18 PERSPECTIVES A resource for the radiology industry brought to you by ADVOCATE

ASK

Not all billing companies provide the same level of service. Make sure you will receive proper management attention and management reporting. Ask for a sample of the management reports that you will receive on a monthly basis.

Ask how they quantify and report on claim denials.

Ask how they quantify and report whether insurers are paying the proper amounts.

Ask them about their management philosophy. Compare their answers to their competitors.

Do they bill for one or two specialties? Or are they a data-processing firm, processing claims for

many specialties?

Beware of the company with very low fees. You will get what you pay for.

Beware of the companies with multiple products, like software and billing. These are two very different businesses and one area usually gets all the attention, causing the other product line to underperform.

Find out how long the company has been in business. Beware of the new company. A new firm has a lot of glitches to work through, and you do not want to be the guinea pig.

Meet their management personnel and ask how the company handles sub-specialized management disciplines within their organization. Ask about

TIPS FOR SELECTING A BILLING COMPANY

A physician’s decision to change billing services is never an easy one. Fear of a transition is the

main reason most radiologists are un-willing to move to a better billing option. This fear is usually based on the nega-tive experience of a colleague regard-ing a particular billing service. Advocate has extensive positive experience with the process of transitioning our clients’ radiology practices. We have developed many special management tools that have made our transitions smooth and seam-less. There are many questions that one should ask a perspective billing service. Once your practice makes the decision to explore other billing options, consider the following:

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such topic specialties as information technology, coding, financial analysis, and staff audits.

What sort of communication do they plan between your group and their billing company?

What is their initial clean claim submission rate and how do they monitor improvements?

Do they have the proper bonding and insurance?

Try to get a feel about whether they are an innovative, proactive company. You don’t want just a data-processing firm. Do they understand their business and yours?

Do they routinely audit personnel?

Most importantly, check their

references. References can you tell you the real story.

Have them explain in detail their data integrity improvement process.

Do they perform eligibility verification prior to claim submission?

Do they perform any verification steps to see if patients registered by the hospital as self pay actually have some type of coverage?

Have them explain their entire self pay billing process.

Have them explain their claims status verification process.

Do they utilize software to verify payors have paid the proper amount and does their system provide reporting to monitor on a monthly basis.

Have them explain their denial management process.

Have them explain their medical

necessity reduction efforts.

Find out what feedback is provided to radiologists on report format & content?

Have them explain their process for verifying all exams are billed.

Ask if there are any charges other than the monthly fee.

Find out if they prepare a revenue budget and variance analysis. If yes, have them explain how they will accomplish this.

Keep in mind, any potential billing company can say the right things; however, can they provide data to back up their answers? Are the processes transparent? While it is the billing company’s job to do just that and bill/obtain the most reimbursement for you and your group, do you currently have easy access (at your fingertips) to monitor your data daily? At ADVOCATE, we’ve made sure we do all of this and more.

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