Top 3 Considerations to Effectively Evaluate a Billing Company

effectively evaluate a billing company

Given today’s climate, and the pressures of healthcare practices collecting on their fees, physician groups and professionals need to know how to effectively evaluate a billing company. Declining reimbursements, increased costs from complex regulations, and higher employee costs are just a few of the reasons why these groups should consider hiring a billing service or replacing their current one.

Here are three considerations to effectively evaluate a billing company:

1. Performance vs. Price

Billing services tend to reflect “you get what you pay for.” It’s easy to set up and operate a billing company that can handle simple tasks, but it’s a different thing altogether when looking for a highly optimized service that can achieve high levels of net collections, consistently. If a practice just focuses on the price, many factors – denial management, A/R management, patient payments – may be overlooked, directly impacting the practice’s revenue.

Therefore, it’s imperative for practices to look at both performance and price to determine its best interests. Companies might be able to find a low-cost service, but that usually means they have less investment in technology, training, and repeatable processes. To make sure you are collecting all the fees that are owed to you, you need to consider performance as a key driver in your decision-making.

2. Reporting and Dashboards

Another avenue to explore to effectively evaluate a billing company is reporting and dashboards. A few years ago, access to real-time data and information gave companies and practices a competitive advantage; now it’s standard just to stay in business. Today’s leading companies offer their clients robust advanced analytical reporting and “dashboards” showing practice performance at a glance plus the ability to drill down into details as needed. It’s important to ask to see the billing company’s standard monthly reporting package. 

Along with “charges, adjustments, and payments,” these reports should also include summaries by payer, by location, and by physician. Additionally, being able to receive customized reports, and in the formats you need them in, would be ideal. Be sure you’re able to visualize the most important elements of your billing practices so that your practice can maximize its reimbursements.

3. Technology

A final way to effectively evaluate a billing company is to see how advanced their technology offerings are. Technology is what enables real-time data, so the incorporation and investment of emerging technologies like artificial intelligence (AI) and machine learning (ML) should be included in your billing company’s offerings. 

You can read about the importance of AI in medical billing by reading our white paper, “Why AI Technologies Are Essential for Your Medical Billing.” 

Given the constantly changing regulations and complexities within the industry, technology is imperative. It’s a huge advantage to deal with a company that has its own proprietary software and IT resources. Remaining independent of third-party services enables your practice to receive customized features, interfaces, implementations, and increases time management. Of course, the billing technology used by a billing company must be robust. The company should be experienced with front-end interfaces of all types, whether from a hospital ADT or ECC system, RIS, PACS, LIS, or EMR. Finally, make sure that they will be responsible for quickly and seamlessly integrating their technology into your current stack. Your business can’t afford any downtime, as that will directly impact on your revenue collection.

To learn more about best practices and how to evaluate a billing company, check out our “How to Evaluate a Billing Company” white paper, get in touch with an AdvantEdge expert, or stay up to date on company and industry trends by visiting our Linkedin page