How to Find a Medical Billing Company for Your Health Center Start-up

Medical billing is not a task that can be done easily by anyone. In the recent days, healthcare billing has faced rapid changes due to today’s ever-changing laws, regulations and reimbursement models.

This therefore calls for health center start-up administrators and medical practitioners alike to be shrewd on how they choose a professional medical billing company because their practice depends on the performance of these companies. Below are some of the important aspects your health center need to consider for you to choose a dependable medical billing company.

Training and experience

Getting a billing company with experience is a plus, but that does not mean that you don’t consider a new company which is knowledgeable and committed to ongoing or continued education. Look at it this way, if a company has a small client base, it is most likely that they will spend quality time on your practice needs.

Ask to know their credentials, their education background and their commitment to further education. Going for a small billing company means that you will enjoy more personalized experience.

Coding

Coding can be viewed as a separate service which has to be done by the physician himself. But it is good to hire a billing specialist who has a general knowledge about it. This way, they will be able to spot errors in coding and recommend the possible solutions. Though it is not mandatory for specialists to hold a certification for coding, ensure they have proper certification from recognized bodies.

Practice management system/software

How is the health center billing company planning to provide practice solutions? Is it going to use your current practice management software or do they already have a better one put in place? A good billing company is supposed to ease your concerns about the software to utilize, whether yours or theirs.

Technology & software utilization

Automating some tasks such as claim submissions and billing may save time for both of you. It could be an intimidating investment to use practice management software, but you can be sure it streamlines the whole system and it pays off in increased revenue and efficiency. With the right practice management software in place, billing specialist can access patients’ data and invoices from a central point hence limiting the need for massive paperwork and filling.

Data security

You have to ensure that your data or access to it is safe with the billing company you choose. How secure are data backups? Does the billing company provide full backups both on and offsite? Enquire to know computer and network data security policies put in place in case you want your data captured or restored.

Procedures for claim follow-up

Enquire to know the procedures the billing company follows to settle claims. Dig deeper to understand other issues such as resubmissions, denials, appeals, secondary and tertiary claims.

Reporting & deliverables 

It is good to know the kind of reports you will receive from a billing company. Are they able to provide you with the special custom reports you may require?

Ensure that you will be able to get these basic reports from your specialist when you require them: practice analysis, accounts receivables, transaction and claim status reports?

HIPAA compliance

Make sure you know the procedure a company has put in place to adhere to all HIPAA and state regulations on security and privacy before hiring it. A thorough understanding of HIPAA privacy and regulations is vital for long-term trust in a medical billing provider.

Managed care

Look for a billing company that can handle tasks related to managed care like obtaining authorizations, alerting the provider of need for new authorizations, and advising the provider on the number of visits left on an authorization.

Procedures and policies

What does the company do in case of emergencies, vacation or any other similar situation that arise? A good billing company should put procedures in place for the periods they are not available and for emergency cases.

Services available and fees applicable

What fees are charged and what is included in those fees? Find out whether the percentage they are charging is for full practice or just insurance payments. Let it be clear which fees are for which exact services before deciding to sign that contract.

With the above considerations, you can be sure that you are in the right track of hiring the right professional billing company. Ensure that the billing company meets the above criteria before you consider working with them.