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How to Choose the Right Billing Company: 11 Helpful Tips

With outsourcing becoming a norm in our industry, I wanted to share some friendly insights to help you choose the right outsourcing partner for your practice. As the founder of an outsourcing company, I've always believed there's room for everyone to thrive. We've even connected potential clients we couldn't serve with other reliable companies that consistently deliver great services.

However, recently there's been a massive surge in outsourcing companies, making it tough to pick the right one, especially when you're not sure what to look for. I've seen firsthand the impact of less experienced companies on practices and their teams. I've further witnessed owners of multiple companies posting requests for guidance in the simplest areas of billing. It's tough to watch practice owners end up in a worse spot when they turn to outsourcing during times of urgent need. To assist you in making an informed decision, here's a list of some critical factors to consider before choosing an outsourcing partner for your billing, or any other role in the practice:

1. Real Client Testimonials: Look for outsourcing companies with genuine client testimonials. Established companies often provide opportunities for you to connect with satisfied clients who are happy to chat about their experiences, both the good and the not-so-good. If the company is relatively new and hasn't had the chance to build up their testimonials, they should, at the very least, offer references from past employers who can vouch for their expertise. If there's no one willing to speak to their strengths, that might raise some concerns about transparency, accountability, and the quality of your potential partnership.

2. Checks and Balances: Let's face it, we're all human, and mistakes are bound to happen, no matter whether you're outsourcing, managing things with your in-house team, or trying to do it all yourself. So it's crucial to manage your expectations and be wary of anyone promising absolute perfection—those claims are often too good to be true. What's important is ensuring that the outsourcing company you are considering has rigorous checks and balances in place to review their team's work, offer guidance when necessary, and own up to any mishaps. Extra points if they offer to teach you, as the practice owner, how to triple-check their work just so you are armed with the knowledge if you feel compelled to do so.

3. Owner Accessibility: Having an active owner involved can make a significant difference in the trust, transparency, and overall relationship with an outsourcing company. Will the owner regularly check in with you? Can you easily reach them when you have questions or concerns? Does the owner actively contribute to their team's success? Transitioning to outsourcing can be a big change for you and your in-house team, and it can take a bit to get through the transition period, especially without the right guidance and support. An active owner will be there to ensure the transition goes as smoothly as possible, answer your questions, and provide guidance to everyone involved.

4. Team Knowledge: The strength of an outsourcing team largely depends on the expertise of its most knowledgeable member. It's essential to ensure that the company has assembled a well-rounded team with varying levels of experience. Also, see if they promote a culture of support among their team members, even for practices they don't directly service. Can they provide clear guidance on billing, from the basics to more complex issues? There are multiple areas in the practice where issues can result in large losses for you, ranging from inaccurate treatment plans due to insurance verification, failure to collect patients balances at time of service, improper use of coding, and more. Your team should be able to identify areas of losses, especially when your collection ratios are abnormally low, and give proper guidance for solutions. Further, I've seen some significant knowledge gaps in areas like posting of dual insurance and managing denials for inclusive treatments, especially when it comes to core-buildups. These gaps often lead to significant losses for practices.

5. Honesty and Transparency: Honesty is a cornerstone of any successful partnership. I've come across potential clients who believed they had to outsource because their in-house team wasn't up to par, only to discover during a practice analysis that their in-house team possessed untapped potential that simply required a bit of extra guidance to shine. In my experience, while I'm always eager to welcome new clients, my priority is making sure what's best for your practice comes first. Sometimes, that means suggesting an investment in your current team, especially if they're enthusiastic about learning and improving. This not only nurtures a fantastic practice culture but also helps support long-term employee retention. Honesty matters in many aspects of a partnership, and it's crucial to find out if the company you're considering prioritizes honesty, even if it means a financial loss for them. During your interviews with potential companies, observe their responses and evaluate how their values align with honesty and transparency. Are their answers driven by a desire to make the sale at all costs, or do they offer honest and transparent feedback that ultimately benefits you as a practice owner? Often, you can gauge whether their culture of truthfulness will persist throughout your potential partnership from your initial interactions.

6. Big Corporation vs. Small Business: Choosing between a big corporation and a smaller business is a personal decision. However, understanding the differences can make your decision-making easier. Most outsourcing companies offer similar services. The delivery of those services with additional value added at no additional cost is typically only found with smaller businesses. Additionally, In larger corporations, small practices can sometimes feel like smaller fish, receiving less direct attention, guidance, and occasionally falling through the cracks. In contrast, smaller businesses often offer a more personal touch. When was the last time you had a direct call with the CEO of a big corporation just to pick their brains and gain knowledge? Now, think about when you last had a conversation with the owner of a small business and felt that sense of familiarity and importance. It's essential to choose a company that aligns with your specific needs, team culture, vision, and the level of attention and relationship you're seeking.

