How To Choose The Right Medical Billing Partner

Medical Billing Company Look

Even doctors need help. It’s a fact of life, and one that applies to the financial wellbeing of your practice. That’s why practices seek the services of medical billing partners. Medical billing partners can make cash flow more consistent, a practice more profitable and life a little easier.

Choosing a medical billing service partner is a big decision, there are many factors and criteria involved in the decision making process. The essential characteristics identifying a great medical billing partner are similar to those you’ll find in a good accountant or financial advisor.

The first thing people will say about a great financial advisor is that they act like your money is their money. They are stingy with the personal allowances, and always looking for areas to eliminate extraneous expenses so more money can be invested for the future.

Medical billing partners make their first impressions with strong statistics on claims recovery (typically over 96% success rate) and reduced patient account receivables. Their reputation is shaped by successes they have in processing claims, submitting the paperwork or digital data, and payment collection. In short it all amounts to how stingy they are with the money people owe you.

Stinginess isn’t the end all, as a matter of fact, in an odd way it is regulated by the government on many fronts. All potential medical billing partners must employ certified, medical billing specialists. These specialists need to pass a series of tests to receive certification. Some medical practices even have their own in house, certified, medical billers. So all certified medical billers are the same then right?

Not so fast.

Certification is just the first step in what is a very tedious and intricate profession. A certified medical biller ensures a minimal industry standard. Once a specialist has been certified the learning really begins. The current medical billing environment requires an understanding of 17,000 billing codes and the restrictions of insurance carriers. The job is made even more difficult by the ever-changing insurance carrier requirements. And all of that is about to change. By now you know the details of ICD-10 – consisting of no less than 120,000 additional new, detailed billing codes for implementation by 2014. ICD-10 will add on average, 700 hours of education time, for each practice management team.

Saying that life just became much more complex for every medical practice in existence is an understatement. The variables have increased 8-fold, which means that you will likely be seeing fewer patients on an already maxed-out schedule. How in the world will you achieve positive cash flow and profitability in an environment of decreasing doctor production?

The answer is simple, experience tempered with stinginess. Not yours, but that of your medical billing partner. Experience is always a great asset, but a long track record is not worth much if it isn’t a good one. Make sure your prospective medical billing expert has references to validate their track record. You can look into the billing partner’s track record by asking references about claims recovery percentages, the average number of days for patient A/R and by the total annual write-offs.

Once you are satisfied with the answers it’s time to interview your potential partners. Remember, your goals are both short and long term. Also remember that stinginess doesn’t equate to mean or aggressive behavior but rather an iron fist in a silk glove. As a matter of fact, if you understand that honey attracts more than vinegar you’re way ahead of the game.

Considerations for your practice’s immediate future include processes by which your new partner will:

1 – Provide a cost benefit analysis

2 – Stay current with carrier policies

3 – Schedule insurance claims rejection follow-ups

4 – Develop Patient Account Receivables recovery strategies

5 – Prioritize carrier follow-up and project potential case write offs

Considerations for your practice’s long-term future include processes by which your new partner will:

1 – Review technology applications and efforts to meet meaningful use

2 – Establish clear and enforceable “time of treatment” financial policies

3 – Establish Patient Account Receivables due date milestones

4 – Develop Patient Account Receivables recovery strategies

5 – Provide an account of patient interactions in the collections process

6 – Provide numerous indicators of practice performance

Ultimately, the biggest question for both short and long term considerations is: Does the potential medical billing services providor act like they are trying to recover their own money? If they do not exhibit the ingenuity and stubborn resolve to outlast the carriers, and outsmart patient stall tactics – keep looking.

CRT Medical Systems would like to be among those potential medical billing partners that you speak with. CRT has been in business for over 30 years and there isn’t much we haven’t seen in technological developments, health care legislation and insurance carrier evasion tactics.

If you would like to hear more please call me, CRT president, David Doyle @ 248-679-1700.


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