You’ve decided to outsource your behavioral health billing. That’s great news. Outsourcing lets you focus more on treatment and less on your back office processes. But, you’re not quite there yet. Select the wrong company and you could end up with more headaches than you have currently.
There are a number of critical questions to ask the companies you’re considering; we’ve summarized them here. Explore each contender’s history, reputation, policies and procedures, and be sure you have a complete understanding of what they can and can’t do, before you choose. Armed with this information, you’ll make a more-informed decision that better meets your cost, process and compliance needs.
What’s their experience with behavioral health billing?
Every industry has a different set of accepted billing protocols. Be sure the company you choose has a deep understanding of and expertise with substance abuse billing procedures, including all addiction billing standards and laws. They should also have an understanding of the day-to-day issues that can arise when working with managed care companies.
And, don’t hesitate to ask for references. If they’re proud of their track record, they’ll happily provide names of current and former clients in the addiction treatment field for you to contact.
How knowledgeable are their employees?
This question is multi-layered. What can they tell you about the people who would be responsible for your day-to-day billing activities?
How good are they at their jobs? What credentials do they hold, and are they properly registered and licensed where necessary and according to state laws? Ask about the certification and continuing education requirements for their management and back office staff, as well as the ongoing training that staff receives to stay up-to-date on the changes in healthcare coding and reimbursement rules.
If their back office staff have a question on the job, what resources are available to them? They should have access to up-to-date Current Procedural Terminology (CPT), insurance payer guidelines and other treatment criteria. They should also have knowledgeable and seasoned management staff available for when they need to escalate difficult cases.
Do they have strong compliance and privacy protection procedures?
Their processes must meet the standards of billing compliance, which typically means the guidelines set by the Health Insurance Portability and Accountability Act (HIPAA) and the Office of the Inspector General (OIG).
Maintaining your patients’ privacy should be high (if not at the top) of your list of requirements. The company you choose must have plans in place to protect privacy while also preventing fraud and abuse.
Do they have a compliance officer or committee responsible for setting and maintaining their privacy controls? At the least, they should have a compliance program in place. Ask to review their plan and explore how they address a range of topics, from the more specific HIPAA compliance for email encryption and home-based employees to the more general billing processes, reimbursement and employment and Occupational Safety and Health Administration (OSHA) requirements.
What reports do they provide and can you get them whenever you need them?
Having access to reports is important for your addiction treatment center’s revenue cycle management, while also helping you understand and manage the health of your practice.
Ask to review sample reports, like an A/R aging report, charges and payment analysis, activity summaries and a key performance indicators report. These reports will provide you with a variety of metrics, including:
- How your practice performs on important revenue cycle metrics,
- Whether or not claims are being paid on time, and
- How appropriately carriers are paying.
What’s their fee structure?
Fee arrangements for billing companies can vary. Some charge a percentage, for example, while others may charge a monthly rate or a flat fee. For those charging a percentage, is it based on charges or receipts? How are refunds handled? Is there a start-up fee for the billing service company? Are there any other administrative costs?
(As an aside: do you know how much you want to spend every month on outsourcing your billing? Make that decision before begin these conversations.)
Trust is Crucial with your Behavioral Health Billing Company
Whenever you contact your third-party billing company, you expect the transaction to be:
- Completed without error and
- Fully confidential.
Asking these critical questions can help ensure that the company you choose will accomplish all of this while maintaining compliance with industry and managed care standards, increasing your accuracy and improving your service quality. Take the time to explore your options and ask the right questions, and you will find the right partner.
Are you looking for a billing company that’s a true partner? Call us, Infinity Behavioral Health Services, today at 866-677-5264 to start the conversation.