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9 Steps for Choosing the Best Medical Billing Company

At some point, every healthcare practice has to decide how they are going to handle their medical billing needs. They can either choose to handle it in-house or outsource it – or in other words, let a professional medical billing company manage it. The medical billing process can be complicated and time consuming for healthcare professionals, who are busy taking care of patients full-time. It can be very beneficial for practices to outsource their billing, so they can save money and leave back-office tasks to experts in insurance claims and billing. 

If you decide you want to outsource, you will want to make sure you are choosing the best medical billing company for your needs. There are tons of medical billing companies to choose from and it can be overwhelming to make an informed decision. We’re here to help with this 9-step guide to choosing the best medical billing company for your practice.

1. Determine the scale of your practice’s needs

The first thing to understand when finding the best medical billing company for your needs is that different companies specialize in different account sizes. Some are more equipped to handle large medical practices with many physicians that accept many different forms of insurance. Others specialize in smaller practices with lower budgets, few physicians, and few insurance carriers. 

To determine your account size, you want to consider three things – your practice’s size, budget, and accepted insurance carriers. Based on these factors, you will want to choose between three different types of medical billing companies:

Small-scale billing services

Small-scale medical billing services are great for smaller practices. They are geared toward practices with smaller budgets, data volume, and physicians. On the positive side, they can provide more personalized, one-on-one service and can be highly reliable. Additionally, they tend to be cost-effective and can save your practice a good chunk of change on billing. However, you want to make sure smaller-scale companies have significant experience to handle your billing needs.

Physician practice management company

A majority of practices will need a physician practice management company. Typically, these companies provide billing (and other) services for practices with 200+ staff members. They are well-established and well-equipped in the medical billing and coding field, and can normally handle very high volumes of data at a time. In fact, they are able to take almost all administrative and back-office tasks off physicians’ hands. However, they may charge you extra for certain billing and coding services, which can get pricey for some practices. Make sure you ask specific questions about how their billing works.

Professional Billing company

Partnering with a larger professional medical billing companies can allow you to add valuable features to your account. This can allow you to lift even more weight off your shoulders so you can focus on patient care. These companies, however, usually cost more and require you to allocate a larger budget to medical billing and coding needs. When shopping around for professional medical billing companies, make sure to ask what plans are available, what features are included, and what the additional cost will be.

2. Find Companies with Experience in your Specialty

Certain medical billing companies will be better fits for certain practices. In fact, some medical billers have just one area of focus, but are experts in that specialty. Others will have credentials in several areas of specialty, and work with a variety of practices. 

The number one thing you want to make sure of before hiring a medical billing company for your physicians is that they have sufficient experience in your specialty. This is crucial, since the #1 cause of denied claims and revenue loss for practices is incorrect billing and coding. Some practices would rather work with a company that focuses on just their specialty. That way, they know they are working with the top experts in the field, will have their undivided attention, and will avoid errors. Other practices simply want to assure a company has worked with plenty of other practitioners in their field successfully. Ultimately, it’s up to you and your colleagues to decide your priorities.

Here are a couple questions you can ask to assure a medical billing company has sufficient experience in your specialty:

  • How many years total experience do your billers have in my specialty?
  • Does your staff have training in my specialty?
  • How many billers will be managing my account?
  • Do you stay up-to-date on billing and coding updates in my specialty?
  • Do you have any testimonials from other practices in my area of specialty?

These questions should help you gauge the reliability of the billing company.

3. Ask for a Cost Breakdown

Of course, when it comes to outsourcing essential services like billing, we all want to get the biggest bang for our buck. But there is more to take into account when looking at a price quote than that bottom line cost. In addition to keeping costs down, you should think about what exactly you’re paying for each with the service.

