Foremost Questions to Ask Before Outsourcing Medical Billing Services

Medical Billing Services are becoming more popular as outsourcing medical billing helps physicians save time and money. It can speed up reimbursement because the company looks for small errors that can slow down payments. However, finding the right medical billing service can be time-consuming.  

If you plan to outsource medical billing services, here are some essential questions to ask. 

How Long Has Your Company Been in the Medical Claims Processing Field?

The field of medical billing is extremely complex.  The biller should be aware of the ICD-10 codes and other changes, especially within your specialty.  Though certification is essential, the experience gained through handling different claims over the years is significant.  

If the company plans to assign a regular biller to handle daily claims and receivables, ask the company how they will manage if the person is sick or goes on a vacation. 

How HIPAA Compliant Are You?

Before you choose any provider to outsource medical billing services, find out their HIPAA compliance. Just telling they are “HIPAA compliant” is not enough. 

Every service provider must perform an initial assessment, designate a compliance officer, HIPAA security officer, and do periodic assessments to find their HIPAA compliance progress. Ask the company questions related to data security, fax security, email security, document destruction, and equipment destruction. 

Is Your System Compatible With the System I Have? Do I Need to Invest in a New One to Use Your Services?

You have systems in place. Though you should not be adamant against a few changes, you should not agree to revamp the medical biller entirely. If some conversion is necessary, find out the costs. Ask how the company will help in the transition process. 

What Types of Reports Do You Provide?

You need to find out the reports you will receive and their frequency. Ask the company for a sample of daily, weekly, and monthly billing reports they send to their clients. This will help you decide whether they will work for your operation or not. At the minimum, you should receive the following reports. 

  • Aged account receivables 
  • Denial reports
  • Credit balances 

What Services Will You Provide for Billing Costs?

You may want to know what you are getting for the billing dollars. Some of the services that should be part of the billing package are:

  • Sending patient statements
  • Working accounts receivable 
  • Follow-up on low-ticket claims 
  • Resubmitting denied claims 
  • Informing provider clients about contract issues that may arise

How Does Your Company Handle Denied Claims?

All practices need to have systems in place to handle denied claims. The medical billing service provider should have procedures in place to track and analyze denial reports. It should be able to track whether certain services are targeted, or another essential criterion needs analysis when you outsource medical billing services. 

Whom Can I Call for References for Medical Billing Services? 

Ask the company for references. Spend some time to talk to each company’s references. Ask how long they have worked with the medical billing service and what their experience was. 

Partnering with a medical service biller should not be taken lightly. Spend time investigating, asking questions, and going by old fashioned word-of-mouth while evaluating medical billers. 

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