7. Investment in Your Success: Prioritizing your success is a big deal, in my book. An outsourcing company is responsible for specific roles in your practice, but one that goes above and beyond those roles is one that's truly invested in your practice's well-being, not just in collecting a check. Are they willing to address areas of concern outside of billing, provide guidance in all aspects of your practice, and offer honest feedback on non-compliance with laws and contracts, along with clear guidance on how to make necessary changes? Are they readily available to give your team guidance; especially during this staffing crisis when many front office teams consist of employees who are brand new to the industry and need patience, guidance, and additional resources to be successful in their roles? If you don't have an in-house team member to assist in these areas, is your outsourcing team, who should be an extension of your in-house team, willing to step up and help for everyone's overall success? These are just a couple of ways that your outsourcing company can invest in your success, which ultimately results in everyone's overall success.

8. Cost: In these times, the cost of services is a major factor, and it's entirely understandable to want to save money. However, I'd urge you to research industry trends related to the specific role you want to outsource and ensure that the company you choose is within those trends. While opting for a deeply discounted service can be tempting, in most cases, it can end up costing you more. Companies need to charge enough to compensate experienced team members. Usually, the lower a company's rates, the less they can allocate to compensate their team, resulting in a team of lesser-qualified or even unqualified members. The saying 'you get what you pay for' holds true in this area.

9. Quality over Quantity: This suggestion may not be universally agreed upon, but I find it quite valid. My former employer and mentor once warned me about the 'kiss of death,' urging me to focus on the service I provide over the amount of people I provide it to, and I took that advice to heart. I've seen countless companies hurt practices and ultimately cause their own failure by focusing solely on growth, taking on as many clients as possible as quickly as possible. While that approach can work for many businesses, it often causes outsourcing companies to fail. Look for a company that has a firm policy on the number of new clients they onboard each quarter. This allows them to focus on ensuring a smooth transition for those clients, maintaining the best quality of service possible, while carefully deciding when choosing new team members. This approach helps maintain consistent quality and strong long-term relationships. I urge you to choose a company that prioritizes quality over quantity.

10. Daily Reporting: It's essential to ensure that the company you choose provides some form of daily reporting back to both you and your in-house team. Daily reports serve several valuable purposes—they allow you to capture the true value of the service, foster trust and transparency, and offer a comprehensive overview of daily tasks completed, necessary support, and potential suggestions for improvement. While outsourcing can alleviate the need for direct involvement in the specific outsourced role, adopting an "out of sight, out of mind" mentality isn't the most effective approach in this context. Having a resource that provides a quick daily review proves immensely beneficial, ensuring that you're always informed and well prepared.

11. Security & HIPAA Compliance: When considering an outsourcing company, prioritize the security of patient information. Ensure that they follow HIPAA compliance standards in how patient information is accessed and shared within the company. Look for a company that has a legally binding HIPAA agreement in place to protect sensitive data. Additionally, it's crucial to review their insurance coverage, specifically confirming that they have cyber coverage to safeguard against potential data breaches. While these are just a few areas to consider, they are vital in ensuring the safety and privacy of patient information.

BONUS FACTOR. Talk with Team Members: While it may not always be feasible, this is a valuable bonus worth inquiring about. The chance to converse with a few team members from the potential company can offer additional insights into the organization's structure and overall strength. Most team members have likely gained experience working with various companies over their careers before finding their current home. They can shed light on their personal experiences as team members and provide invaluable insights into how they perceive the leadership and culture of their current company, the level of collaboration and support among team members, and how the company supports continued education. Furthermore, they may offer valuable comparisons to their prior work experiences. If direct conversations with team members aren't offered by the company, you can always make a post in one of the many Facebook groups and ask for feedback from current team members; you're almost guaranteed to receive informative responses.

These are only a few of the many things to consider when choosing an outsourcing company. Most of these questions can't be answered in an initial company interview, but they, and all other things to consider, can be addressed by doing your due diligence and asking for reliable references. Take the extra time to connect with their current clients and ask questions. Search in professional groups for past posts and comments from colleagues about the potential company.

Remember that finding the right outsourcing partner is a vital decision for the success of your practice. Take your time, interview multiple companies, ask questions, and consider these factors carefully to make an informed choice.

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