Hiring a Medical Biller? 10 Essential Questions to Ask

As a private practice owner, consider hiring a third-party medical biller to handle your billing needs. Whether you are new to the idea or have already made the decision, there are crucial questions you should ask your prospective medical biller or billing company before bringing them on board. While this list is not exhaustive, it is a starting point to help you make an informed decision and ensure a successful partnership.

What is your experience and background in medical billing?

Start with the basics. Inquire about the biller’s experience, background, and education in medical billing. While formal education is essential, on-the-job experience and expertise can be equally valuable.

Have you handled billing for practices similar to mine?

Verify that the biller has experience in your specific medical specialty. Different specialties come with unique billing challenges, and you want someone familiar with the intricacies of your field.

Do you have experience with payers in my area?

Each region may have its payer requirements and nuances. Ensure that the biller is well-versed in dealing with payers in your area.

What services do you offer, and what don’t you handle?

Clarify the scope of services provided by the billing company. Some may not handle patient balance inquiries or coding, among other tasks. Understand precisely what they will handle and what responsibilities will remain with your practice.

Can I have visibility into the billing system, and how frequently will we communicate?

Transparency and regular communication are vital. Ensure you can access financial reports and stay informed about the billing process. Determine the frequency and methods of communication that work best for both parties.

How do you handle patient balances and inquiries?

Know whether the billing company will manage patient inquiries about their balances or if your practice will handle this aspect. Understand the level of patient interaction they are willing to undertake.

How many other clients do you currently serve?

Find out how many clients the billing company currently manages. Ensure they have the resources to dedicate sufficient time to your practice’s billing needs.

How do you ensure quality control and accuracy in your billing processes?

Please inquire about the company’s quality control measures and how they prevent billing errors. Accuracy is paramount in medical billing to avoid denials and compliance issues.

Do you work with a credentialing specialist, and how do you manage payer enrollment?

If your practice requires credentialing and payer enrollment, understand how the billing company handles this process. Clear communication and coordination are essential during payer enrollment transitions.

What information will I be able to take with me if we part ways in the future?

While you may not plan on parting ways, knowing what information you are entitled to retain if you discontinue the billing services is prudent. Determine if the data will be provided in electronic or paper form.

Remember, these questions are a starting point. Feel free to ask additional questions based on the biller’s responses. Hiring a medical biller is a significant decision, so you clearly understand their capabilities and your expectations for their services. Open communication and mutual understanding will establish a successful billing partnership.

If you have already hired a medical biller or billing company and have valuable tips or insights for your fellow practice owners, please share them in the comments below. Don’t forget to hit the Thumbs Up Button if you found this blog post helpful and subscribe to my channel for more informative content. Until next time, take care and best of luck with your medical billing endeavors!