Revenue Cycle Management – The Five Things to Expect from Your Billing Company
  1. Accurate and timely coding and claim submission.

This may sign like an obvious expectation, but many companies do not have coders who are specialty specific or have a good knowledge of medical terminology and medical procedures. It is important to ensure that the coders working on your claims have the knowledge and experience to accurately code your claims, so they are complete and legally/ethically maximize your reimbursement. Don’t be afraid to ask questions and ask to meet the coder that will be working with your claims.

  1. Complete claims management.

Your billing and coding company should manage the claims from data entry to collection. That includes being actively involved in coding, submissions, collections, accurate payment posting, denial management, appeals, and providing patient statements. The biller should also be available to take calls from your patients who wish to discuss their EOBs and other questions about their account, thereby freeing up your office staff to manage clinic operations.

  1. Data Analytics.

This may seem like another obvious expectation but are your getting the right data. Most practitioners expect information about their payments, AR cycle timeline, denials, and appeals. But you should also receive and frequently analyze your payer mix by clinic and provider, fee schedule reimbursement, billable versus receivable by provider and payer, AR aging summaries, RVU analysis, and MGMA percentile ranking.

  1. Recommendations

Your billing and coding company holds a wealth of information to help analyze the health of your practice. Include them in the discussions with your practice manager/office manager regarding future strategies for improvement and efficiency. Their information will be valuable. If you are using an independent consultant, they should have open access to your billing company to ensure they are providing you with timely and accurate financial information.

  1. Stellar Customer Support

Not only should your office manager have easy and open access to your biller, but your patients should too. All questions about bills, EOBs, or payment plans can and should go through your billing company. Remember, patients will see your coding company as an extension of your practice, so it is extremely important that your billing company treat your patients and your office staff as golden customers.