What to Look For When Evaluating a Medical Billing Vendor for Your Practice
If you've been practicing medicine for any amount of time you will probably agree that the healthcare industry has become incredibly complex in the past few years. Thanks to ever-evolving regulations and shifting reimbursements models, doctors are forced to streamline their operational processes in an effort to cut expenses and increase revenue.
One of the best ways practices can increase their revenue and stay competitive in a sometimes-shaky marketplace is to outsource their billing to a third-party vendor. But how do doctors ensure they select the right partner?
First by asking themselves a series of questions, and then asking their prospective partners another series of questions.
Questions to Ask Yourself
What are My Particular Pain Points?
Any billing company worth their salt will have policies and procedures in place that will maximize the efficiencies of your practice's work flow and minimize the time it takes you to get paid. And, at this point in time, all quality vendors will have strict compliance programs that will ensure security, privacy and confidentiality of protected patient data.
But beyond these generalities that any physician requires, what are your particular challenges or issues you face on a daily basis? What are your personal pain points? What are your preferences – cloud-based or enterprise-wide solutions?
Once you have a list of your preferences and challenges, you will be more easily able to communicate them to potential partners.
What Stipulations Do I Require in the Contract?
A partnership is a two-way street and an effective contract will outline the vendor's scope of work clearly as well as your responsibilities (ie provide all necessary documentation and authorization for services). Since using a generic contract template is asking for trouble, get some legal advice and determine your requirements: effective dates, termination clauses, compliance requirements, service reimbursements parameters and scope of work.
In What Ways Can My Billing Partner Help me Grow my Practice?
The right billing partner should not only be able to handle your payments and claims, they should also be able to counsel you and evaluate the health of your practice. Ask yourself what kind of assistance you need to determine if your current admin policies, staffing levels, and IT resources are sustainable. How can your billing partner help you make the necessary preparations to meet future goals?
Questions to Ask Prospect Partners
What Technological Capabilities Do You Offer?
Good billing companies offer more than help with claims and reimbursements, they have a breadth of knowledge when it comes to the best technology available to meet your needs and regulatory requirements.
Ask vendors what their experience is with EHRs, practice management systems, and if their solution can integrate into your existing systems. Remember, technology is multifaceted and should help you meet the clinical, administrative AND financial needs of your practice.
Is the Billing Company ICD-10 Ready?
At this point in the game, all billing companies should be up-to-speed with ICD-10, there simply is no excuse to be unprepared. Ask your prospective partners if they have completed …