Ensure Your Outsourcing Arrangement Bears Fruit

If your practice is falling behind in its billing and collections, consider outsourcing those functions. Take care, though: Outsourcing can work either very well or very poorly. Here how to ensure your experience is fruitful.

Pick Only The Best

When outsourcing billing and collections, look for a firm with certified professionals committed to improving your practice financial performance. It should be able to handle electronic and paper claim transmissions, insurance verifications and authorizations, plus standardized billing policies, procedures and protocols.

The firm must adhere to best practices for billing and collections, and provide timely reporting on performance indicators you request. A provider must also have state-of-the-art IT systems and coding methodologies that optimize revenue opportunities while complying with all laws and guidelines.

As competition among billing and collections firms is keen, insist that your pick go beyond basic services, offering training and continuing education for your staff and doctors. Also, ask the firm to contractually commit to identify ancillary income for your practice.

Go To The Core

Even if a potential provider looks good, you should still request a list of references (or even a complete client list) and ask each one about its level of satisfaction with the firm.

Also ask your state medical societies whether the prospective provider is in good standing with them. In addition, determine whether the firm has adopted and documented their own compliance plan that adheres to the Office of Inspector General (OIG) guidelines.

Look at the firm benchmarks, such as claim turnaround times, net collection rate and days in accounts receivable. And determine how often and in what detail reports will be provided to you.

Seed The Contract In Your Favor

When you decide on a billing and collections firm, turn your attention to the specifics of the contract. It should start with a description of the firm expertise in claims submission for the practice specialties, followed by a list of services to be provided, performance standards to be met and a payment schedule.

The contract should also state that the firm will continually update its payor policies and profile information as well as inform your practice of any such changes. Of course, be sure to have your legal counsel review the contract before you sign it.

Insist On A Sweet Deal

Outsourcing your billing and collections function can be a sweet deal, but only as long as you find the right provider and sign a sound contract.