Medical Billing Outsourcing: What to Ask Before You Hire

Medical billing takes time, and unpaid or denied claims quietly cost a practice money. Outsourcing can help, but the biller will handle patient data and your revenue. Here is what to ask first.

What a billing service usually does

• Submits claims and follows up with the clearinghouse.
• Works denials and underpayments, including appeals.
• Reviews accounts-receivable aging.
• Reports on collections, usually monthly.

Questions to ask before you hire

1. HIPAA and the BAA. Will you sign a business associate agreement before any patient data is shared?
2. Training. Has everyone who touches the data completed HIPAA training?
3. Access. Will billers work inside systems and logins I control, and can I remove access at any time?
4. Money flow. Do payments go straight to my account, and never through you?
5. Fees. Is the price a percentage of collections, a per-claim fee, or a flat monthly fee, and what is extra?
6. Reporting. What will I see each month, and how are denials tracked?
7. Exit. What happens to my data and workflows if I stop?

Warning signs

• Asking you to send patient data by personal email.
• Collecting insurance payments on your behalf.
• No written agreement, or no BAA.
• Promises of guaranteed results.

Unpaid claims

Older unpaid or denied claims may still be recoverable, but filing deadlines apply and vary by payer. Ask the biller how they review timely filing limits.

See medical billing through Vetted Teams. Every biller completes HIPAA training and works inside systems your practice approves.

Need this done?

Tell us what you need, where and by when on our contact page, or email [email protected]. We confirm the provider, the scope and the price before anything starts. See how we vet providers and our full list of services.