Each medical facility ultimately has to choose how it will manage its medical billing and what the requirements are for this process. A medical institution can, of course, do this in-house or outsource, which in turn means entrusting it to experienced medical billing companies. The pros and cons should be weighed before setting the task of medical billing to the hospital staff because for the doctor who directly treats the patient, the need to conduct parallel billing processes will be a very difficult task. In turn, medical staff will probably find it financially beneficial to outsource billing – so you can reduce the potential costs and not waste time on claims and billing litigation. If you have already made the decision to use outsourcing tools, then you need to take care in choosing a billing company that will most clearly reflect your needs. And making a choice won’t be easy, considering the number of medical billing companies that exist.
Identify your practice needs
While searching for medical billing and credentialing services for your needs, first take into account that businesses focus on different amounts of finances. Therefore, some companies have a better track record in managing large medical facilities and dealing with a large number of medical professionals. Other companies, on the other hand, may have hands-on experience with smaller medical centres and, correspondingly, much smaller amounts of financial turnover. On this basis, when calculating the bill, you should consider the volume of your practice, the amount of budget and the appropriate insurance companies. After doing this preparatory work, you can determine which of the three types of medical billing firms is most suitable for you: billing services for small businesses, medical services management processes, or the highest level of billing business (the so-called expert).
Look for firms with experience in your field
One of the most important checks you should do for your physician billing company is to familiarise yourself with their experience in your medical services area. After all, this factor will have a direct impact on doctors’ income if claims are denied due to incorrect billing and coding. This is probably why medical professionals very often only accept the services of billing specialists who are specialized in their field. This gives physicians confidence that they will get the billing services they need with as little opportunity for inaccuracy or error as possible.
For other medical facilities, an important factor is the billing company’s experience with other medical centres in the same area of medicine. You can discuss this priority with your staff and choose what is right for you.
Ask for a breakdown of expenses
It goes without saying that everyone is interested in getting the most services for the least cost, including billing outsourcing. However, when reading the pricing policies of billing companies, pay attention not only to the total price; it makes sense to calculate the cost of each individual service. This will help you control financial losses on your billings. Medical billing companies charge for their services by calculating a percentage of your sales, which often ranges from 3% to 9%, according to your speciality. Some billing companies calculate their fees as flat monthly fees.
Make sure the billing company meets the requirements
As with any occupation, there are certain rules for billing that are essential if the business is to stay afloat and make a steady profit. In addition, it is important that rules and laws be followed by all employees, both on the part of the billing company and on the part of the medical facility. So be sure to talk to the medical billing company about what compliance procedures they use, and what actions they take if a violation or deficiency is discovered.