7 Things You Must Consider When Choosing a Medical Billing Company

The medical billing workflow comprises a time-consuming and complicated network of connected exercises. It raises a challenge for medical practitioners in treating their patients with maximum concentration. To overcome this challenge, physicians prefer to outsource their billing and coding needs to the practice revenue management company that maximizes their medical practice experience leaving back-office tasks to the external workforce having expertise in the insurance claims reimbursement process. But, before outsourcing, it is critical to know things you must consider when choosing a medical billing company
It is overwhelming to make an informed decision in choosing the right medical billing company that fully complies with your Payer regulations. In this post, I have listed eleven factors you must consider when choosing the right medical billing solution for your practice revenue cycle management.

Determine the Scale of your practice needs

Medical billing companies are specialized in dealing with various sizes of accounts sizes. Some of the healthcare administrative partners are well equipped to process the revenue cycle of the enterprise medical practices; on the other side, some offer their services to small practices with inadequate resources, limited staff, and limited insurance companies.
Depending on your practice’s size, budget, and the insurance companies you are affiliated with, you must partner with either small-scale medical billing services, professional medical billing services or a physician practice management company.

Look for past experience in your specialty

To prevent revenue leakage in your medical practices, you must partner with a medical billing company with sufficient experience and knowledge in your specialty, as incorrect insurance claim submission and processing is the primary cause of reimbursement failure.

Work with healthcare administrative partners specializing in your practice’s revenue cycle management. You will be confident that you are working with the billing and coding professionals whose services would fully comply with the concerned Payer and regulatory authorities.

Here are some crucial questions you can ask medical billing companies you are considering.

• how many years of experience do your billers have in my practice?
• What type of reports will I receive?
• Can you guarantee transparency?
• How willing are you to adjust to my processes?
• Will your operation alert me about contract issues?

The central concept behind asking these questions to the medical billing company is you should partner with an organization that has been in the industry, proving their revenue cycle services for a long time.

Perform cost analysis between different companies

Most healthcare administrative organizations in the industry charge 3%-9% of your practice revenue collections. Other companies charge flat fees for service charges. I have breakdown the cost analysis process you can apply for different companies:

1. Decide your billing preference. First and foremost, you must decide your preference for how you want to be charged, whether you pay by a  percentage of revenue or a flat fee. You can list down the companies that charge you according to your preference.


2. Rate Comparison List down five companies and compare their rates. How much are they charging?


3. Prefer a robust medical billing service. Do not compromise on the quality of the service just because of the price difference of a few dollars. If a company charges a few dollars less than others, it doesn’t mean they provide premium quality services.

Must be up-to-date on compliance regulations

It is crucial for your medical practice to partner with a medical billing company that strictly follows the compliance rules. You must verify whether your service provider is equipped with the latest version of the ICD-10 regulations and whether their revenue cycle management workflow process complies with HIPAA regulations.

Payment methods

The medical organization must consider what payment methods its practice management company has. Your medical billing company must remind you about overdue payments to provide revenue cycle services robustly.

Partner with a responsive medical billing company.

Your practice revenue relies on the availability and speed of your practice management company. Your billing company services must be available for you in an emergency. They must respond to you rapidly throughout the revenue cycle workflow process and be available even after the service. These are the most crucial factors that make your billing company responsive; if a company is fully compliant with these qualities, it will provide you with the best experience in maximizing your practice revenue.

State of the art infrastructure

It is vital for the healthcare organization to partner with a practice management company that is comprised of a streamlined revenue cycle process. Your company must be equipped with electronic healthcare resources, including medical billing and coding software, that assist the workforce in accomplishing the results quickly.
There might be a situation where a billing company to which you are outsourcing your billing needs their billing software is not compatible with the software you are using. So you need to ensure that their technology infrastructure must be scalable enough that your running RCM can be incorporated with their system.

Ensure the billing company is conscious in meeting deadline

In the revenue cycle management process, the practice revenue experts need to meet the deadlines in submitting and processing insurance claims given by the insurance carrier. If your billing company is not conscious of meeting the deadlines, they will fail to get reimbursement for your practice promptly.

Billing partner must have a strong and positive reputation in the market

Your clinical practice must outsource your RCM to a medical billing company that has been providing satisfactory revenue cycle services for a long time in the market and has a good reputation. It’s best to get online and look up some of the client reviews of the service to evaluate the billing company’s reputation. You can ask clients; did they experience interrupting services that resulted in revenue loss. Furthermore, you can ask the company for their testimonials and references to verify the quality of their services.

Assure that a billing company offers a support in denial management

When selecting a medical billing company, you must ensure that they should be well-backed by a modernized denial management system. It is critical to have confirmation because several medical billing companies do not have a resubmission process included in their revenue cycle management services or they offer dedicated denial management services for which you are required to pay extra charges.
If you have a clear justification from the company about how they will handle your rejected claims and have a process in place for submission, you will be assured about getting reimbursement for your practices.

Establish open communication lines

When outsourcing your practice revenue cycle to the healthcare administrative partner, you must ensure they have robust and responsive client support. You can establish clear communication with your medical billing service provider. A revenue cycle workflow process that your billing company follows must be transparent throughout the whole life cycle until you get reimbursement from the Payer.

Outsource medical billing and coding services to MedsIT solutions

MedsIT Nexus medical billing and coding services not only fulfill these factors but goes beyond them. We deliver excellent quality and operational standards to meet customer expectations. Our streamlined revenue cycle services helped us to sustain the long-term business partnership and allowed us to manage your complete revenue cycle.