Tips for Those Interested in Learning How to Screen a Medical Billing Company

Hiring a company to help with medical billing can make the whole process a little bit easier, but only if you choose the right company. Not all companies are created equal, so it’s important to learn how to screen a medical billing company.

Software and Services

The most convenient medical billing and coding companies will have in place an integrated system that includes scheduling, documenting, and billing. Using the right practice management software then allows the whole process to go smoothly. The medical billing service should generate all the insurance claims and submit them, follow up on these claims, post and process any payments received, invoice patients, and deal with any questions patients have about their bills. They should also transfer any bills that aren’t paid in a timely manner to the appropriate collection service. Services that also offer medical coding, appointment scheduling, transcription and insurance eligibility verification are preferred, as this further limits the work that the medical office needs to handle on their own. The company also needs to have the right procedures in place to make the most of the software they use, including a process for data security, data backup, data sharing, and data recovery.

Billing Method

Companies that handle billing for medical practices typically charge either a percentage of the amount of the charges they bill out or a percentage of the amount of money they actually collect. Make sure to check the fee schedule to see which is the case when trying to decide between companies. You want to opt for a company that only charges based on what they actually collect. This helps ensure the company is motivated to work at collecting the money owed and actually keeps working to collect unpaid bills. Most companies in the industry charge a fee of between five and six percent of what they collect, but some may have a minimum monthly fee. Some companies may charge a fixed fee for each claim submitted instead, which can be more cost effective for some practices but doesn’t provide as much incentive for the company to keep trying to collect denied claims from the insurance company or unpaid bills from patients. These rates should stay the same throughout the length of the contract, which is typically 12 to 24 months, and then be open to renegotiation.

Experience and Success Rate

You will want to choose a company that has significant industry experience, as they will be better able to bill the insurance companies in such a way that most claims are accepted on the first try. This is called the first pass acceptance rate, and the best companies have a rate of 98 to 99 percent. Experience isn’t just a matter of how long a company has been operating but also whether the employees have the right certifications and specialties. Look for a company with staff members that have American Medical Billing Association certification. Also, make sure the service has people that are familiar with the procedures for billing in your specialty, as billing procedures aren’t the same in all specialties.