4 Mandatory Things To Ensure When Outsourcing Your Billing Needs

4 Mandatory Things To Ensure When Outsourcing Your Billing Needs

Medical physician and practices are striving to upgrade and outsource for improving revenue cycle and reduce cost. By opting for outsourcing your billing, you get the advantages of experienced biller and best practices of billing without going through the hectic process of recruitment or managing staff. The decision to outsource impacts the bottom line of the company so, it needs a thoughtful approach.

outsourcing billing


Finding a company with experience in your requirment with a compliantly track record will optimize your revenue. It is foremost to know what credentials the billing company have? This is an important factor to ensure before choosing your billing and coding partner. You need to have the information about your outsourcing company on following aspects;

  • The reputation of the company.
  • Time period they have been into this business.
  • Do they carry professional liability insurance.
  • Demand for a written contract of the services which they are claiming.
  • The number of clients they acquire.
  • Ask for some reference, so you can contact the current clients for the reviews about their services.
  • Ask for a written compliance plan.

A credential company will help impact your business in considerable way as they have already dealt with complicated tasks in the past.

Training of the Employees

You need to make sure that the your billing service company is holding certification from a Professional Billing Organization. The company should have professionally certified coders working for them.

Your second step should be extracting more information about the guidance and ongoing education the company provides to their employees. The service should be updated with the new codes of CPT and HCPCS.

The billers too needs to know about the aspects of coding to perform excellent job for your practice.

Cost of The Service

Some billing company’s fee is based on percentage, you need to know whether it is the percentage of charges or percentage of receipt. It is good to have a knowledge about handling refunds.

You are required to know about the instructions of the company about the start-up fee. You need to select a company you can trust for billing because even if you are outsourcing, you will be responsible for your own claims.


You should always make sure that their service should help you with forms, office processes, superbill design etc. Learning about the parameters the company put into use for underpayment or denial will give you a better understanding about the management of the company.  You should know the protocol of the company in case of missing any information or any error is discovered.

Ask whether the service can provide you with the reports for determining physical compensation level and also can they report on capitated service utilization. Make sure that you ask for their month end report to judge how robust the company is in their services.

Medical billing is an important aspect of the healthcare industry. You need experienced personnel to navigate all the complex areas involved with billing and coding. It becomes even more important to choose the right billing service for keeping up in the healthcare marketplace for success.