What to look for when hiring a biller

Medical billing or practice management is not to be taken lightly. We are not here to tell you that anyone can do it. We are here to say that as physicians you must choose this person or company with extra care because your practice depends on it! FACT: A Biller can make or break an offices income.

Before you can choose a billing person you need to know what your goals are. Some practices benefit by outsourcing their billing to keep patient care separate from billing and reimbursement issues. Decide first if outsourcing your practice is indeed what is best for you.

The following are what you should look for: Experience or training-while experience is always a plus don't rule out the new billing center who is knowledgeable and continues to educate themselves. If you overlook a billing center with NO current clients, or only one or two clients remember that means extra time they have to spend on your practice. Just make sure their knowledge is up to speed in your specialty and they will continue to educate themselves. Ask for credentials, type of education they have accomplished, and what their future goals are for their business. „X

Request the amount of knowledge or credentials they have in coding. While coding ultimately should be the responsibility of the physician, a good billing person should be knowledgeable about coding issues and be able to spot errors, and advise.

Request references „X

Ask questions such as "How will you follow up on claims?" What type of appeal system do you have in place? The Biller should know that follow up is the most important task and that appeals must be done. Keep in mind that not all Billers do appeals. „X

Ask what type of reports you will receive for your practice? How frequently? (Monthly, quarterly, annually, etc.) It is recommended that posting payments and adjustments be made in office and not by the Biller. This way you can watch your percentages closely.

Can they track and manage managed care visits? „X What type of practice management software are they using? Can they provide you with remote access or a read only copy in the office to help you and your staff collect the appropriate copay's? Again, it is recommended that posting and adjustments are made in office and not by the Biller. „X Are they up to date on their coding books? „X

What are their collection practices and procedures? i.e.; do they provide soft collections, alert you to take action on accounts needing extra attention? Ask how they will inform you of the calls made, appeals made, and problems with any accounts. „X How can you reach them if you should need them? Are their hours of operation consistent and can you depend on them to be there during business hours of operation? Will they return your call within a 24-hour period? „X What are their fees?

If it is based on a % will it be of total practice collections, or total charges billed? Do they have a startup fee and what does that start up or setup fee include?