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Evaluating Your Medical Billing Company: Top 7 Areas to Spotlight

By: Diversity Technology, Inc.

Choosing the right medical billing company for your medical practice is an extremely important decision. Once a partnership has begun though, practice managers should not be content to sit back and let their contractor run the show. It's your practice and your livelihood, so be prepared to re-evaluate regularly the relationship with your medical billing company to ensure effectiveness, timeliness and efficiency.

Here are 7 important areas to spotlight when assessing your current medical billing company.

1. Open Communication– What response do you get when calling your medical billing company with a problem? Do you have a direct phone number to speak with someone immediately responsible for your medical billing, or do you navigate a maze of transfers between departments? Do you need to leave a voicemail each time and wait for a call back? Your medical billing company should be readily available with open, objective communication, and account managers should be prepared to respond to your needs quickly. Even if leaving a voicemail, you should be able to expect a follow up call quickly.

2. Timeliness– Does your medical billing company pursue the most efficient claim submission avenue available in all cases? While paper submission might be required for certain claim types, the vast majority of medical billing claims can be sent electronically for a much faster turnaround.

3. A/R Turnaround– What does your medical billing company's overall turnaround look like? For most electronic medical billing claims, payment can be expected in as little as 2-3 weeks; paper submissions in as little as 3-5 weeks. Daily claim generation will yield these quick turnaround times– medical billing companies who only provide weekly batch submissions or periodic transmittal might add as much as another 1-2 weeks to the turnaround. Also, consider their policies on denied, underpaid and stalled claims. Are they waiting too long before calling the carrier for an explanation or resubmitting?

4. Patient Invoicing– Collecting patient balances is often the most difficult and least rewarding piece of the medical billing puzzle. Since each practice's patient base is different, a good medical billing company should be able to customize patient collections to meet individual needs– including various types of invoices and degrees of follow up.

5. Follow-Up on Secondary Claims– Does your medical billing company pursue secondary and tertiary claims? These claims will often be of little value or a waste of time by contractors with percentage based contracts, but a good medical billing company (regardless of the fee structure) knows that ALL claims are important to the practice and are an important detail in sustaining long term relationships.

6. Identifying/Addressing Errors– Steps can be taken to reduce errors, but mistakes do happen. The real question here is how does your medical billing company respond? A good medical billing company will look at each situation impartially, map out effective steps to correct it, and then execute the plan. If they fail to do so, your medical billing company should be prepared to say so and present options for alternative action.

7. Objective Reporting– What types of reports do you receive from your medical billing company? Are they consistent and in-depth? Does the medical billing company provide comparative analysis from month to month? Reporting should be open and forthright- easily and clearly identifying both positive and negative performance for the practice, as well as the medical billing company. Make sure you're getting all of the information you need to manage your practice – as well as assess the performance of your service provider.

As you consider your relationship with your medical billing company, use these seven points as a guide. For more information about working with a professional medical billing company, remember that Diversity Technology is a nationwide provider of leading medical billing services. We help practices navigate the difficulties of today's insurance reimbursement environment and offer effective medical billing solutions with objective reporting and practice management advice. Contact Diversity today for more information.