Surgical Billers

Here are a few tips for choosing the right medical billing service for your practice:

• Choose a medical billing service with expertise in your medical specialty, as each specialty has it's own insurance regulations governing claim submission and payment. It is imperative the billing service stays current with the constantly changing claim submission regulations to ensure the fastest insurance reimbursement. For surgical billing, we recommend choosing a billing service with certified coders, whom are highly trained in correct coding.
• Make sure the billing service does not require insurance payments be deposited to their account. Many services have enacted this requirement, which is considered illegal by Medicare. These same services will hold your income hostage for any dissatisfaction they have with your office. Do not give them this advantage over you!
• Make sure there is no setup fee required. There is no justification in paying a startup fee with any billing service. If they will not waive this fee, find another billing service.
• A billing service does not need to be local to provide your practice with excellent services, however make sure they are familiar with the insurers of your state. With today's technology, a billing service can be located in any state, thus giving you a broader base of potential candidates. Many medical practices make the mistake of considering only a local billing service, which might not always be the best qualified company.
• Make sure the majority of claims are submitted electronic, as this is the fastest and most accurate way to send insurance claims. Not all insurance carriers are set up to receive claims electronically. At the very least, make sure those insurers you bill the most are submitted electronically if available.
• Ask for references and make sure those providing the references have used the medical billing service for longer than six months. It usually takes that long to determine the success rate of the billing service.
• Ask the medical billing service what is their annual "denial rate" or the number of denied claims per year. The denial rate should not be higher than 5% for any given year and the smaller the denial rate, the better for you.
• Ask the medical billing service what is their "average turnaround" on the payment of claims. This is not always up to the billing service, as each insurer pays claims at different cycles, but you don't want to wait more than 35-45 days for processing of your claims.
• Ask the medical billing service what reports they provide to assist you with managing your practice. Make sure there is an internal report for tracking your accounts receivable and a listing of your monthly transactions.
• Ask the medical billing service if they are compliant with HIPAA regulations. All medical practices and their business associates (including medical billing services) must be compliant with the OIG's regulations for patient confidentiality.