Medical Billing Services: What To Look For

Apparently, many people have been promised things that were
never delivered when dealing with medical billing services.
Sadly, I don't know of any companies that I really feel
comfortable recommending. What I can offer is a few tips
when looking for a billing service:

Experience: Personally, I put this at the top of my list. I
don't want to spend time and money dealing with someone
trying to climb the learning curve.

Investment: What are they doing specifically to stay ahead
of the ever changing world of medical billing? If they are
paying for people to take classes, ask to see some
certificates.

Size: I don't like to go with massive companies, but I
refrain from hiring one man shops as well. Basically, I
want the company to be small enough that if I call, I am
never on hold for more than one minute. However, I also
avoid being the only client a company has.

References: I take this part very seriously. It isn't just
about verifying that the references exist, I like to ask
the references specific questions. I would ask, for
example, if the billing company had ever fallen behind. If
the reference says no, I know right away they are not
telling the full truth (everyone falls behind at some
point).

Reports: Don't just ask what types of reports they can
produce. Ask what they have experience in doing and then
request to see two examples from a past month. If there is
any delay in producing this, I'd begin to wonder how
truthful they were being.

HIPAA: What metrics have they taken to meet with the
necessary guidelines? Many people feel that outsourcing the
work to other countries creates a liability. I don't agree
that non US citizens are any more or less likely to violate
HIPAA standards when standards are in place.

There are obviously many other details to consider, but
these are a few that I always like to keep an eye out for.
They may also apply to other types of services as well.

Our billing staff is small in our office, so when accounts
go past due for more than 120 days, we send them to a
collection agency. It is the ugly fact of modern medicine
that some people cannot pay for proper care, so it is with
a heavy heart that we do this.

The agency we use charges 30% of what's recovered, and they
have a pretty good track record. They have recommended that
we cut our collection time to 90 days, as the longer you
wait, the harder it is to collect.

I recently read a survey that said after 90 days, a
business has only a 69.6% probability of recovering its
money. After six months, the odds drop to 52.1%. Those are
daunting numbers, but I am less than sanguine about
squeezing every patient dry. We make a healthy profit, and
often the people who don't pay can't. Officially, I cannot
condone such behavior, but privately, I am sympathetic.

Often, I will take delinquent accounts home with me and
review the history. If a person is elderly and without
insurance or a means of support, or if they have paid
something but seem genuinely unable to complete the
payment, I sometimes make a judgment call. After all, we're
in the business of making people healthy, not bankrupt.

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