Additional billing services

Medical Billing Services Buyer's Guide

Many medical billing services offer more than just claims submission and accounts receivable work. Make sure you evaluate the benefits of extras, from in-depth reporting to practice management and other services.

Reporting
The quality and availability of reporting is another distinguishing feature among medical billing services. With detailed and comprehensive reporting, you can better adjust your billing practices to improve revenues.

As part of your evaluation, get sample reports from each of the providers you're considering. Compare how many options you have for sorting and filtering the information – is it easy to look at only the largest claims, or the oldest, or all claims for a single person?

Monthly overview reports should lay out your entire billing picture: the total number and value of claims submitted, paid, rejected, and still outstanding. The provider should also report on all denied claims and what steps they've taken to correct them, as well as those that have been written off or turned over to a collection agency. Finally, providers should offer an easy-to-read accounts receivable aging report so you can track how effective the service is at collecting on claims 30, 60, and 90 days after the claim was submitted.

If you use a web- or software-based connection to the billing service, you should be able to pull additional reports on your own at any time. Also, look for a system that lets you export data so you can do your own analysis.

Practice management and EMR
Some billing service providers also offer medical practice management (MPM) and/or electronic medical records software (EMR). These systems are important purchasing decisions on their own, so avoid making a decision based on convenience. However, using one provider for all your office software systems does simplify integration issues – and a completely integrated system is quite powerful.

For example, with an integrated billing, MPM, and EMR system, doctors can enter a diagnosis during an exam, and that code is automatically stored on the patient's electronic chart and forwarded to the billing service along with the relevant insurance and demographic information. To achieve the best level of integration, make sure the systems you choose use the industry-standard HL7 protocol.

More common than complete MPM or EMR offerings among billing services are basic practice management features that are built in to their billing system. The most common example is scheduling and appointment management: since the system needs to have demographic and insurance information on all your patients, including scheduling features is a natural fit.

Additional billing services
Some billing services offer other financial services as well. For example, medical financing, which is similar to factoring, can help you address short-term cash flow problems. Medical financing can provide a loan based on your expected receivables at a better rate than you'd get from a bank. Other providers may incorporate accounting features into their software packages, or provide an easy way to export financial data for use in a standalone accounting program.

Providers can also provide consulting and/or training to help you improve your coding and claims submission processes. They can combine their thorough understanding of your current operation with the experience of many other providers to recommend the best methods to reduce rejections or improve collections.