I may be able to answer some questions, if you have some specifics. I own a billing service in CA, specializing in ortho and spine. I have handled billing for physiatry, also. I think a lot depends on your individual situation.
If you outsource your billing, you need to make sure the company is able to handle electronic billing, provides monthly written reports, provides you with a good contact person, has experience in medical billing (not dental or veterinary, etc!), and offers you a decent price.
In the situation of starting up a new practice, I would also suggest a person or company who can help you establish your new practice from the financial end---by helping set up your fee schedule, Medicare paperwork, insurance contracting, etc. These are critical areas for a new provider and many things need to be taken care of right away to ensure revenue starts coming in as soon as possible. Beware, some billing companies don't offer such services, or may charge you an arm and a leg for it.
If you hire someone to do the billing in house, I imagine you would want someone pretty experienced. The only problem with that is that the price for a good biller with experience is rarely less than $20/hr, especially here in CA.
Whether you deal with an in house biller or a billing company, be sure the folks are experienced with appeals to insurance carriers and follow up. You need someone aggressive to follow up on unpaid items....not someone that will just take the payment you got and move on. If a claim is paid incorrectly, it must be appealed. An experienced biller or company will have a method for handling such a workload.
In the case of a solo practitioner, especially a new provider, I might recommend a billing company. You won't have to deal with training an employee, worrying about the computer system and software and other ancilary details, and you won't be paying for employee benefits and such. Sometimes providers think they can do it in house cheaper, but I have found that in many cases, the stress and time involved takes away from any money saved by not having to pay a billing company.
A billing company, like ours, would be able to handle your situation. We charge a flat percentage of receipts, which is usually from 6-8%, depending on the specialty and volume. We don't nickle and dime providers for postage and claim fees--we include that in our overall percentage price. Should a provider be out of our area, we can set up for email, fax, or Fed Ex to get the data--whatever is convenient for the provider, and all of that is at our expense. We have several providers out of our local area and we find no problem with long distance issues. Gathering charge, medical, demographic ,and insurance data from your existing EMR should not be too difficult...often, data can be uploaded, downloaded, emailed, faxed, etc. very easily. Somtimes, direct access to your software system is authorized for the billing company to access your data over the internet, etc. There are many solutions available.
Cheaper is not always better, so you have to be careful in making your decisions about your billing. Don't hesitate to ask other providers for their opinions or ask for names of office managers, etc that may be able to offer you some advice. Billing is the financial backbone of your practice and you just can't afford for it to be done poorly.
If you have any more specific questions about what to look for or you decide you'd like to talk to us more about how we may be able to help you, please don't hesitate to contact me. I can be reached at
[email protected] or 925-292-0395. More information about our company can be seen on our website at
www.aebillingsolutions.com. If we are not the right company to help you, I may be able to recommend someone for you--I have contacts in several states.
If you run across other folks who may need some advice, don't hesitate to pass on my info!
Elizabeth Williams
A&E Billing Solutions
Livermore, CA
