What Questions Should You Ask a Biller Company Before Hiring Them?

Billing is a function that is critical for the financial cycle of all health care providers including midwives. It requires attention to detail and experience with the electronic and paper systems used in billing healthcare services. It is clear that understanding billing procedure is important to you as a midwife. While you may see a lot of billing courses online and in some institutions, billing for your own practice is crucial and time consuming that may affect your practice as well.

Hiring a biller company could be an option that you can consider for your midwifery practice. If you will hire a biller company you can avoid doing everything on your practice like submitting timely medical claims to insurance companies and payers such as Medicare and Medicaid, preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing, setting up patient payment plans and work collection accounts, updating billing software with rate changes, updating cash spreadsheets, and running collection reports and so many grueling tasks that will greatly affect your services.

However, after you reached into the decision of hiring a biller company, the next consideration you should deliberate is asking “who will you hire?” Do you have any specific criteria based on your needs? Background checking with their previous clients, did they encounter previous issues and how they were able to overcome those issues. To help you with that, here are some questions that you can ask a biller company before hiring them for your midwifery practice.

1.    What will it cost?
This is always the main thing on everyone’s mind. The rate should be under 8% of collected charges. A percentage is a better option than a flat rate—the percentage usually goes down as your collections go up. Also ask about start-up fees, termination fees, data conversion fees, and any other additional costs. Some companies charge extra for patient collections follow up and other services.

2.    Can they provide references? 
Have they worked with practices that are similar to yours in size, scope, and/or specialty? Do they have testimonials, or can you call someone directly for a reference?

3.    Who owns your billing data? 
Your billing data should belong to you, and you should be able to take it with you if you choose to change services or bring your billing in-house.

4.    What kind of training does the staff have? 
Are they certified? What type of ongoing training do they receive? Are they using the most up-to-date resources and guidebooks (i.e., CPT, HCPCS, etc.)?

5.    Do they have any professional affiliations?
Does the service, or its employees, maintain any professional affiliations such as HBMA?

6.    Do they have a compliance plan in place? 
Are they HIPAA compliant? What are their security protocols?

7.    Who will actually be working on your account? 
Can you meet (on the phone or in person) the actual people who will be working on your account?

8.    Can you get a guarantee of transparency? 
How often will you receive reports showing the financial state of your business and the billing service’s progress? How will they communicate with you and how involved will you be in the billing processes?

9.    Are most of their services electronic? 
In this day and age, most of the processes should be electronic from eligibility verification to remittances. They should also offer credit card processing and online bill pay for patients.
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10. Are there billing follow up items that they don’t handle?
Don’t assume that a billing service will do everything or that everything is included in your rate. Ask up front and be sure you know if there are services that they don’t offer.
There are a lot of choices out there. You may have some questions that are specific to your needs, but the following ten questions should apply to any practice. Ask them to each service you speak with and then compare the answers. Use these questions to help guide your decision when selecting a medical billing service. It’s worth it to take your time evaluating your options so that you get the best service possible from the start.

Additional Resources
Lea Chatham Lea writes educational articles to help medical practices improve their businesses. In addition to Kareo. (2013, February 26). 10 questions to ask before hiring a medical billing service. Kareo. Retrieved May 13, 2022, from https://www.kareo.com/blog/article/10-questions-ask-hiring-medical-billing-service