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Just How Good is Your Billing Company?

February 21, 2017 | 10:18 am
Published by | Krunal Popat

With all the difficulties associated with denials of claims, the transition to ICD-10, high deductibles, and the complications of following the Affordable Care Act, having the right medical billing specialists can make all the difference. They provide you with the expertise needed to help your practice with its revenue cycle management.

A recent survey by AHIMA showed that up to 35% of organizations believed that they would actually lose revenue because of the ICD-10 transition alone. So, it’s little wonder that more practices are switching to firms and consultants to handle their medical billing and coding needs.

Whether you hire a company or a medical billing consultant, it is important to understand if you are using the right services for your needs. This will mean asking the right questions so that you get the best service.


There is no substitute for a specialist in being properly certified. They should be part of the professional community that words on claims. In addition, the company should provide regular training for their employees to make sure they are up to the expected standards. Plus, if you have a particular need in coding, they should be able to handle it. So, make sure the company or medical billing specialists you use are properly certified and experienced.


It is true that many in the field are well adept in doing the easy work, but may have more difficulty with the harder challenges of billing and coding. So, you will need to ask the following questions;

  • How much experience do you have in the field?
  • Who has the responsibilities for collections?
  • What methods do you use for billing the claims?
  • How do you deal with issues like denied claims, down coding, high pending ARs, and services that are bundled?
  • Is there a basic strategy that you follow for all of these challenges?

Dedicated Management

Is there a dedicated manager for your particular practice? This is another very important question to ask because otherwise you might get lost in the shuffle. You should also find out about the capacity of the company itself because if they take on too many clients, your services will suffer.

Having a dedicated manager is good because they can better understand and handle your particular billing needs. In addition, there should also be experts available to work on your claims around the clock if necessary. The better the overall service, the better your revenue will be thanks to their dedication.

Get a Business Associate Contract

This is common with most companies and medical billing specialists or consultant. However, it should have a clause that lets you out at any time if you are not happy with their services. This is important because if you discover that they are not working their best for you, you will not have an easy way out.

Also, you’ll want to know if they keep track of their performance and how they have improved over the years. Benchmarks are a good thing when working with a medical billing consultant or firm. That way, you can see the improvement in your revenue cycle management.