Vendors take the burden of managing claims off of staff.They help ensure that proper coding is applied to medical claims to facilitate payment between the patient and the health care provider.Helping with insurance verification, IT and software, and collections may be offered by some billing vendors.You can find the right vendor by looking at their rates, reporting methods, and operations.
Step 1: Determine what type of service you need.
There are a number of basic functions that any vendor should be able to meet.You may want to consider removing a vendor from your list if they don't accomplish any of these.The functions of a medical billing vendor include claim generation and submission, carrier follow up, payment posting and process, patient invoicing and patient support.The number of services that a vendor offers means they will increase their fees, but you should make sure that the basic services are met.Registering and admitting patients, IT and computer support, medical transcription, insurance verification, and compliance with state and federal laws are some of the services that can help.
Step 2: Decide what interface you want.
Online portals and electronic software are used by most medical billing vendors.See which services will work best for your practice.Cloud-based systems are able to protect themselves from accidental memory loss, but they need a consistent internet connection.Some services will add late fees to your account.There are many different forms of payment that the service accepts.Your patients will be more likely to pay on time.
Step 3: Determine a budget.
How much you can afford to pay each month can affect the services you receive from a medical billing vendor.Basic billing and coding software can start at $200-$400 a month, but can become more expensive depending on your specialty and additional services.Installation and training are some of the other starting costs.
Step 4: The quality of service should be measured.
You should make sure that the company you hire is reliable and fast.To make sure the company will perform efficiently for you, create a checklist.Do they use certified medical billers?How quickly is their billing?How long is it between the generation of the claim and the payment?How many charges are sent to the collection agency?How do they protect sensitive information?What kind of insurance coverage do they have?Is there liability coverage for security breeches?What are their back-up procedures in the event of a disaster?
Step 5: Make sure they meet the standards.
Different countries have different compliance standards for medical billing.Vendors in the United States need to meet strict compliance requirements.Medical billing vendors are not allowed to operate without proper licensure, so you should conduct due diligence to make sure they meet standards.The Department of Health can help you identify your nation's compliance regulations.If you are using an offshore vendor, you need to make sure they meet the standards for your nation as well.To find out if they meet standards, you can ask the vendor to show you their accreditations and certifications.
Step 6: Require accreditation.
One of the governing bodies that oversee regulations and certifications should accredited every medical vendor.Vendors who pass rigorous standards will be accredited by the healthcare billing and management association.You will need to make sure that the vendor complies with the law.You can find this information on the vendor's website.
Step 7: Evaluate the benefits of using an electronic health record vendor.
You can pick from three primary categories of billers.You can either use a local company, an offshore company or an electronic health record vendor.Not all vendors offer medical billing services, but if they do, this may be the best option for you.Since the vendor has access to the medical information necessary to complete billing, you don't have to keep an eye on it as it's sent to a third party.
Step 8: You can compare local and offshore companies.
If your vendor does not offer medical billing services, you can use a local or offshore vendor.A billing service vendor in your area can help you with your billing needs.On-site support is available with local vendors.A local vendor representative can come to your office to help if something goes wrong.Local vendors are more expensive than offshore ones.Low rates can be offered by offshore vendors who handle large caseloads.With offshore companies, you can get your work done at a lower cost.Poor customer service and technical support are some of the things that come with outsourcing.Your patients' financial information may be at risk since this company is offshore.
Step 9: You can compare billing models.
Vendors can approach collections aggressively or passive.Vendors who are aggressive will move accounts to collection agencies more quickly.It takes more time for passive billing models to move accounts to collections agencies.If the speed of collection is important to you, you might go with a more aggressive vendor.Aggressive billing models can reflect poorly on your office's reputation with patients, particularly those in lower-income areas.
Step 10: Determine how much a vendor charges.
The costs associated with working with a medical billing vendor can vary.Local and offshore companies charge different amounts of money.The percentage that vendors charge for processing claims is the primary feature to look for when comparing prices.Don't hire a vendor that defines collections as your practice's complete revenue, rather than just the revenue they help to collect.They will charge you more when they define it as your complete revenue.The charge for processing claims is an industry average.
Step 11: Consider the total costs.
Beyond the monthly or percentage-based fees, there will be other fees associated with hiring a vendor.Find out if the vendor charges additional fees for online or telephone technical support.Do they offer round-the-clock support?You can find out if they charge for an upgrade to the software program.Determine what the installation costs are.A one-time startup fee is charged by many billing vendors.You want to know if an increase in the size of your practice will affect your rates.Vendor rates will be adjusted based on the number of doctors in the practice.Don't pay low rates.Vendors will advertise low rates to attract uneducated buyers.Low rates can be attractive, but they often aren't the best deal.The full scope of services that you need to complete your billing services, like resubmitting claims, are not offered by many of the vendors.
Step 12: You can compare reporting styles.
You need consistent access to your financial information with a medical billing service.You want a billing service vendor that will give you frequent reports, at least once a month, that include a denial, operations, and data analysis report.You should see if you can access the report online.The operational reports should show the total claims processed and dollar amounts submitted.A log of the vendor's follow-up actions should be included in the denials reports.You want to be able to sort this report by the amount paid, so you can identify the smallest payment amount that the billing service will fight for.You should see a linear analysis of the amounts paid overtime.If these reports are online, they can be exported to excel spreadsheets for further analysis.
Step 13: There are vendor reviews.
When choosing a medical billing vendor, it is important to know what other customers think of their services, their reliability, and how they handle billing.Customers will be satisfied with the vendor's practices.You can find reviews online by searching for the name of the vendor, and you can also ask other medical offices that you have a relationship with about the medical billing vendor that they use for a recommendation.
Step 14: To see certifications, ask.
A medical billing vendor can demonstrate their commitment to quality and transparency by becoming certified through a number of different professional organizations.The vendor of the Certified healthcare billing and management executive program is committed to supporting continuing education for their staff and keeping up with the latest industry developments.You can ask to see the certifications the vendor has.Vendors will display their certifications on their websites.You can research the certifying organization if you know what certifications they have received.It is possible to demonstrate that the vendor is legitimate and less likely to misuse your financial information.
Step 15: Vendor size and scale should be compared.
Look at the firm's gross annual billings and the number of claims it processes annually.You will want to know how many other practices the firm is handling and whether there is enough vendor staff to handle additional firms.If another firm is added to the vendor's workload, you'll want to make sure they don't suffer any reductions in quality.Larger vendors tend to have more specialized billing tools that are more expensive for small vendors.
Step 16: Compare the number of people working.
You are choosing a vendor based on how well equipped their staff is.You want to know the educational background of the staff members, as well as the management's experience.Do you know how large the staff is?A vendor with sufficient support is what you want.Ask, "Would adding your practice require the billing firm to hire additional staff?" If so, you might consider going with another well-established vendor.
Step 17: Go through the entire contract.
Many medical officers enter into contracts with medical billing vendors without fully understanding what their contract guarantees and how services are rendered.If you want your lawyer to consult on the legal aspects of the contract, have them go through the line by line.A pillar of your practice is billing.Your organization will suffer if the medical vendor isn't providing enough services.
Step 18: Installation and training costs should be considered.
Depending on the vendor you are working with, you may need to arrange for a technician or vendor representative to come to your officer to install the software.The installation fees should be included in your contract.The software can be accessed through a standard Internet browser.