As you compare potential medical billing services, take the following steps to determine the best candidate:
1. Get a full picture of the company's features.
Claim scrubbing and follow-up are par for the course. You'll also commonly find that RCM companies include reporting, consultation, and EMR and PMS access with your services. Check for these features as you speak with company representatives.
You should also determine whether the features that accompany your medical billing leave the company or your own team responsible for entering and coding charges. It's worth asking if your billing service candidates are following the most recent ICD-10 coding system updates. You should also get a sense of the billing company's experience with other practices in your specialty. Lastly, ask about the depth and extent of reporting and analytics solutions.
2. Compare prices.
RCM companies will generally take a monthly percentage of your collections instead of charging a flat fee. The percentage will vary based on the factors described above, and different billing services may quote you different percentages. Think about whether a company that charges you more would provide better services than your other candidates before making a decision.
As you compare prices, you should also check whether the RCM company includes EMR system and PMS access with its billing services. These inclusions may justify the company charging higher prices. That said, most medical billing services require you to use their PMS (and a few have the same rule about their EMR system). In some cases, migrating your data from your old platform to your new one may incur additional charges.
3. Determine how long setup and implementation will take.
Since you'll be installing software (unless you are opting to work through your existing software provider for your billing), you'll need to account for the implementation process in the timeline. Fully setting up the software side of your billing services often takes several weeks to three months. Sometimes, the setup process results in additional fees, though we found that many companies include implementation and training for free.
FYI: Medical billing setup and implementation can take anywhere from several weeks to three months.
Check whether your medical billing provider includes free training with your implementation. If it does, chances are you'll be paired with a dedicated account manager who will help you set it up. You may also get access to setup resources you can browse on your own time.
4. Figure out your support options.
With medical billing services, support isn't just about phone calls and emails; it's about having a full, transparent window into your billers' work at all times. Look for providers whose PMS platforms include a portal where you can see your claims' real-time status and look over your third-party billers' work.
On the traditional support side, you should check whether you can reach your provider by phone, email or live chat at all times or just during weekday business hours. The company's representatives should be happy to assist you and easy to reach.
Your billing service should also provide you with your payers' electronic remittance advice and explanations of benefits. These documents are important for obtaining a transparent view into your payers' operations.
Tip: When dealing with something as sensitive as your practice's finances, you should thoroughly vet any potential service partner to guarantee trust and transparency.
5. Consider patient engagement tools.
Medical billing is primarily a payer-facing need, but not entirely. Since most medical billing services require you to use their PMS, they may also manage the patient portal that most PMS platforms include. This means that your billing service can directly send patients their statements and follow up on unpaid charges. Should statements go unpaid long enough, your billing service could even oversee the process of sending patients to collections.
It's important to find out whether the patient portal will cost your company extra or is included with your billing services. You should also find out how exactly your company of choice pursues unpaid bills and how long it waits to send these bills to collections.