4 Major Issues to Consider Before Taking the Plunge & Engaging a Medical Billing Services Provider

Thanks to the passage of several recent laws like the Health Insurance and Portability and Accountability Act, HIPPA, and the more recent Health Information Technology for Economic and Clinical Health HITECH Act there has been an increase in the number of firms that are offering medical billing solutions for the healthcare providers.

This is largely due to the ease with which all these issues can be dealt with using digital electronic means.

The Electronic Health Records, EHR, act went a step further to make sure that all patient information is presented in an electronic format. In a nutshell this refers to the systematized collection of patient and population electronic health information in a digital format. The bottom line being to make it easy for this information to be shared across different health care settings such as hospitals, billing and insurance providers, making for seamless and accurate transfer of patient information.

Medical billing services providers were the first to spot this opportunity and to use these laws to position them as the people who do all the billing and payment tasks while the hospitals engage in their core mandate which is to provide high quality healthcare to the population. As a healthcare provider you need to consider whether these services are appropriate for your setting and here is a list of things that you need to ask yourself before taking the plunge.

  • Cost- You need as a healthcare service provider to be aware of the cost that you will incur once you commit yourself to the service provider. The range of charges is usually in the region of 4-9% of your total monthly income.

Therefore you need to find out the level of services that you will receive clearinghouse payments and if they exist whether they will be lumped alongside the commission fee, and whether this rate will include the co-pays to your staff.

  • Bouquet of Services – Broadly speaking no two medical billing services providers are alike and so you need to be fully aware of the nature of services that they will be offering and exactly how they will go about the entire process.

For instance, some will scrutinize your medical claims and follow up on the payments with the payer (insurance company) while others will go beyond the scrutiny to analyze your accounts payable periodically. Do deep research to identify the partner who will offer you exactly what you need.

  • Interaction – Find out if the billing services provider will engage with the patients directly i.e. in collecting their demographic and medical information and the whole idea here is for you to find out the level of interaction that you want the company to engage in with your patients and to make them tailor their interactions according to your wishes.
  • Support – You will require a level of service from the medical billing services provider that will take care of all your needs and emergencies as they arise. You must be kept in the loop throughout the course of the relationship in all the decisions that they make that relate to you.

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