Consulmed: Medical Billing & Consulting Specialist

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Questions to ask billing company

Find the right billing company

  • Have you been in business for at least 10 years?
  • You want to know if the company is working out of a basement somewhere using third party software. Is it just someone wanting to work from home, or are they established with a long-term commitment to the business? Do they answer the phone when you call!
  • What is their experience/background
  • Do they truly know your business, did they work as a biller in a practice, or do they really know the "business" of healthcare? Have they ever owned a practice?
  • How many employees do they have? Can they support your practice?
  • This will allow you to quickly assess whether they can perform. With a "mom-pop" staff, you are subject to performance/cash flow delays when someone gets sick, quits, or goes on vacation.
  • Will I have a dedicated team to my account? Will it be more than two people?
  • Here again you want to understand if one person will be doing your billing, or if a team be assigned to provide you better coverage.
  • Do you have the ability to dedicate a separate team to do "Claim Status" only?
  • This is key, and the single piece that most billing companies and in-house billers don't have time to do, or don't have the staff to dedicate to this function. This is where you differentiate between who is just "pushing" claims out, vs. those that are aggressively chasing them for you.
  • Does your fee include re-filings, secondary insurance & statements?
  • This should be part of your fee because it is a standard reality of the billing process.
  • Can I send my claims or transmit them to you electronically
  • Most good billing companies should be able to accept your claims, either by mail or secure electronic methods, regardless of their location.
  • Do you handle claims data entry, postings, etc.?
  • You should not have to do any of this in-house, otherwise, you might as well do it all yourself.
  • Do you have web reporting available?
  • This will give you closer access to your billing activity.
  • Is your technology up to industry standards?
  • This will ensure security of your data and maximum efficiency.
  • Are they partners with industry leaders and organizations for monitoring all new and changing regulations?
  • This will ensure your claims are sent as per current CMS/Medicare rules and standards. Also ensuring your practice processes are per industry regulations.
  • Is their coding evaluated by an AAPC certified coder?
  • Coding is being scrutinized more and more. Up-coding and improper coding will flag your practice for potential audits.
  • Are they providing feedback of my practice productivity, profitability, and efficiency?
  • Providing detailed reports, reporting revenue, productivity and other financial needs ensures practice profitability.