Permit me to jump in here and add to Susan’s discussion yesterday. . I happen to be a fan of billing services for smaller practices, and have used them in the past for clients with success.
A small correction: billing services should be paid as a percentage of collections, not claims. This insures that they have an incentive to follow up to collect on a claim. Generally that will be the practice.
Your contract with the service should be reviewed by an attorney. You should retain the right to dismiss them at any time (with some provision for transition), all records are your property, and you should retain possession of sufficient records so that you could take over billing at a moments notice.
Look at the mundane things – what will you bill look like? Will the service use a professional looking envelope? No joke – I’ve seen bills that I almost mistook for junk mail. Envelopes should be imprinted, not using stickers or – yes, I see it – rubber stamps.
Calls about accounts should generally still come to the practice itself. If they go to the service, you direct the policies for handling requests for payment plans and discounts. Keep an eye on this, monitoring how calls are answered and if patients say anything to you. From time to time, you can ask patients about their experience with the company
When interviewing companies, ask specifically about backup and disaster plans – what happens if there is a fire or computer crash? Visit their offices, and look around for up to date manuals. Ask about the training and continuing education of all employees, and ask about membership in professional associations.
It is mandatory that the service bills electronically. Frankly, I would avoid the one person at home operations. With these setups you are vulnerable to the one person getting sick, disabled or killed, and are unlikely to have the fully functional disaster backup and recovery capability that you need.
Your responsibility is to review you’re A/R on at least a monthly basis. No account should ever go to collection without the explicit permission of a physician owner, and the practice administrator/manager should be involved in the decision as well. Personally, I believe that all pending collection accounts deserve at least one last call before a referral out. I would call early on – many people will offer a credit card when called. Your bill is just another one in the pile.
If you are currently using a service, every few years do check around and meet with other services, to compare performance and cost. If you already are handling billing and collection in-house, have a review done of performance from time to time. Your people need support, and you need to invest in up to date manuals and ongoing training manuals. Part of what you pay for with a service is this kind of expertise, but the expertise is not unique. You can build an expert team in-house by recruiting good people and investing in their skills.
Small practices are often best served by a billing service. For larger practices, it comes down to preferences, and the degree of management attention that you want to spend on this function. As with any professional service, get references, interview carefully, and monitor performance over time – and don’t be afraid to change if you need to.