Should I Outsource My e-MDs Medical Billing? Part 2

Should I Outsource My e-MDs Medical Billing Part 2

You’ve decided to outsource.  Great!  Decision #1 behind you.  Now what?  Well, you need to decide on the right billing company for you.  Here are some things to think about:

Q: How does the billing company integrate with my current practice management system?

As a third party billing company that works exclusively with e-MDs practices, we use the practice’s current system to perform all billing functions.  Some companies may have a system that is independent from your system.  For example, you use Allscripts and their system might be based on an Epic platform.  How are you going to get your claim information to them for processing?  Fax?  Secured email? Dropbox?  There could be additional costs and staff time commitments associated with those options.  You may even be asked to build a third party “data bridge” to migrate information between systems.  That could get expensive as well.

If they are using your practice’s system, will they need training?  How well do they know the product?  If they can’t use the billing module inside your practice management system, you may be missing out on reimbursement opportunities.

Q: Who controls my practice data?

This is a great question.  Over the years, we have seen a number of clients deal with billing companies that would keep their data from them.  The companies would use some proprietary software and then hold all of the data from the practice until a monthly meeting where the billing company would share “selected” reports.  You need to look for a company who will not only provide billing transparency, but one who will offer to educate you as a client on what to look for on a daily, weekly and monthly basis from a reporting standpoint.

Q: How does the company communicate with my practice when there are issues?

With all of the concerns surrounding HIPAA in this day and age, you need to make sure your billing company has a secure way to communicate with you regarding sensitive Protected Health Information (PHI).  If your current EHR system has an internal messaging system, fabulous!!!  If not, what is the plan to have discussions concerning coding issues, front desk procedures, patient payment plans, etc.

Q: Where is billing company’s billing team located?

This is not merely a statement in support of “Made in the USA”.  Rather, this is to have greater control of your practice’s data.  There are a number of billing companies who charge extremely low fees for their services (2% of collections or less).  That’s a warning sign that the people working your account may be in a foreign country.  Who’s mandating their HIPAA compliance?

Q: How much should you be paying for an outsourced billing service?

Most companies base their fee on a percentage of the amount that is collected for the practice (The exception to this is NY).  If you are a small practice, $15,000.00 or less in practice revenue per month, you could be looking at anywhere from 6.5-8.0 % of collected amounts.  For larger practices the percentage goes down.  A practice with 6 Million in revenue per year should see a percentage in mid 3% range, and so on.  Of course, this varies by specialty and area of the country.

Q: What services should I be receiving with that percentage?

Most companies will pay for cost of clearinghouse fees, statement costs, eligibility costs as a part of their fee.  Having said that, read any outsourcing contract very carefully. Are there startup charges? How about costs for things like sending reports? What happens if you want to end your agreement? Check your contract length and make sure there is an out for you prior to the end of the term.  You want to know that the money you save by outsourcing isn’t offset by often overlooked “fine-print” fees.

In conclusion, outsourcing is a great way to increase practice revenue, remove office drama, and allow your clinical team to focus on practicing medicine.  Feel free to reach out if you ever have any questions or are on the fence about making the move.  I’d be happy to provide some coaching on the topic.

Solor is a specialized third party medical billing company for e-MDs® Practices.  e-MDs® is a registered trademark of e-MDs Inc.  e-MDs Inc. is not affiliated with Solor, Inc., our products, services, or website.