by Plutus Health
Determining whether to use in-house or outsourced billing is a critical decision. Many providers find security in constant oversight of this crucial process. However, hiring a certified professional billing company ultimately offers greater time-savings and revenue-generating potential.
To achieve this potential, practices must determine which features are most valuable. Competent providers will have a ready-made list of inquiries to pose to a billing agency.
What questions do you need to ask to choose the best outsourcing billing partner?
Inputting charges leads to approximately 5% of insurance denials. The process is uniquely challenging due to shifting insurance contracts and national standards. As such, practices must allocate significant resources to handle coding internally.
When outsourcing coding, it’s preferable to consolidate the task with the biller. This centralization allows you to send less information and sign one contract. Also, you eliminate holdups caused by needing to communicate a coding delay to the biller. So, practices must determine how adept a candidate is at both tasks.
Healthcare has different specialties with distinct regulations. Coding dental implants is notably different from coding mental health therapy. Specialization is the best tool for handling unique requirements. Learn if the company structures its workflow to target certain specialties. Some billing companies hire and train staff with the goal of maximizing competency in one field.
The average claim processing time is between 30 and 60 days. However, complications during the partner data transfer process can cause significant holdups. Notably, failures to establish compatible software or provide software that can be used effectively are common.
Ensure that your medical management software is something the billing company is comfortable using. If not, you’ll need to spend time transferring to a new system. Depending on this system's features, changing software may be a wise long-term investment.
Modern billing advancements dictate that any competent company should have heavily automated systems. These programs speed up processes and reduce billing and coding mistakes.
While this software is impressive, it currently still requires human oversight. The errors the overseer finds are typically complex. As such, pairing experienced, well-trained staff with modern programs is the most desirable combination.
Seasoned organizations are typically more reliable than new entities. The more jobs a company has successfully executed, the better. Request a summary of similar clients and their outcomes.
Accomplished billing company understand how important long-term goals are to healthcare finances. Ask if the company will map out an improvement plan with you. This map should contain achievable, measurable goals that the billing company can regularly review.
Maintaining a close eye over your billing process is critical for long-term growth. Modern practices must observe poor performance quickly to begin forming adjustments. As such, it’s preferable for billing companies to provide complete transparency and regular reports.
Unfortunately, some organizations only send annual reports. Ask if the biller can provide a monthly or bi-monthly financial report. If you’ve created a long-term plan, the partner should prepare analytics that outline shortcomings. Some offices will offer suggestions for improvements based on current trends.
A competent partner will alert you regarding contracting errors. Payers may under-reimburse contracted services. Catching these discrepancies can be difficult, and your billing company is an integral safeguard.
Plutus Health is an organization dedicated to combining technological improvements with top-tier staff. This combination consistently hands our customers a maximized revenue flow. Our quick clean claims delivery has earned us a loyal consumer base with diverse needs. Visit our website to discover how our systems can improve your revenue cycle management.
1. Can the billing company provide high-quality coding?
2. Is the billing company well-equipped to handle your specialized field?
3. Does your current software systems have the needed functionality to provide an optimized revenue cycle and does it seamlessly match your partner’s software and knowledge?
4. What level of automation has the billing organization paired with experienced workers?
5. How well has the billing companies previous clients fared?
6. Does the company send regular reports?
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