7 Checkpoints To Consider Before Selecting A Medical Billing Company

Medical billing can be horribly tedious and very time-consuming for HME & DME practitioners!

The problem appears to be getting worse! The number of exposed records more than doubled year over year, from 5,138,179 records in 2017 to 13,236,569 records in 2018. Moreover, the penalties for HIPAA violations can be severe. It is difficult to keep up with the constantly changing rules, regulatory requirements, and technologies in the medical billing field. Therefore, finding the right medical billing company becomes crucial to running your practice.

Outsourcing medical billing offers health practitioners increased control, reduce overhead costs, and secure the medical billing process to safeguard against any breach or hacking attempts. It allows you to improve your cash flow and stay up-to-date with regulatory compliances. Choosing a medical billing company may seem to be an uphill task, but knowing which questions to ask can help you make the right choice.

Here are the 7 checkpoints to consider before choosing a medical billing company.

#1 Technology and Software used for Billing and Practice Management

Is the outsourced medical billing partner equipped with the latest hardware, software, and trained staff to fulfill your requirements? Working with a medical billing company that has the technical expertise to integrate patient billing, denial management, Account Receivables (AR) management, and put together the fragmented pieces of your revenue cycle can help speed-up processes and improve revenue outcomes. If you’d prefer any specialized medical billing software, it is best to communicate and confirm with them in advance. You must also ensure that they offer an integrated EHR that fits your office needs to better manage your patient’s health information.

#2 HIPAA Compliance

Outsourcing to an experienced company with HIPAA (Health Insurance Portability and Accountability Act) compliance gives you peace of mind and ensures protection and confidential handling of patient’s health information. HIPAA compliant medical billing companies helps you stay updated with current rules and regulations. It also helps improve revenue cycles, reduce claims rejections, adhere to high standards of care, quality and ethics, minimizing errors, reducing exposure to fraud, and increased efficiency and reduce costs. 

#3 Real-time & Transparent Reporting

Do they assure you transparency with near real-time reporting and regular communication? You should be able to access information and track what’s happening with each account, 24×7 at your convenience. You’d want a communicative billing partner who’s responsive, helpful, and keeps you engaged at every turn. Open communication lines can mean the difference between a mismanaged billing department and one that boosts your bottom-line. It is important that the billing partner agrees on the level of service for you to reap the full benefits of outsourcing medical billing.

#4 Industry Experience and Proficiency

Look beyond the number of years that a company has been in the business. Do they bring familiarity with certain specialties and specifically carry billing certification in your specialty? Since billing procedure varies by medical specialty, you would want to choose a medical billing services partner that is familiar with your specialty and must demand proof of their expertise and experience in that particular specialist practice. 

Also, your billing vendor must be proficient with the latest version of (International Classification of Disease) ICD-10 code to help you save time and money. Since coding plays a critical role in meeting the need for accurate and reliable healthcare data, accurate and compliant coding of ICD-10 is highly important.

#5 Strong Reputation

Partnering with a medical billing company is not a decision to make lightly. Be sure to take your time investigating, including online feedback. Seek reviews from medical professionals and go even beyond client references to seek detailed information on their past performance. Do they perform above the industry average? Ask for their billing and collection performance and specific metrics including denial/ rejection rates, net collection, the average number of days in AR and others to accurately evaluate them.

#6 Additional Support

Will the company provide feedback and insights on how to improve your practice or just restrict themselves to sending a one-page financial statement each month? You must agree on the basic level of services that shall be provided by the billing vendor for a smooth functioning. This should include claim generation and submission, AR follow-up, carrier follow-up, payment posting and processing, patient invoicing, support, and other related functions. Medical billing companies must provide additional support that goes above and beyond their basic responsibilities, such as:

• Periodic Analysis of AR – Wherein experienced medical AR analysts evaluate AR follow-up and revenue cycle management to maintain positive cash flows.
• Practice Management – Billing partners offer monthly reports on billing issues and provide insights and feedback for better practice management
• Payment Follow-up – Involves following up with patients who don’t pay bills on time and deal with delinquent accounts, which is critical in maintaining a healthy cash flow
• Denial Management & Reporting – It includes identifying common denials and trends to improve HME/ DME’s revenue and collection rate as well as patient satisfaction.

#7 Select the Right Price Model

You should choose an affordable medical billing partner that focuses on quality of service and results. Make sure to select a payment plan that works for you. There are usually four broad price models offered by medical billing companies:

• FTE Model – The billing company charges for hiring a dedicated resource working for a project. A client gets 40 hours a week excluding sick time and any other leaves.
• Fee-Based – The billing company charges a fixed amount for each claim submitted.
• Percentage Based – The billing company will either charge a percentage of the total collection or a percentage of gross claims submitted.
• Partly-Fixed or Hybrid Model – The billing company charges a flat fee model for certain carriers and the percentage basis for others.

As one of the leading medical billing service providers, Analytix Solutions brings a combination of highly-trained and experienced staff with cutting-edge technology. Analytix is HIPAA compliant, possess an ISO certification for secure data, and offers flexible engagement models and payment structures.

Next Steps

• Learn more about Analytix’s Medical Billing Solutions
• Choose the right medical billing partner, email us at sales@analytix.com or call us at 781.503.9000 today.
• Follow us on LinkedIn and Twitter for additional opportunities to engage.