Switching Medical Practice Billing Companies

The Lifecycle of a Medical Claim: Identifying Practice Problems

Getting Patients Involved When a Claim is Denied

Locating the Strengths and Opportunities at Your Medical Practice

Balancing Your Payer Mix: A Critical Necessity for Your Practice

Payers and Cascading Payments: Tips for Your Medical Practice

Five Common Denials Halting Payments to Your Medical Practice

Medical Insurance Primer for Practice Staff

Evaluating Your Medical Practice Billing Company

Implementing Change in Your Medical Practice

Getting Paid from Secondary Insurance at Your Medical Practice

Working with Workers' Compensation Medical Billing Codes






 
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