RCM questions you should ask when reviewing a medical billing company

What happens? When you chose a wrong billing company, something similar can happen to your practice But, what’s more to it is that choosing a ‘good’ medical billing services almost always guaranties an increase in collection rates, and reduction in overall rejection or denial rates!

How should you choose your billing service? By asking them a lot of questions! 23 RCM questions you should ask when reviewing a medical billing company

1 2 3 4 Do they provide a summary of your current ‘Accounts Receivable’? 2 Do they offer ‘Denial Management’ on your existing claims? 3 Can they keep track of and make analysis of your ‘Rejected Claims’? 4 Can they offer a ‘Code Analysis’ based on your existing medical practice’s history?

5 6 7 8 How good are they at ‘Contract Analysis’? Can the billing company add value to your business with their ‘Fee Scheduling’ knowledge? 7 Do they have ‘Certified’ coders taking care of your coding needs? 8 Do they utilize ‘Specialty Specific Coders’?

9 10 11 12 Do they offer ‘EMR Specific Billers’? Will they offer ‘Patient Eligibility Verification’ services? 11 Are they having separate teams for handling claims, rejections and denials? 12 How transparent are their reports?

13 14 15 16 Is the medical billing company offering any dedicated revenue reporting app/platform for the organizations to keep track of their revenue whenever needed? 14 Can they offer benchmarking services to track your doctors’ productivity levels with other doctors in the area? 15 Do they offer patient billing services? 16 Are they engaging ‘Insurance Specific Calling Teams’?

17 18 19 20 Is the billing company ‘HIPAA Compliant’? Are their teams well-versed at mapping codes from ICD 9 to ICD 10? 19 Will they be providing ‘RVU Analysis’ specific to your healthcare organization? 20 Do they offer ‘Contract Negotiation’ services to maximize your revenue?

21 22 23 Would they assist the medical practice in ‘Credentialing’ with a specific insurance company? 22 Do they schedule weekly/monthly governance meeting? 23 Are they having teams who can manage ‘Patient Support’ and ‘Patient Portal’ to assist you with patient management?

Does your billing company answer these questions..

Summary of a practice’s A/R

Top CPTs of a medical practice in Tennessee

Physicians Performance Reporting Apps

Coverage Plans Unreviewed Rejection Reports

Physicians Productivity Analysis Report

What must be considered is that as the no What must be considered is that as the no. of rendered services increase so does the cost/fees. The healthcare practice must engage a proper balance by considering their in-house proficiency and the billing company’s expertise to work out a cost effective, performance-centric solution. And, keep in mind, that you get what you pay for.  Lower costs aren’t always the better option, and a lower fee of smaller bottom line doesn’t always save money!

Hope this article helps you choose your billing company wisely