12 questions to ask before hiring a medical billing service

If you have decided to hire a medical billing service for your practice, you now have a big decision to make — who will you choose to manage this crucial aspect of your business’ success? 

There are a lot of choices out there. 

You may have some questions specific to your needs, but the following 12 questions should apply to any practice. 

This is always the main thing on everyone’s mind. The rate should be under 10% of the collected charges. A percentage is a better option than a flat rate — the percentage usually goes down as your collections go up.

Also, ask about start-up fees, termination fees, data conversion fees, and any other additional costs. Some companies charge extra for patient collections follow-up and other services.

Have they worked with practices similar to yours in size, scope, and/or specialty? Do they have testimonials, or can you call someone directly for a reference?

In addition to checking references, it is a good idea to do a quick internet search of the billing service to ensure it has a good reputation. When looking at the reviews, check to see if there are patterns in the number of clients that have a positive experience with the company, and say that it delivered what they promised. Has anyone experienced errors that resulted in revenue loss?

Your billing data should belong to you, and you should be able to take it with you if you choose to change services or bring your billing in-house.

Are they certified? What type of ongoing training do they receive? Are they using the most up-to-date resources and guidebooks, such as CPT and HCPCS? Does the service or its employees maintain any professional affiliations, such as HBMA or AMBA?

Just because a billing company says it is HIPAA-compliant doesn’t mean it has the right level of compliance for your needs. It is important to ask specific questions about the company’s security protocols, including email and fax security, data security, and its processes for document and equipment destruction (such as getting rid of an old computer with patients’ PHI on the hard drive).

Can you meet (on the phone or in person) the actual people who will be working on your account?

How often will you receive reports showing the financial state of your business and the billing service’s progress? How will they communicate with you, and how involved will you be in the billing processes?

Nowadays, most of the processes should be electronic, from eligibility verification to remittances. They should also offer credit card processing and online bill pay for patients.

Don’t assume that a billing service will do everything or that everything is included in your rate. Ask upfront and be sure you know if there are services that they don’t offer.

A good billing company should track basic KPIs, which measure the financial health of your practice. Monthly billing KPIs may include number of days in receivables, receivables outstanding over 120 days, and denial and resolve rates.

Ask if it provides educational information and assistance to help your practice with MIPS tracking. Even reminders of when MIPS information is due can help to ensure that your practice can earn a financial reward versus losing money to another practice that met the MIPS requirements.

Use these questions to help guide your decision when selecting a medical billing service. It’s worth it to take your time evaluating your options to get the best service possible from the start.