Outsourcing Strategy 101: Crucial Questions to Ask Healthcare Billing Companies

Practice Management

Outsourcing Strategy 101: Crucial Questions to Ask Healthcare Billing Companies

Date Posted: Thursday, June 30, 2022


Healthcare billing companies are excellent partners to the mainstream medical industry-hospitals and independent or group clinics. With complex medical billing and coding guidelines increasing in recent years, it is becoming pretty challenging for providers to maintain healthy financial management by themselves. Healthcare billing companies assign dedicated professionals to take care of this job and make the practice more efficient.

Outsourcing regular day-to-day work proves to be beneficial if you have the right partner to support you. However, outsourcing a part of your job means working with another company as an extension of your team. It would help if you planned out your outsourcing strategy well before going into business with professional healthcare billing companies. This article will take you through essential questions that you must ask the healthcare billing company before signing the papers. 

1. What is the standard turn-around time they maintain for processing their clients' claims?

Time is of the essence when filing medical bills and sending them to insurance companies. Several healthcare organizations suffer from a severe lag time in processing claims from the time of service. It can then lead to late charges and often errors in claim management. Leading healthcare billing companies maintain a standard turnaround time (TAT) of 24 to 48 hours. They have dedicated teams working on specific accounts who are adept at their work to provide the best service to you. So make sure you ask about the TAT they maintain because it will affect your workflow significantly.

2. What is their reporting and correspondence practice?

You must have a transparent relationship with your outsourced partner and stay on top of every update that might affect your business when it comes to outsourcing. Most professional healthcare billing companies are offshore. Maintaining a healthy, transparent business relationship could get challenging if you don't have a proper communication channel. Experienced RCM companies who have been in the field for more than a decade have mastered the business process outsourcing practices. 

They have a reporting workflow where they have daily, weekly, monthly, and quarterly reports sent out to different levels of management to update them about any new development in their accounts. Leading offshore healthcare billing companies work in U.S. time shifts to be in regular touch with their counterpart from the healthcare organization. Ensure that the company you choose has a standard reporting practice that is aligned with your business goals.

3. What kind of process do they follow for staff training?

Outsourcing medical billing and coding can be challenging because their work performance is directly going to impact your revenue flow. Medical billing and coding guidelines often keep evolving, and payment rates and codes are updated every year. A medical coding team must be aware of all new updated changes and how they will implement them in their client's workflow. Therefore, staff training is a critical parameter to note to know how the company invests in improving their performance and delivering the best results to their clients. Look for healthcare billing companies that follow set guidelines and modules for staff training to keep them well informed at all times.

4. What is the comprehensive list of services they provide to their clients?

You might have contacted a few healthcare billing companies to inquire about a specific aspect of the revenue cycle management issue you are facing. But you should also know which other services the company can provide other than the one you asked for in the first place. For example, you could be looking for denial management services only. But the company should have the ability to handle end-to-end revenue cycle management services to support you in any time of need. 

Professional RCM companies with years of experience in this field understand their clients' pain points. Besides usual billing and coding services, they are also experts in provider credentialing, medical transcription, data processing, and customer support services. Knowing these points could be beneficial for a healthcare organization, since having a partner with sound knowledge and processing capability of the industry could help you when you decide to scale up.

5. How are their customer support channels?

Customer support is exceptionally crucial for a business relationship to yield good results. If you have an outsourcing healthcare billing company working from an offshore location, you should know how and when you can expect your problem to get resolved if you run into one. Because customer service is one of the building blocks of a business relationship in current times, you must know how you can approach your offshore team. Leading RCM companies provide 24/7 customer service for their clients through phone calls, text chats, or email support. Make sure your business needs and goals are aligned with their service. In the healthcare industry, you could run into an emergency at any time. Since medical billing and coding involve dealing with sensitive patient health information, you should have ample resources to reach out to in case of any need. 

Apart from these very crucial questions, there are simple yet vital points that you must know when planning your outsourcing strategy in healthcare billing:

  • How can they support you in case of scalability?
  • Are they HIPAA compliant?
  • What other security measures do they take to safeguard patients' safety?
  • How long have they been in the industry?
  • Are they experienced enough in the specialties you have in your organization?
  • What are some of the client testimonials that they can share?

Some Questions to Ask Yourself

Before chalking out your outsourcing strategy for healthcare billing companies, you must have a clear goal regarding your own business. You should know the purpose of outsourcing in the first place and exactly which services you should consider outsourcing. Make sure your business goals align with the healthcare billing company you choose. Evaluate your finances and tally them with the outsourcing option to understand how you can benefit from it.

We hope this article helps you understand the different crucial questions you must ask healthcare billing companies as part of your outsourcing strategy. 

Shehan Wilson is Assistant Vice President - Sales, Mergers & Acquisitions at QWay Healthcare. Shehan comes with 19+ years of experience in various domains of U.S. healthcare markets. He has hands-on expertise in developing lean and cost-efficient business models for providers and hospitals. He works to ensure his customers gain value in outsourcing their back-office functions and truly benefit, by delivering designed solutions using the right process design, technology, and human resources. For more information, visit: https://qwayhealthcare.com/hospitals-and-doctors

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