9 Useful Tips in Hiring the Right Medical Billing Provider for Your Practice

Medical Billing

Small and medium-sized medical practices may face challenges and problems in the processing of medical coding and billing. Many physicians and administrators are finding ways to facilitate the process. If you are one of them, you can think of outsourcing medical billing services to help you.

You can achieve several benefits if you decide to outsource your medical claims processing. You can save on operating costs like personnel wages and benefits, as well as electricity expenses. However, you can only realize these perk if you hire the right third-party provider. Here are the types of medical billing providers and tips on how to choose the appropriate company for you.

Types of Outsourcing Medical Billing Companies 

There are three major types of third-party providers you can hire to manage your medical coding and billing operations. Understand their qualities and capabilities to determine which one is the right for you.

  • Light-service medical billing providers – These are home-based providers that process medical coding and billing on a per-job basis. If you have a limited budget, you can hire their services. Make sure to hire those with proven experience in healthcare bill processing.
  • Full-service medical billing companies – These providers can handle all your coding and billing requirements. Medium and large practices often hire these companies to focus on providing care to their patients.
  • Physician practice management firms – If you want a customized medical coding and billing service, hire these companies. However, be ready to pay a higher amount for their services.

How to Select the Right Provider for Your Practice?

There are several things to consider when you are planning on outsourcing medical billing services. Choosing the appropriate company can improve your reputation and cash flow. Here are some tips for selecting the best provider for your practice:

  • Determine their service offering costs in advance. You can ask the fees for their service early on to know whether you can afford it or not.
  • Inquire about their reputation in the industry. A reputable provider will ensure the efficient processing of claims.
  • Obtain information about their business size and industry experience. Make sure they have a sufficient number of qualified staff to process your claims.
  • Ask for their knowledge of the latest International Classification of Disease Code version (ICD-10). Proficiency in ICD-10 ensures error-free medical coding and billing processing.
  • Demand proof on their specialty billing practices capability. If you plan to expand specialties or subspecialties, make sure your provider can cover it.
  • Assess their responsiveness.  Ensure your provider has the speed and availability in medical processing to avoid causing inconvenience to your patients.
  • Verify their compliance with HIPAA. Select a provider with the Health Insurance Portability and Accountability Act (HIPAA) certification.
  • Ask about their medical billing software. Make sure the technology infrastructure of your provider meets your requirements. Also, ask about the scalability of their software.
  • Know their business continuity plans during emergencies. Inquire about their backup methods to ensure continuous service during emergencies like natural disasters and epidemics.

Hiring the right third-party provider for your medical claims can make or break your practice. By following these tips, you can avoid the stress associated with claims processing and focus on providing the needs of your patients.