Today’s healthcare practices have more than their fair share of hassles. Ever-increasing non-medical obligations such as compliance and reporting are continuously weighing them down and this is forcing them to move certain non-core functions such as billing, coding and collections outside their practice. Though this move has proved to be a jackpot for many, others seem to have hit the rock bottom and lost substantial ground by failing to ask the right question. So what are those questions that you should ask before outsourcing medical billing services to an offshore company? Here is a brief overview of the things that needs to be clarified before signing on the dotted line-

Question 1: What is the scope of services provided by the billing company?

This is the first and foremost thing that needs to be clarified by the service provider. Healthcare practices often forge partnership with third party service provider hoping to cut down on the staff and cover the cost of a billing service. But this does not happen always because service providers have a tendency to push back research and follow up activity on the practices, say experts. There are also instances where billing companies cite the lack of access to medical records or other information and ask the practices to do the needful to appeal for denials. Hence make sure that all the protocols for missing information are clearly defined before entering a deal. It is advisable to have a clear idea about who is responsible for payment posting, coding, claims submission, charge entry, patient demographic entry, account receivable follow up, and so on. Also make it a point that they compensate the allocation of any of your resource as a liaison between your practice and billing company in one way or the other.

Question 2: Is the interest of the billing company well-aligned with yours and what is the cost that you have to pay for leaving them if the performance is less than satisfactory?

Most billing companies are less interested in serving clients who pay flat-fee. Instead, they would prefer to give more priority to clients with percent of collections fee arrangements, say experts. Hence assess your requirements and make sure that the prospective service provider is competent enough to meet your interests. Also, before you finalize the deal, assess what will be your options if the service provided is not up to the mark and the costs for opting out of the service.

Question 3: How satisfied are your prospective service provider’s current clients?

Be proactive and try to zero-in on a billing company that will provide the level and quality of service that is in-line with your practice’s philosophy. Take a cue from the concept of mystery shopping, which is widely used in today’s retail outlets, and call the prospective service provider as a patient to see how they interact with patients. Avoid medical billing companies that fail to meet expectations in customer service, as hiring them would mean losing greater revenues in future due to unhappy customers.

Why should you Outsource Medical Billing Services?

Undulating economic conditions, unprecedented health emergencies induced by pandemics, dynamic regulations have brought medical billing services to the mainstream. Here’s a look at some of the key benefits obtained by outsourcing medical billing services to capable vendors:

Minimal Billing Errors– Outsourcing medical billing services opens access to domain-specific experts who have the required experience to execute the most complicated claim submission processes with low to no errors. Medical billing being one of the core objectives, vendors ensure that their employees undergo rigorous training and assessments to be able the execute this objective in an error-free way. Their workforce has the integrity of minimizing the instances of rejected claims as they conduct a thorough review of claim documents prior to sending it to the payer.

Improved safety An industry-recognized outsourcing company have the integrity of providing complete transparency in their billing process. Such enterprises are compliant to the HIPAA regulations and deliver completely safe medical billing processes to safeguard clients from any potential hacking threats. They are expected to have a robust security framework in place to guarantee clients data confidentiality and create a safe haven for sensitive customer information.

Consistent workflow – Maintaining an in-house team to execute medical coding and billing functions can at times fall flat due to a sudden depreciation in employee strength which takes a direct hit on a healthcare enterprise’s revenue generation prospects. Outsourcing vendors assign teams that are at the constant disposal of their client to ensure an accurate and accelerated processing of claims.

Big savings on money – Medical billing outsourcing services exempt healthcare enterprises from the recurring expenses on salaries, benefits, and training for maintaining an in-house medical coding and billing department. They would also not face the requirement to invest in office infrastructure to house the department. An outsourcing vendor offer flexibility in their pricing models that allow clients to choose the best plan in accordance with their requirements.

The Bottom-line

It makes perfect business sense to outsource medical billing services to a third party service provider to ride over today’s uncertainties. But this does not mean you blindly enter into a partnership and jeopardize the future cash flow into your organization. Ask the right questions to pick the right outsourced medical billing service provider and have complete peace of mind.


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