First Thing To Ask You Medical Billing Company

8 Questions To Ask Your Medical Billing Company

As a medical practice, you probably spend much of your day tackling medical billing. Whether you’re filling out claim information, submitting bills, or tracking down payments, you likely find the process time-consuming and labor-intensive. Outsourcing medical billing is a great way to save time on medical billing tasks without sacrificing quality and accuracy.

Benefits of Outsourcing Medical Billing

Outsourcing medical billing services provides hospitalists, clinic managers, and other medical professionals with a consistent billing and collections process that can make revenue cycles more sustainable. Because medical billing companies work solely on this task and don’t get distracted by other administrative components of your practice, you can reduce error rates and get paid faster. 

Partnering with a medical billing provider who understands the industry helps you stay in compliance with ever-changing insurance rules and government regulations. You can also free up more time to care for patients, tackle other administrative tasks, and market your practice to attract new business. 

The Top 8 Questions to Ask Your Medical Billing Company

Multiple factors contribute to a successful partnership, and you want to find the right fit. Gathering detailed data on potential companies will help you make an informed decision that gets the results you want. Before you choose a medical billing company, ask the following questions so you can partner with the best team for your business.

1. What Are Your Collections Rates? 

Collecting your outstanding bills is vital to keeping your practice afloat. The 1st medical billing metric that should be on your radar should be collection rates. Many companies average 80%, which means you won’t collect on 2 out of 10 of your medical bills. 

The American Academy of Family Physicians recommends an adjusted collection rate of 95%, which refers to the percentage of reimbursement you actually collected versus the amount allowed. With over 20 years of experience in revenue cycle management, PUREDI offers an average collection rate of 95%. 

Partnering with an experienced medical billing company helps improve your revenue cycle and cash flow, which in turn allows you to effectively treat patients without worrying about business operations. Look for a company with knowledge you can leverage to boost your operations. 

2. Will I Be Able To Speak to Someone in the U.S.? 

Time is of the essence in the healthcare industry. You are required to submit claims and other documentation within a given timeframe for proper reimbursement. When your system glitches or stops working altogether, you need someone to help you fix it as soon as possible. 

Medical billing is a specialized field that requires a unique skill set. Any software company can outsource its tech support, but this could be a drawback for medical billing. Each country has its own set of healthcare guidelines and regulations. If your software is malfunctioning, it could impact your ability to be compliant with Medicare, Medicaid, and other rules and regulations. 

At PUREDI, you can always speak with an account manager based in the United States. Speaking with overseas account management teams can make communication difficult. Our U.S.-based account managers are well-versed in our software and will work with you to get your system back online quickly.  

3. How Long Do You Work Claims? 

The longer your claims remain outstanding, the more they impact your cash flow. Your medical billing company may strive to reach an 80%–90% collection rate. Therefore, they may set limits on how long to work on an outstanding claim, as they're not committed to collecting on every bill. For example, a company comfortable with an 80% collection rate may consider an account uncollectible after 364 days and write off the money as a loss. Look for a company that is dedicated to securing your payments. PUREDI will work on your claim for as long as it takes to collect. 

Our team consists of experienced medical billing professionals who can assess your outstanding claims with scrutiny. We can also work with you to assess your billing and collection processes and improve them to reduce your average revenue cycles. 

It’s important to work with a medical billing provider with the necessary experience to take on insurance companies and get them what they need to settle outstanding claims. 

4. What Is Your Denial Rate? 

There are plenty of reasons insurance companies and other providers deny claims. Many times, claim denials happen because you failed to file within the deadline or because your form is missing information. Denials are frustrating, but working with the right partner can help you keep them in check. Experienced professionals understand common causes of errors and know how to fix them. 

PUREDI has an average denial rate of 5%–10%. However, we have a 93% submission success rate and will work on claim denials as they come back. We offer a denial codes library and other tools that help maximize your chances of successfully resubmitting each claim. If we do experience claim denials, we will assess the initial submittal to determine why it was denied. It could be as simple as tracking down medical records to prove that you submitted the claim within the timeframe. 

Choose a medical billing partner who understands claim denials and works to correct them before writing the payment off as uncollectible. 

5. What Reports Do You Provide? 

As you search for a medical billing service, consider how a company can help you improve your practice. Medical billing software often features reports and analytics that offer valuable insights into your revenue cycle. 

Look for companies that track important metrics to inform your business strategy. See whether your provider tracks metrics in real-time or within a specified period. Real-time metrics help you make data-driven decisions that help you improve your business. 

For example, when you’re first starting with your medical billing partner, they may show you a high average accounts receivable number. Use this information to assess your practice and make positive changes to shift these metrics. 

PUREDI tracks several insightful analytics that can boost your operations, including days in accounts receivable, clean claims rates, and average reimbursement times. Use the data to set goals and measure your progress. 

6. What Training Does Your Staff Have? 

Your medical billing company should hire experienced, certified professionals who are familiar with billing terminology and relevant coding systems. Regulations and requirements change so often that navigating the medical billing system can be time-consuming and complicated. Look for a provider who stays up to date on the latest coding and compliance standards in the industry and encourages their staff members to continue their training and education. 

Ask each potential provider how they train their staff and how they stay current with industry changes. At PUREDI, we employ a team of highly trained professionals with ample experience. We stay updated on industry regulations, coding changes, and trends that may impact your business. We can help you stay in compliance with shifting rules and evaluate your previous claim submittals to reduce claim denials. 

7. Do You Make Patient Phone Calls? 

As you collect outstanding medical bills, you will contact insurance companies and patients. Your medical billing provider should be able to contact patients to clarify missing information, ask questions, and attempt to collect outstanding payments. 

Some companies provide teams whose sole responsibility is to call patients with questions and collections issues. Choose a partner who can handle this responsibility professionally. Patient calls don’t always go smoothly, particularly when trying to collect money. You need a team of experienced professionals who can stay calm and collected and empathize with your patients. 

Experienced medical billing professionals can also walk your patients through their bills to help them better understand charges. PUREDI routinely calls patients as part of our medical billing services. 

8. How Much Do Your Services Cost? 

Outsourcing your medical billing services can seem like an unnecessary expense, particularly if you’re strapped for cash. However, a third party may be just what you need to collect on outstanding payments and improve your cash flows. 

With the right medical billing company, you can reduce your revenue cycle and keep more cash on hand to cover the cost of service. That said, you still need to find a company that meets your needs while accommodating your budget. 

PUREDI’s medical billing software is customizable, offering you the features you want at the price you need. We offer multiple pricing models to fit your practice, including a subscription model starting at $199 per month per provider. At this level, you get unlimited claims transactions and unlimited eligibility transactions. 

We also offer a transactional model for agencies watching their wallets more closely. If you want a full-service solution, ask about our professional revenue cycle management solution, which includes a dedicated account manager, claim review before submittal, and more. 

Leave Your Medical Billing to PUREDI

When you choose to outsource your medical billing and revenue cycle management, the right partner makes all the difference. Choose PUREDI to access our cloud-based, intelligent software developed by industry experts. 

Schedule a demo today to see how we can help you.