As per the Grand View Research report, the global medical billing outsourcing market is set to grow at a pace of 12.3% CAGR through 2027.

It goes without saying that outsourcing your medical billing needs can provide your business with a wide range of benefits. However, it all depends on the type of partner you choose and their accountability. Investing on the wrong partner can backfire in irreparable ways. So, before outsourcing it is always important to know whether the partner you choose would be a safe bet to invest on? Therefore, in the first place you need to how to evaluate your partner before you team up with them.

Here is a list of questions that would help you analyse and decide whether the company you choose is going to be dependable in the long-run or not:

How many years of Experience does the Company have?

You can easily weigh the credibility of a medical billing company by knowing the number of years of expertise they have. The complex task of medical billing needs certified specialists to handle. Especially with the ICD-10 rules being adopted, the medical billing outsourcing company needs to be flexible and adaptable to evolving industry standards.

According to an American Health Information Management Association article, the transition to ICD-10 codebook will increase the time taken for medical coding to 69%.

Knowing how the company handles customer feedback, their benchmarks for keeping up quality and how regularly they update their regulatory changes would give you an insight of the company culture. You could assess the customer satisfaction rate to know the quality of the services provided.

Read Also Benefits of Considering Outsourcing Your Medical Billing Needs

Can they Integrate Seamlessly and be Compatible with your Workflow System?

It is necessary for the medical billing company to be able to integrate with your system workflow, without any expenses from your business side. Mind it, they would have to blend into your company culture, rather than the other way round. Even if any transitions or changes are required to be done to your current system, the third-party vendor would have to support you through the process.

It is also essential to ensure that the third-party vendor is HIPAA compliant with a designated compliance officer and a HIPAA security person. By knowing how often they carry-out compliancy assessments and record compliance progress, you could gauge their accountability regarding data security and adaptability.

How Often would they Provide Progress Reports and What Information would it Contain?

You would have to be able to gain real-time access to performance reports to be able to run practice management from your own systems. The third-party vendor would have to provide you with their performance reports on a regular basis (weekly, monthly or quarterly). By asking for a sample report, you would get a glimpse of the information the medical billing company reveals regarding their performance.

Lookout for the following information, as a minimum requirement to invest in the medical biller:

  • Details of credit balances
  • Complete reports regarding denials
  • Aged account receivables

If find that the company is maintaining consistent transparency in their billing processes and your accountants can easily utilise their financial reports to keep track of the progress, then you have a good partner in hand.

How does your Company Handle Rejected, Unpaid and Denied Claims?

A transparency data released by the Centers for Medicare and Medicaid Services (CMS), in 2019 about 17% of in-network claims were denied with 14% of in-network claims denied by issuers in 2018.

When the claims do not get accepted, it is necessary to know the process a medical billing company carries out to clear the setback. A trustworthy partner will have a well-defined procedure to tackle and prevent future denials. This comes usually in the form of regular analysis and audits before claim submissions. Look for the average denial rates. It’s a safe bet to invest in a medical billing company which has a denial rate of 5% or less.

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Where is your Company Put Up and What are the Working Hours?

You could decide the medical billing company you want to put your trust in, by verifying the location they are put up in. A company may claim to follow the US regulatory compliances but would not be put up in the US. Knowing the timings of their availability, would let you know whether they would be able to serve your customer needs whenever the requirement arises. Ideally, choosing a medical billing company that functions 24/7 is better for meeting your demanding needs.

Signs of a Trusted Medical Billing Company

The company you choose should be able to alert you about any contract issues, give you reliable references, provide you with affiliation proofs, and be transparent about the billing costs. You could depend on looking at online reviews of the company you consider choosing as well as the word-of-mouth feedbacks. By asking the above questions, you could save a great deal of time and money, and most importantly rest assured of meeting your back office needs up to expectations.


Clean Claims On First Submission




HIPAA Compliance


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