How do I control my off-site billing service?

Maintaining Control of an Off-Site Service One of the big concerns that medical practices have when it comes to hiring a remote service provider for such duties as billing is worries over how to maintain control over the process. After all, if you were to have issues you would like to review with the billing service it is hard to sneak in a lunch meeting a week away if the service is located two time zones away. Thanks to email, instant messaging and even Skype businesses have come a long way when it comes to becoming more comfortable with a remote service provider. However, there is nothing quite like the personal touch to make sure that the professional relationship continues to be mutually beneficial. One way to ensure control over the process is to have a standard set of expectations from both sides. While the medical practice may think that their responsibility begins and ends with paying the billing service’s invoice on time each month, there are additional responsibilities to consider. For instance, each side should come to an agreement concerning when raw claims data will be sent to the biller’s offices. It is unreasonable for the provider to send one batch per month and still expect a 30-day turnaround time from the date of service. Further, there should be an established set of reporting each month or each week, depending on the needs and desires of the medical practice. The reporting may include claims received, claims sent to health-plans, percentage of Medicare claims, number of denial appeal letters generated, or any other data that the office deems important.

The medical practice should also feel comfortable enough to ask the biller to produce the occasional ad hoc report as well. This may be detailed denial reports, CPT based reporting, turn-around time for payments, etc. This sort of information can prove to be very valuable should a medical practice be negotiating a renewal of their Humana or Aetna contract and wish to bring some data to the table.

Finally, the key to maintaining a sense of control over your off-site service is to have faith in their abilities coupled with open lines of communication. This starts by selecting a service that you feel is a good fit with your medical practice and continuing to work through any issues that may arise.

For informational purposes only.