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Four Steps to Selecting a Medical Billing Services Partner

Untitled Document Finally, some good news from the healthcare industry. Providers and clinics have found an ally in the effort to collect revenue and reimbursements from insurance carriers. Third-party medical billing services offer the expertise and resources to follow up on receivables.

Not all medical billing services are alike, however. It takes careful research to find a trusted partner capable of taking over revenue collection, arguably the most important function of any business. Industry experts offer the following four criteria for selecting a medical billing service:

1. Business Services
Not all service providers are equipped to provide the full range of services; performing a needs assessment will help narrow the field of candidates. Medical billing services range from single-employee home businesses to large practice management companies. Each offers advantages for a certain type of business. The smallest shops offer personalized attention useful for clients practicing in a particular niche. Practice management companies offer comprehensive back-office services to relieve the administrative burden of running a medical practice. Between these two extremes lie the majority of billing services, which focus on accurate claims submission and aggressive follow-up to boost collections.

2. Business Practices
Next, experts advise doctors to examine the business practices of different service providers. Qualities to consider include:

  • Aggressive follow-up. The number one positive attribute in a billing service is an active and aggressive follow-up approach. Insurance carriers can be reticent to reimburse claims, and may attempt to deny them on administrative technicalities. Tenacity is key. One industry analyst observes: Your service should not be passive, but rather fight to get you a better return, monitor government programs to ensure correct payment, and keep up with all your billing contracts.
  • Confidentiality. Privacy has emerged as a central issue in the wake of HIPAA, the 1996 federal act protecting the security of health data. Since medical billing services handle sensitive patient information, its important to ensure that this third party complies with security regulations.
  • Timeliness. Timely submission of claims is imperative in a billing system littered with time limits for filing claims. A medical services provider should know and observe the particular deadlines for different forms.
  • Fee structure. The cost of the service will vary depending on whether the provider charges a percentage of the collections or a flat fee for service. Evaluate which of the fee structures suits your business.
  • Specialty focus. A specialty focus indicates familiarity with a specific billing protocol, and can lead to better collection results.
  • Accessibility. Communication between service provider and client is critical for an effective partnership.

  • 3. Human Resources
    A professional, trained staff is critical to ensuring the best return. Make sure that the billing service provider employs agents who:

  • Understand both ASP and Unix-based medical billing systems
  • Are familiar with the latest medical insurance coding standards
  • Have extensive experience in the field
  • Before hiring a billing service, find out whether the business invests in regular continuing education for its staff. It is also advisable to find a service that supports its own staff rather than hiring subcontractors.

    4. Technological Resources
    Finally, access to advanced medical billing technology can have a significant impact on the billing services ability to get results. Electronic submissions reduce the kind of administrative errors that account for most of the claims rejected by insurance companies. Services that support Palm and PDA medical billing introduce another level of efficiency into the billing process.

    Medical billing services represent an important partnership capable of increasing a clinics revenue by thirty percent or more. It pays to find the partner capable of realizing the full financial value of your medical services.

    American Medical Billing Association
    Medical Transcription Daily
    Preferred Health Resources
    Using Medical billing Companies
    Premier Billing Network

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