If you have recently outsourced your medical billing, or looking forward to outsourcing it in the near future, there are many important questions that must be asked. Not only is it important to choose a reliable, reputable, and effective billing company, but if the wrong billing company is chosen, it could have a severely negative effect on your bottom line, and possibly put you out of practice.
Because of this, it is important to know what you can expect from reliable pediatric billing services and make your choice wisely.
How does the billing company send their claims? Can they send both electronic and paper claims when necessary? Some insurance will reduce payment rates, or deny claims entirely, if they are not received electronically. Also, ensure that the billing service has a claims follow-up process in place.
Other services that may or may not be offered by your billing service are patient billing and collections services. Patient balances are always an issue, and unpaid patient balances must be sent to collections. If your billing service does provide patient billing, ensure that they have a way to send patients to collections, and then communicate this information with you so that further unpaid patient balances will not be incurred by the same patient.
Two important services, which should be provided by your billing company, are regular reports and communication regarding your claims. The types of reports that should be provided are aged accounts receivable reports for both insurance and patient balances, activity summaries, practice analysis, and notes regarding unpaid claims, such as requests for medical records. Checking billing services reports is the best way to assess the work they are doing for your practice, and ensure that they are working as hard as possible for you.
Your exact needs in regards to a billing practice will depend on the size of your practice, your medical specialty, and the complexities of your billing. These four components, however, should be addressed in all contract with a billing service, and expectations regarding these four areas need to be set in your contract with the billing service before the work begins.