What to Avoid When Choosing a Medical Billing Service?

Buyer Beware

You have taken an important step in improving the efficiency of your medical practice. You have decided to outsource you medical billing. You need an expert, someone who will advocate on your behalf. And, you want someone who will handle the drudgery of coding, billing, collecting, and working with insurance so that you can spend more time focusing on your patients. As you begin your search for a medical billing service, you want a reputable, fair priced, proven provider.

doctor billing

Here are 5 things to avoid when choosing a billing service.

1. Cheap Rates

Anytime someone is offering incredibly low rates, much lower than their competitors, you should be wary. It’s probably too good to be true. Find out the risks involved. Ask questions about their security measures, fee structure, and industry expertise. Most medical billing services have a steep minimum revenue requirement, which makes an incredibly low offer unlikely. Some companies offer one submission service per claim. That means they will not do the extra work to appeal, resubmit, or work on denied claims. Avoid those companies.They are not worth your money.

2. Long-term Contract without Metrics

Be wary of a long-term agreement without any performance metrics. Most billing contracts are subject to renewal each year based on the performance of the service. A good medical biller should make you money – more than you were making when your medical billing was in-house. That’s because their sole job is to negotiate on your behalf, getting you the best price for the medical services you provide. If they aren’t making you more money, find someone that will.

3. Deceptive Fee Structure

Pay attention to a medical billing company’s fee structure. Most services charge a percentage of collections that they are responsible for, i.e., payer reimbursement and patient balances. But some billing companies charge a percentage of net collections, in other words, the total revenue of your practice. This includes services that they were not responsible for but brought in revenue.

4. Offshore Service

Some of the main complaints about a billing company that is based offshore include:

  • Difficulty in understanding the representative
  • Lack of knowledge and expertise of the US insurance system
  • Inability to stay up to date with payment changes, and the number of times transferred before speaking with the right person
  • Privacy concerns

Offshore services are typically cheaper because they charge per claim rather than a percentage of total collections. Remember, you get what you pay for.

5. All-in-One Service

A one-stop shop in the medical billing world is a company that handles all of the medical billing for a practice, as well as medical IT, and practice management. A one-stop shop CAN be a great solution. However, keep in mind that these are complicated fields that are constantly changing their requirements and policies. That makes it difficult for any one company to stay on top of every area. Often, they can be lacking in one of these service departments. But not always. If you find a one-stop shop service you like, ask detailed questions about the background of their staff, the training they receive, and how they stay current on each facet of their job.

Learn More

Check out our Medical Billing Buyer’s Guide to learn more.


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