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The billing company you hire will become a vital part of your organization, and it's crucial that your new set of employees are people you can trust. However, many billing companies will 'over-promise and under-deliver' by making false marketing claims and stretching the truth in their sales pitch/advertising, in order to gain you as a client. Here are some warning signs to be on the look-out for so you can make sure to hire a company you can trust:
1. FALSE PROMISES
"We WILL get your claims paid faster!"
"We can get you reimbursed for 100 PERCENT of billed charges!"
While these statements sound promising, if it sounds too good to be true, it probably is. Unfortunately, no billing company has control over how fast insurers write a check. They also cannot promise such high reimbursement rates—especially with so many payers on the market.
Choosing the wrong company can result in payment delays, or worse, the inability to collect on services you provide. When you choose a billing company, you need a group of experts that you can trust, and a company that knows how to solve specific billing problems.
If you are considering hiring a billing company, first think about what problems you are trying to solve. Then, make sure the company has the solutions you need by asking specific questions about your problems.
2. High Accounts Receivable Balance
When your accounts receivable balance is sitting mostly in the 'over 60-day' category, you are at increased risk for not getting paid. With each day that passes, it is more likely that the claim will go unpaid. You want to keep your entire A/R balance low, but you should aim to receive all payments in under 60 days.
Your third party medical billing company should make sure that the transfer of patient and insurance data is properly collected and submitted in a timely fashion. This will ensure that claims are submitted accurately the first time, reducing delays in payment and claim denials. Your billing company should also take steps to ensure you know where you need to collect. Weekly reports highlighting patient co-pays and balances can help you stay on top of collections, and is a service the billing company you hire should offer.
3. Frequent Staff Turnover in Your Facilities
Training new staff members can be difficult. Your billing company should work with your facility staff to ensure they know the processes for seamless insurance payment. For instance, they should coordinate with your staff to:
Collect of patient demographics and insurance info before the first appointment
Upload patient information in the electronic health record
Verify that medical notes in health record are complete and signed for each day the patient was seen
Keeping all staff up-to-date on these simple practices can make a huge difference in the financial health of your facility.
4. Lost Billable Days
In some cases, payers deny billable days for not meeting medical necessity. When you hire a billing company, their utilization review team should work closely with your clinical team to prevent billable days from being lost. Weekly (or more frequent communication with clinical staff) can help you get maximum days authorized for the patient.
5. Unjust Claim Denials
If authorized claims are denied, your billing company should be ready to help you overturn those denials. They should provide a review of records and help you draft an appeal letter to the payer or to the state.
Before you hire a third party medical billing company, you need to know their services and support will fit your needs. At Datapro, we offer comprehensive services to solve these common billing problems and more. Schedule a complimentary 15-minute consultation with Datapro experts by calling 805-579-3537 or contacting us online.