Danger Signs That You Need To Be Alert To While Selecting A Medical Billing Company

Outsourcing medical practice billings can be a very sensible and profitable decision and is especially useful for those who do not have the people, infrastructure or even the funds to keep the function in-house. There is always a running debate as to which is less expensive – in-house or outsourcing and there are always practices that are transiting from one system to the other. Outsourcing is not without its pitfalls, and there are a number of danger signs that can alert you of hazards that might cause friction or financial loss during the period of the contract with particular medical billing service provider. Some tell-tale signs that should warn you:


No Existing Clients in Your Particular Specialty

While billing services have the training to handle all medical specialties, it can be very difficult for a biller to be up to date on the rapidly changing environment of your specialty just for you. If they have multiple clients in the same specialty, there is obviously more incentive for them to know and learn the latest techniques, terminology, and compliances. If they do not have clients in your specialty, you need to be extra careful in laying down performance standards for them to abide by.

Too Selective About References

It is quite true that if you ask medical billing services to give you references they will obviously give you the names that will give them a good report. Ask for the entire list of clients and see if they are readily amenable or just give you a list of selected clients. If the number of clients on this list is a small percent of what they claim to have, then it is a good time to wonder about the quality of services rendered to the rest.

No Access Given to Look up Patient Records on Their Billing System

It might seem strange but there are a number of companies who simply refuse to give their customers login credentials to enable them to check patient records and accounts. There are many reasons, which may be given by the agency but really you should be looking askance at this reluctance to give access to after all what is your own data.

No Permission Given To Run Own Reports from the System

Ask to see sample reports generated by the service provider. You will be surprised to see that many operators give reports on spreadsheets using data inputted manually from other sources. Since the report is not system generated, one can never be quite sure regarding its veracity. It is better to stay away from agencies that will not allow you to generate reports on the fly so that you can monitor the situation and not let discrepancies be covered up.

No Interaction Permitted With the Account Leader

The biller might claim that they have a large team of account servicing executives, all of whom will be responsible for handling the work but you should insist on a meeting with the senior executive who is supposed to be in charge of your account. This will not only enable you to put a face to the relationship but also make a particular person accountable for coordinating with you. Also, the interview will permit you to evaluate whether he is a dynamic individual capable of adding value to your practice or simply a robot capable of only entering data into the system.

No Performance Guarantees Given

One of the foremost considerations in awarding an outsourcing contract is that the biller must be ready to offer concrete turnaround times for processing claims, entry of charges, etc. If the performance benchmarks are not clearly settled at the very outset, you will never be able to achieve any real efficiency in your billing. There is little point is transferring your internal inefficiencies to someone else and paying for the honor.


Choosing a biller is not as simple as it seems. There are lots of agencies out there who simply do not have either the competence or the integrity to service clients in a professional way that’s mutually beneficial. Be on guard and exercise due diligence on the factors that are especially important to you so that you do not lose out instead of increasing your profitability.

Author bio:

Graham Dickson is a veteran in medical billing services having worked in senior positions for a number of reputed agencies. A passionate blogger, he has written dozens of articles on the benefits and hazards of outsourcing billings.

Image Credit: Sandeep Aegis

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