There are a few different ways a medical billing company will charge you. Many will charge by a percentage of your revenue – usually, somewhere between 3%-9% of net collections, depending on your area of specialty. Others may charge a flat fee, or a flat fee plus a small percentage of revenue. To do a cost analysis between different companies:

  • First, decide as a practice if you have a preference as to how you want to be billed. Would you rather pay by a percentage of revenue or flat fee? You can likely narrow down companies by how they charge.
  • Compare rates between a few companies. We recommend keeping this comparison between 5 companies or less, to prevent feeling overwhelmed by options.
  • Make sure to go “line-by-line” when comparing price on quotes. Just because one company is x dollars cheaper than another, doesn’t mean the services are equal in quality. The goal is to find a company that provides a robust service at a great price.

Learn more about typical pricing models for medical billing services.

4. Assure the Company is Compliant

All healthcare practices need to strictly abide by compliance rules and regulations. It’s 100% crucial and non-negotiable for a practice to stay in business and be successful. When speaking with prospective medical billing companies, make sure to find out how they follow compliance rules. You should also ask them to provide you with a list of compliance procedures they take as a company, as well as how they ensure each employee is following rules and regulations.

5. Research Company Reviews

Making sure the company you hire has a good reputation is crucial. As with purchasing any new product or service, it’s best to get online and look up some client reviews of the service. When looking through reviews, ask questions like:

  • Did prior clients have a positive experience with the company?
  • Does the medical billing company deliver on what they promise?
  • Did prior clients experience any errors that resulted in revenue loss?

Additionally, you can ask the company if they have testimonials or references that can vouch for their work. Before you sign that contract, you want to be positive your practice’s revenue is in good hands. If you end up being displeased with the billing service, it can be difficult to get out the contract once you’ve made the decision.

6. Find out How Many Billers are Assigned to your Account

Some medical billing companies will assign just one biller to each account. Others will assign several billers. There can be pros and cons to each method. When having just one biller working on your account, your relationship with that biller can be more personal, and they can give you their undivided attention. However, you may be able to get more done with more billers at work. It largely depends on the size of your practice and the relationship you hope to establish with your biller.

You will also want to find out the credentials, years of experience, and specialties of each biller assigned to your account. This way, you can ensure it’s a good fit for both you and the medical billing company.

7. Look into Software Compatibility

Are you currently using software internally for patient accounts, financial data, and other back-office tasks? You may want to look into medical billing companies that use software that is compatible with the one you’re using. Transitioning into a new software can expend extra time, money and resources. There can also be a learning curve as you train your colleagues to use the new software. You can also ask medical billing companies if they include software training upon signing a contract. If so, ask whether or not they offer it for free. 

Additionally, asking about which software a billing company uses can help you make sure your staff is comfortable with the user interface. As busy healthcare professionals, you will want to optimize your workflow and prevent complications with data entry. You are hiring an outsourced company to help with your workflow, after all. You should make sure it’s as easy and seamless for you as possible.

8. Establish Communication Expectations

One concern many practitioners have when deciding on whether or not to outsource medical billing is that they will experience broken communication. When billing occurs outside the office, you don’t have the convenience of walking down the hall and asking questions that require an immediate response. Plus, since financial management is so crucial to your company’s day-in and day-out duties, you want to be sure that if you have a question, you’ll get a timely response.

Before hiring an outsourced medical biller, ask them about their communication style. How soon do they respond to calls, questions, and requests? If you have an urgent question, will they be there to answer it for you when you need them? These questions can be crucial to developing a trusting relationship with clear and open communication with your medical biller. 

9. Ask How They Handle Rejected Claims

Did you know 65% of medical billers never edit and resubmit rejected claims? This can be a huge problem in the medical billing industry. It causes significant revenue loss for healthcare practices every year.

When deciding on the best medical billing company, be sure to ask them how they handle rejected claims. Make sure they have a process in place for resubmission, so you can assure you’re getting the money you worked hard to earn. Additionally, ask about their rate of rejected claims. If the company reports a high volume of rejections or denials from insurance carriers, it’s a sign that they are not billing and coding correctly.

Learn More

If you are searching for the best medical billing company for your needs, we can help! 360Connect has 13 years of experience connecting medical practices with the best medical billing company that fits their practice. To get started, just visit us here and answer a few simple questions about your practice. Then, we’ll put you in touch with our best billers that can accommodate you. We’re always 100% free with no obligation to buy!

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