Medical practices are having a hard time with ICD-10 transition, claim denials, Meaningful use, high deductibles and complying with the ACA (Affordable Care Act). With these challenges, providing higher quality of care and getting paid are linked to each other.
According to a 2014 survey by AHIMA, 35 percent believed that their organization’s revenue will decrease during the first year of ICD-10 compliance .27% did not yet conduct revenue impact assessments.
Due to these challenges many physicians are thinking about outsourcing their billing services. According to Black Book Report 2015, about 95% of independent practices are looking to outsource their billing services and technology. 64% of those practices are viewing a addition of new software and outsourcing support to improve their RCM services.
So if you have a prospect and it’s a decision making time, hit these questions hard at your billing company!
Ask for a Certified Coder?
- Is there a certified coder working on your claims? Are they a part of a professional community?
- Is there a regular training of employees in the billing company?
- Do you have specific coding needs? How will your biller gain the knowledge when required?
Get them to crack the iron balls!
- It is sad to say but yes, most billing services are focused on tasks that are easily achievable.
- Make sure your biller knows all the tricks of the trade. If not make him crack the whip for your money.
- Did your billing company tell you about your collection responsibilities?
- Are you aware of a collection agency if required?
- How do they deal with common challenges like high pending ARs, denied claims, down coding and bundled services? Do they have a strategy?
Do you have a business associate contract?
- Does the billing service have an agreement?
- How flexible is the agreement?
- The agreement must have a clause which states that the client can end the service anytime if he/she is not happy with the service.
- If they don’t offer this agreement then walk away immediately
Do you have a dedicated manager?
- Did you check the capacity of the billing company?
- How many medical billers are working currently? Is it a single contractor?
- Large Billing companies do provide a dedicated manger.
- Does the billing company offer a dedicated 24/7 experts team to work on your claims?
is there any benchmarks for the biller!
- Did you check if he has any benchmarks to keep a track of his own performance?
- How does he decide a god or bad performance?
- Benchmarks could help you understand what are the chances of improvement
The Medical Group Management Association (MGMA) puts out a yearly report benchmarking the 120-day aging bucket based on the type of medical specialty.
What should be a biller’s workload ranges?
Medical practice experts Deborah Walker Keegan, PhD, FACMPE, Elizabeth W. Woodcock, MBA, FACMPE, CPC, and Sara M. Larch, MSHA, FACMPE, suggest the following figures for billing office staff workload ranges.
They recommend that you review and emphasize the quality of the work, not just the quantity. The ranges are based on seven hours per day, assuming one hour for breaks and interruptions
EMR integrated Medical billing reports!
- The question to look for is, what reports will be available for me to access when required?
- Do you depend on your billing service to send reports on their own, to view billing and collections?
- If you do then what information do you expect in the reports?
- Ex: how did your business perform this month compared to the last
- You always wanted to know what revenue signals you can track
- Ex Top ICD-10 codes, Top payer, last month collection vs current month and many more.
What is the Healthcare revenue Analytics App!
- BillingParadise recently launched theBillingBridge a new healthcare revenue Analytics App.
- This iOS App helps physicians to track and optimize their revenue signals.
- Not only physicians, but billing companies can send reports to their clients.
- More about this App @ http://apple.co/1KVOsUp
What is the cost of a new EHR or the cost of upgrading to their system?
- For a new EHR, Practice management system and/or a billing system,
- A potential billing company should be able to link you to the best and certified EHR as per your speciality
- If you get it at no monthly subscription cost then it would be the best offer you have cracked.
- If you have the technology with you then it is an opportunity to upgrade your billing software & PMS. Check the cost and process of converting to their software
- And the type of training and how their software will integrate with the EHR.
How safe is your medical data?
- Since medical data breach is on the rise, the bottom line now is protection of medical data.
- Check what kind of protection the billing company offers it’s clients from data breach by their employees.
- Check if the billing company assures it’s clients against fraud and theft by their employees.
Ask For A Reference
- Insist to provide contact info of any of their clients in your Area and your speciality.
- This will help you get answer to almost all your questions regarding the services
- It would work best when your practice goes through a software platform conversion, to help you understand how they work.
Don’t let any above questions ignored or turned over. If it happens, close the call immediately. It’s always better to have the answers first. What questions or checklists you have for your billing company?
