Medical billing companies

How to choose a medical billing company

A billing company takes over the work between the visit and the payment: charge entry, claim scrubbing and submission, payment posting, denial follow-up, A/R work and patient statements. The best ones also tell you why money is late, not just that it is.

What it usually costs

Most billing companies charge a percentage of what they collect for you, commonly somewhere between 4% and 10%. Lower rates usually come with higher volume or fewer services included. Some charge a flat monthly fee or a fee per claim instead. Always ask what is included in the rate and what is billed extra, for example patient statements, credentialing, old A/R clean-up or setup.

Questions to ask before you sign

• How many practices in my specialty do you bill for today, and can I speak to one?
• Will your team work inside my EHR and PM system, or move claims into your own?
• What is your first-pass claim acceptance rate, and how do you measure it?
• How quickly are denials worked, and who decides when to write something off?
• Which reports will I get each month, and can I see a sample?
• If we part ways, how do I get my data and open A/R back, and what notice is needed?
• Will you sign a HIPAA business associate agreement (BAA)?

Red flags

• A percentage rate quoted before anyone has looked at your payer mix and claim volume.
• Long contracts with a large exit fee and no performance terms.
• No access for you to your own billing system or reports.