Outsourced Medical Billing - Top 5 Tips for Selecting the Right Service Provider

A medical billing service can improve the efficiency of your billing system, reduce denials, cut down operating costs, boost reimbursements and save valuable time that can be devoted to patient care. These services are better equipped to adapt to continuously changing billing codes and industry requirements.

But can a medical billing service deliver the promised results? Yes, it can. However, to find the right medical billing service for your practice you will need to undertake a comprehensive evaluation, one that transcends the regular performance track record metrics. The following five criteria will enable you to identify real expertise from market hype and find a reliable, long-term medical billing partner:

1. Quality of resources assigned to your account

The best criteria for selecting a medical billing service provider is evaluation of the number of employees assigned to the account, and their expertise. Before hiring a service provider, consider the following aspects:

* Number of employees who will support the account and their credentials.

* Length of experience of the employees.

* Experience in practices specialty. Many agents specialize in collecting a specific type of claim, such as nephrology, chemotherapy, radiology, cardiology, or vision care.

2. Commitment to regulatory compliance

As a medical practitioner, you are directly responsible for complying with legal regulations, whether or not you outsource collections to a medical billing service. For example if a billing service changes codes to increase collections, you will be held responsible for any regulatory incompliance.

To assess how well medical billing service providers’ follow regulations, ask them to give you a list of compliance policies and procedures used by their staff. Also, inquire about the training and methods that providers’ use to inform their staff about current state and federal rules, regulations and guidelines.

3. Dedication to maintain customer service standards

A medical billing service, which interacts directly with your patients, has a significant impact on the reputation of your practice and customer satisfaction. Therefore, the service should meet your customer service standards and project the right image of your practice on patients. A professional medical billing service will always have published customer service guidelines for its staff to follow and will review these guidelines with you before attending to your patients.

4. Performance and Accountability Metrics tracking and reporting

When you outsource billing responsibilities to a medical billing service, you should have comprehensive performance metrics to evaluate their performance. Ask potential providers about their standard performance benchmarks and productivity measures, and whether they regularly review employee performance. Professional medical billing services maintain their accountability by regular updates on performance and progress through monthly overview reports and account receivable reports. Additional reports must be made available to you when using a software-based or web-based billing service. Reports must be clear, easy to read and sort for different types of information. Get sample reports from service providers to determine if they meet your requirements.

5. Use of IT resources and billing software

Ask the medical billing service provider about the medical billing software and other technology resources. Evaluate their security features and ease of use. Additionally, if the service provider owns the medical billing software, ask about the frequency of updates.

Several medical billing services have now moved towards electronic claims submission. In this case, you must assess their technology solutions and automated systems, their security and how often the systems are updated to keep pace with industry changes.

Assess potential medical billing service providers on the above-mentioned criteria to identify the right medical billing partner for your practice and reap the rewards.