Medical practices are required to undergo huge changes from time to time to keep up with the new regulations and technology introduced by CMS in healthcare industry. Take the upcoming ICD-10 implementation, for example. Physicians have already begun preparing their staff (both clinical personnel and billers) for the regulations introduced by CMS for the new coding system.
The challenge
One of these regulations requires practices to upgrade their medical billing system completely. As it sounds, upgrading the entire medical billing system of a practice is a very expensive and lengthy task, which is why many small and medium practices are considering outsourcing their billing to medical billing companies.

The risks
Outsourcing medical billing to a third party is indeed a huge risk. However, this option is feasible for practices that lack the resources, space, people or finances required to keep Medical Billing in-house.
Cheaper options: Despite the need, physicians must be very careful in choosing a billing vendor for their practice. They should avoid medical billing companies that cost much lower than the industry average. Yes, discard the “free medical billing” and “1% of your collections”. Such deals are backed by numerous hidden costs, substandard service, and huge cash flow disruptions for the practice that opts to join them.
References: Some vendors avoid giving any references other than the ones on their printed list.
Limited services:  Others don’t provide physicians with daily reports and access to their software to check patient accounts.
Such billing companies may not provide good results or improve practice workflow and can drag medical practices to bankruptcy.
The evaluation criteria
Alternatively, providers must carefully evaluate Medical Billing Companies on the following criterion:

1. Level of service

All medical billing companies offer basic billing services like claim generation and submission, payment processing and patient invoicing. Providers should thus look for companies that provide additional services like tracking of submitted claims, pursing of denied claims, regular follow-ups, and timely reporting. The medical billing companies should also comply with any recent or upcoming CMS regulations or health IT changes like ICD-10.

2. Industry experience:

In addition to relevant healthcare industry experience, the medical billing vendor must also be familiar with the specific medical specialty of the physician or medical practice. Choosing a vendor that is already familiar with the practice specialty will be a plus point for the physicians as this means the new partnership will get along smoothly and there will be no decline in practice revenue.

3. Use of technology

The medical billing service provider must also make use of technology in such a way that it reduces the gap between the provider and biller. For example, the billing company must have flexible medical billing software that can be integrated with the provider’s EHR.

4. Pricing options

Medical billing companies may charge medical practices a percentage of its collections or a flat fee. Some companies have a hybrid pricing option, which includes both flat fee and percentage rates. There are other billing companies that offer all three pricing options to medical practices. Physicians must look for a reasonable pricing option that does not exceed the industry rate or is very cheap. The pricing option can be compared to the kind of services the company offers or how other providers have reviewed the company.

5. Capacity to take on new clients

Lastly, providers must observe the past  the Medical Billing Services Reviews  and determine whether it has the capacity to take on a new client or not. Sometimes a medical billing service takes in too many clients that its resources fall short to handle the outstanding bills, or in following up on the numerous claims sent to different insurance companies. This can affect the performance of the company as well as the revenue of all the clients.
The criteria mentioned above can help medical practices in finding a suitable vendor to handle its outsourced medical billing. Moreover, physicians can further narrow down their lists of billing vendors by observing their ratings and reviews on top rating websites like Top Ten Reviews, Software Advice, Technology Advice and Capterra. These sites also offer consultancy services for practices that are still unable to find a suitable billing vendor.