Outsourcing Medical Billing and Collections: How to Successfully Transition from In-House Billing Operations

Consider this situation: Brandon has recently transitioned to a remote work structure. He plans to hire a virtual community manager. To do this efficiently, he preps a series of questions to assess job applicants—years of experience, comfort of working in a remote setup, experience with team management, salary expectations and so on. Brandon shortlists a few candidates following the first interview round. He conducts a few more interview rounds with the shortlist and hires one candidate who starts a month later.

Wondering what this has to do with transitioning an entire process? To begin with, it is about asking the right questions to arrive at the best possible solution or conclusion.

Outsourcing Medical Billing Collections: Questions You Must Ask Your Vendor

We’ve curated this list to help you ask your vendor the right questions when you decide to outsource medical billing services.

Question 1: How experienced is your billing staff and do they have any certifications?

Answer: Outsourcing medical billing collections is no small feat. That’s why you must know who is handling your billing processes and whether or they are qualified to do so. Confirm with the service provider that they work with experienced and trained billing staff who are backed by certifications or accreditations. It may also be worth inquiring about their communication and time-management skills—ask about the number of accounts each person handles.

Question 2: Are you HIPAA-compliant?

Answer: Most outsourcing billing service providers comply with the Health Insurance Portability and Accountability (HIPAA) Act—it safeguards patient health information and medical records. However, merely being compliant isn’t enough. Vendors must work with compliance officers to monitor and ensure that all HIPAA standards are met. These officers must ensure that compliance violations (if any) are attended to and dealt with in a timely manner.

Question 3: Do you share periodic reports with your clients?

Answer: The vendor must share customized reports detailing the status of accounts receivable and billable services to help you access information concerning your business. You may choose how frequently you want to receive these reports.

Question 4: Can you tailor your services to suit my business requirements?

Answer: The essence of outsourcing your processes and paying a fee for it is to get specific services which fulfill your business requirements. That’s why you must ask the billing vendor if they can customize services to fill the gaps in your current billing operations or workflow.

Question 5: What’s the frequency of submitting claims. How long do you take to process them?

Answer: The frequency of claim submissions and the time required to process them is fundamental for revenue inflow. Now that you know what to ask your service provider, let’s move on to navigating the transition process.

How to Transition to Outsourced Billing?

The process of transitioning from in-house to outsourced billing services can be unnerving. Here are some tips that will help make the processes easier and let you avoid potential snags.

Explain the process to your employees

Chances are that your decision to outsource medical billing and collections is triggered by staffing changes. Let’s say an in-house biller resigned from your company. It’s not easy to constantly replace skilled talent. However, if staff attrition is the reason your processes are suffering, outsourcing billing services may actually be a practical idea—it’s an opportunity to control staffing costs and improve operational capability. Outsourcing may create a sense of fear in your employees with regards to their job security. For this reason, you should clearly communicate the reason for the strategic change.

Choose a reliable outsourcing partner

Choose an outsourcing partner that can act as an extension of your day-to-day back-office functions. Often outsourcing can lead to challenges like delays in communication. The provider you choose must be responsive to your needs and pull their own weight to release the administrative burden on your staff.

Sometimes a bargain may seem worth it, however, the services may not not deliver the best ROI. For instance, a certain outsourcing provider may advertise their services at a discounted price of 30%. However, issues like billing errors, inefficient follow-ups and poor communication may disrupt margins.

Hopefully, these tips will help you easily transition and settle into outsourced medical billing.

Choose HelioNext as your partner in medical billing management services. We have more than 15 years of experience managing pre-collections, eligibility verification, claim submission and settlement, contract negotiations and denial management for a variety of clients.

Deliver value-based patient care while you leave your administrative burden with us. Get in touch today!