From the Atlantic to the Pacific:

Using an Out-of-State Medical Biller

When it comes to organic produce, local is probably best. Looking for a plumber?   Using a guy from your zip code is probably the way to go. However, when it comes to outsourcing medical office services such as billing and credentialing it can prove to be very cost effective to search outside of your local area.

The first question medical offices may have is this:  Is it even legal to use an out-of-state service? As a matter of fact, it is absolutely legal and many medical offices choose non-local service providers. When shopping for a remote medical biller, be certain to convey to the service that you expect them to be knowledgeable about any and all related statutes that may apply to your state, outside of federal guidelines.

Medical Billing

The reasons for using an out-of-state service are varied. It may be that that you can get a more reasonable rate with a non-local company or the service level that you can receive at a distant company may be better than what you are able to get locally. Additionally, many practices would rather that their immediate medical community (including billing services) not be privy to their financial information, client base or revenue stream. In some areas these communities are fairly tight-knit and information may flow in ways in which physicians do not approve.

Another reason can be the additional services that a remote company may be able to provide to your medical practice. While simply getting the billing piece out of your hair is great, perhaps you also want someone to work on credentialing, create web content or tackle other administrative duties. Frequently, wrapping up a package deal is much cheaper than using several vendors for a variety of functions.

Also, an off-site company may have unique expertise in your type of specialty and utilizing them may maximize your reimbursement from payors. This may hold true for an allergist, anesthesiologist, specialty surgeon or chiropractor. In some of those cases, there can be bundling or benefit issues that a particular biller may be savvy about.  Thus, using them is healthy for your bottom-line.

Finally, perhaps you live in part of the country where medical billing services are not on every corner the way Starbucks are jumping out at you on every street in New York City. For those in the Upper Peninsula of Michigan, isolated Alaska or mid-South Dakota medical biller resources may just not be there. In those cases, off-site is a very logical choice.