Choosing a Medical Billing Company
How agile is your RCM company?
"We have never subscribed to the notion that each medical practice must fit within the confines of a ridged, inflexible service offering. What is good for one organization may not necessarily be the right fit for another. Rather, our approach is to custom-tailor our services and solutions around each and every client based on their specific, individual needs. The result is a medical practice which not only achieves maximum revenues, but also experiences refined work flow and fewer headaches."
– Markus G. Mulhauser, President & CEO, AgilityMD/PractiSource, LLC
While some companies make blanket claims that they are the “best” billing company for all medical practices, AgilityMD (a division of PractiSource) takes the approach that each company, just like each medical provider, is unique in it’s own ways and that the two must match each other to correctly achieve the best possible outcomes.
To make things more confusing, there are over 500 medical billing companies which use the AdvancedMD™ platform to provide medical billing services to medical providers. Some are local "mom and pop" shops - while others are large, overseas groups which rely on volume and automation (rather than service and maximized revenues) as their business models. Neither is right or wrong - but choosing the right partner for your practice can be difficult and confusing. From management perspectives to operational procedures, customer support and system offerings, there are a many differences to consider.
We suggest making sure that the company you chose matches your desires in the following areas:
Ability to maximize revenues. Sure, all billing services say they will maximize revenues, but how confident are you that the companies you are considering can actually do it? Take every function of the billing process as well as the people who perform the work into consideration.
Follow-up Protocols. This may seem similar to the above, but it is so important (in our opinion) that it deserves its own category. How do they perform insurance and patient follow-up functions, and how in-line are these processes with your ideal expectations?
Stability and Size. Look at the entire spectrum and everything in between. Are you dealing with a “mom and pop” shop with limited resources and the associated risks? Are you better suited by the opposite end of the spectrum? Is the company subject to the whims of venture capitalists and investors? What is the background of the executives? Are they profitable? Are they going to be around to serve you in the long term? No answer is right or wrong, but they need to be compared to your expectations and desires.
Systems. While the ability to maximize revenue is most important, you should also choose a company that provides you with a billing management system that comfortably suits your needs in a variety of ways such as appointment scheduling, data transfer, patient tracking, and reporting. Systems should be highly accessible, user-friendly, and have extremely high level functionality. You may also want to make sure that the system provided can seamlessly work hand-in-hand with Electronic Medical Records (EMR) systems both now and in the future.
Internal Structure. The internal structure of the organization should be conducive to both maximizing reimbursement and to customer service. Determine if they use billing “assembly lines”, or if they have a one-on-one or small team approach. Make sure the company structure makes sense to you and meets your expectations.
Level of Experience. It is important to note not only the experience of the company, but also the experience levels of the actual specialists, supervisors, and managers who will work on your account.
Billing Service Internal Procedures. You can often tell a lot about a medical billing company by their internal procedures and protocols. Believe it or not, many don’t have any. Ask what type of quality control initiatives they have in place. See if these initiatives are formalized.
Customer Service. There is not a salesperson in the world who won’t tell you that the company they represent has the best customer service. So dig deeper. Ask about policies. Most importantly, make sure the structure of the company does not hinder your access to the specialists who actually perform work on your behalf.
Transparency. Make sure that data regarding billing is available to you at all times. That means charge data, payments, outstanding claims, user notes and follow-up detail should only be a few clicks away. This level of transparency ensures that you can audit your billing service and maintain complete control over your practice.
Redundancy. Outsourcing your billing to an outside service can have the added benefit of creating a level of billing redundancy to make certain your revenue cycle stays on track and generating maximum income. But don’t take this for granted. Investigate levels of personnel redundancy to make sure that your billing continues to be processed properly without delay if a specialist leaves unexpectedly. Also check into redundancy related to the company’s computer systems.
HIPAA and OIG Compliancy. Make sure that your billing service has a formal and correct HIPAA and OIG compliance policy. This is essential in ensuring security for both you and your patients.
Patient Relations. Different billing companies treat patient billing and calls in different ways. Check into the procedures and tactics used to collect payment from your valued patients. They should not only be effective, but should also reflect the manner in which you want your patients treated.
Workflow Changes. Ask yourself if your organization is going to have to completely change the way you function just to accommodate your billing service, or if they are willing to work with the way you operate. A billing company should have options which integrate seamlessly with your processes and not require significant change or realignment. Can they help you create internal workflows that are efficient?
Cost. What is the overall cost? Look at the details. What is included and what is buried in the fine print? Are things like software, training and postage included? Are there startup fees or any hidden costs? Do fees seem exorbitant or perhaps even too good to be true? Sometimes you get what you pay for (good or bad). Make sure to compare apples to apples. Cheapest is not always best.
At AgilityMD, we believe in long term, mutually beneficial relationships with our clients. And that starts by making sure we are the right match for you. Please do not hesitate to contact us today to see how our answers stack up.