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Medical Billing

The Questions to Ask a Billing Company Before You Sign

The answers that predict a good relationship are about definitions and termination, not about promised collection rates.

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2 min read · by White Glove Medical Billing
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Most billing evaluations focus on results a vendor cannot control. The questions that actually predict the relationship are duller and more specific.

On money

  • What exactly counts as collections? Copays taken at the desk? Capitation? Incentive payments? Refunds netted?
  • Is there a monthly minimum? No minimum on a percentage arrangement means small practices are served at a loss, which shows up as service.
  • What is billed separately? Clearinghouse fees, statements, postage, setup.
  • How is legacy A/R priced? It is harder work and should not be at the standard rate.

On the work

  • Do you code, and are your coders certified? If they code and are paid a percentage, what governs the interaction?
  • How is clean claim rate defined? Clearinghouse acceptance or first-pass payment. The answer tells you a lot.
  • How quickly are denials worked, and rejections? Rejections are the invisible queue.
  • Which metrics do you report, and can I reproduce them from my own system?

On the ending

The most revealing section, because it is the part vendors have thought about least.

  • Who works outstanding A/R after notice, for how long, at what rate?
  • What data do I get back, in what format, and how quickly?
  • Do payer enrollments stay in my name?
  • What is the notice period, and is there a penalty?

The tell

A vendor who answers these precisely has been through a transition and learned from it. One who waves them off in favour of talking about collection improvements is selling an outcome they do not control.

Denials Piling Up?

We handle the revenue cycle end to end — coding by certified coders, claim submission, denial management and appeals, and A/R follow-up, with six reported numbers every month.

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