medical billing and coding services

In order to find a good medical billing company, you need to be certain about your billing needs. “Billing” is a broad term that encompasses many different jobs. Medical billing, Medical payment, Medical collections, Medical coding, And the list goes on.

  • Do you need biller to submit claims and post payments?
  • Are you overwhelmed by insurance contracts and fee schedules?
  • Do you need help with delinquent accounts receivables?
  • Do you need help with medical coding or medical record reviews?
  • Are you concerned about compliance?
  • Do you want to outsource your billing or tackle it in-house?
Good Medical Billing Company

What Are Industry Standards?

Here are three simple questions to ask:

  1. What percentage of our billing is in arrears?
  2. What percentage of our billing gets bounced back from insurers?
  3. What percentage of our billing gets written off each year?

Best practices in the industry are:

  1. 2%
  2. 1%
  3. 2%

As good a practitioner as you are, survival and success of your practice will greatly depend on the efficiency and effectiveness of your billing process. How do you find a good medical billing specialist or medical billing company? You’ve got to define your needs first. Then as you interview candidates or candidate companies, you’ll know what you are looking for.

Consider these different reasons for hiring a biller:

  • You have to replace your current biller
  • You have started a new practice or added more providers
  • Your practice never had a biller, but now more help is needed
  • Your outstanding accounts have increased significantly and your team is overwhelmed
  • Your practice has grown significantly and billing can no longer be done as before
  • Providers need insurance credentialing and other insurance related work in addition to billing and coding
  • Insurance contracts need to be worked on
  • Billing workflow needs improvement, so biller needs to be an effective strategist
  • List any other reason for your decision
Medical Billing In House VS Outsource

The next big consideration to hiring a medical biller is to decide whether to outsource the work or do it with your own staff. Cost is surely a major factor, but you have to make sure that billing is both cost effective and maximum revenue generating. Cost analysis to consider:

In-house:

  • Do you have the space to hire the person or people you need?
  • What is the additional expense to put biller on your payroll?
  • Do you have the management staff to run a billing department?
  • Who will ensure all claims are being paid properly? (It should not be the same person doing the billing.)
  • List any other concerns

Outsource:

  • How much of the office work can be delegated to a third party to increase efficiency and reduce cost?
  • What guarantee will the medical billing company give you on claim payments and increased billing and coding efficiency
  • What is their performance record for billing other providers?
  • What guarantees are in place to avoid financial loss?
  • List any other concerns

Third party medical billing company can actually cut cost and increase revenue…provided you find the best fit. Medical billing companies are able to tackle revenue generating work from different angles because they have staff specializing in different parts of the revenue cycle.

There will also be no downtime as the company will have multiple billers. It’s like hiring several billers for one job. Outsource medical billing companies will work as independent contractor, so there is no added taxes or benefit cost. They will receive payment according to their performance, so there is a great incentive for getting all claims paid and to get highest possible fees.

There are few billing companies who will also guarantee payment for all claims and will pay the practice for any claims they fail to bring in payments for.

One Size Doesn’t Fit All

Almost all medical billing companies and recruitment sites attempts to find your fit with preset questions or 10 minutes tests, a one size fits all approach. They are designed to fit you into their shape.  Your practice needs are unique to you, so the steps you take to make your determination will need to be unique as well.

If you determine that a person or a company has the qualifications you are looking for, you have to set up effective communication to make the fit determination. If all that matters to you is price, you’ll end up with the lowest bidder. And as a client of ours once said when they joined our firm, “We went with the lowest price and we discovered we got our money’s worth.” After you sift through all your criteria, the last question should be “How much do you charge?” or “What is your pay expectation?”

So, how do you find a good medical billing specialist? If you are looking for the cheapest biller, you will have many options, but your practice might lose a large amount of money if billing is not done right. If you are looking for the best, you have to really get to know the biller. Does the biller have comprehensive understanding of the job, willingness to go beyond requirements, and capability to do the job right 100 percent of the time?

Start with the questions we gave you at the beginning of this article…and we will have more to offer you in the coming weeks. If someone is an expert in his/her field, he/she should be able answer your all question in simple terms that makes complicated billing problems easy to understand.

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