Choosing (or changing) the medical billing service you work with can be stressful. You aren’t just picking the company that will handle day to day billing—you’re selecting the RCM partner you’ll count on to keep your organization compliant, ahead of the curve, and forward-looking as reimbursement shifts from fee-for-service to value-based models.
Here are 4 key things to think about when considering medical billing service vendors:
#1 – Expertise and experience in medical billing
Medical billing is complex. So look for expertise and experience—especially in the operations leadership and key staff. Yes, this will mean fewer basic errors. But it will also ensure the team is proactively seeking the most accurate and beneficial billing outcomes, because they’ll know what’s possible and how to achieve it. The right partner will also identify targeted revenue-enhancement opportunities, and bring them to your attention. That type of insight requires experience.
#2 – Payer reimbursement and patient billing
With the rise of high-deductible health plans, a greater and greater portion of your revenue will come directly from patients. So unless you plan to handle all patient collections in-house, you should look for a medical billing service with the demonstrated ability to communicate and collect effectively and empathetically.
It’s hard to overstate the importance of this. Here’s why:
First – of course – ineffective patient collections means more bad debt and increased write-offs. But the impact is bigger than just the bottom line. Indifferent and confusing billing frustrates patients, creating stress during what is often an already stressful time in their life. It risks souring the patient’s relationship with their provider, and can even lead to patients avoiding follow-up appointments or additional care they need. The best revenue cycle management partners truly care about the patients their clients serve—and that comes through in how they communicate with patients when it comes to collections. In the end, that also translates to more effective collections. Why? Because when patients understand their options and feel trusted and respected as opposed to hounded, they respond with good-faith efforts to pay their statements.
#3 – Commitment to going beyond core RCM competencies
Efficient claims management. Proactive outreach to payers. Following up on all delayed or denied claims and collecting every dollar possible. Those are a few of the table stakes—but there’s more to medical billing than simply clearing a low bar. Your medical billing service should also have a vision for strengthening your revenue while empowering your staff. That means developing new services and technology that ease your organization’s burdens and enable you to focus on serving patients. From back-office functions like credentialing and denial management to front-office offerings like value-based care assessments and eligibility verification, your RCM partner should have a clear strategy in place to streamline medical billing. They should do more than just solve problems—they should help you identify and take advantage of revenue enhancement opportunities.
#4 – Alignment of mission and culture
With some vendors, you’re looking for a commodity, plain and simple. But choosing an RCM partner is much more akin to hiring a new employee or team of employees. In fact, you’re counting on them to become part of your team. That means accountability, integrity, and transparency are just as important as the ability to deliver healthier reimbursement and better AR performance. Without a foundation of trust, any financial gains will be offset by the cost of time lost to conflict, unnecessary back-and-forth, and passing the buck when it comes to tackling challenges together. Think about what you expect from your best employees and colleagues—that’s what you should expect from your medical billing service as well.