Change Medical Billing Provider

Do you need to change your Medical Billing Company?

Healthcare practices typically outsource their billing for two reasons – lack of resources and/or lack of time. While outsourcing your billing has many advantages, there are certain factors that need to be checked before hiring a billing company. Remember that most outsourcing contracts generally last for two to three years and it would be detrimental to your practice if you choose a billing company that exhibits most of the following:

  • The billing company has no existing clients with the same specialty as yours.
  • They refuse to provide you with additional references (other than those already on their list).
  • You are not provided access to their system to look up your patient records.
  • They do not provide system generated reports.
  • You are not provided access to the lead biller on your account.
  • Their billing software is one that you have never heard about.
  • They do not provide daily reports of completed work.
  • They do not provide service turnaround guarantees.
  • They insist on doing the billing on their software, rather than on yours.
  • They cannot integrate electronically and accept your charges from your EMR.

You have been diligent and checked all the factors before hiring a medical billing company for your practice. However, as days pass, you find something amiss. Revenue management is one of the pillars keeping your practice standing. Problems and disruptions can wreak havoc with the financial health of your practice. You placed a tremendous amount of trust in the billing company that you hired. However, trust does not mean tolerating poor or sub-standard performance. If you find serious trust issues with your billing provider, it is time to evaluate the facts. There are a range of warning signs that point to inefficient and sub-standard performance from the billing provider. If you find these in respect of your billing provider, it is time to cut the cord and find yourself a new billing provider.

Claims rejection rate

Instead of decreasing and stabilizing, your claims rejection rate is going up. That is totally the opposite of what your provider should be providing you with.

Unclear and complicated billing reports

If you feel the need to go to college in order to understand your provider’s monthly report, it may be time to find a provider who offers clean, simple and accurate reports.

Inquiries, disputes and late collections on the rise

Payors, who previously were prompt in their payments with little or no inquiries or disputes, now seem to ask for more supporting material, find more disputed bills and make slower payments. If the larger chunk of payors seem to be showing the same traits, the problem is likely with your billing provider and not the payors.

Patient collections have decreased

Patients generally don’t pay their bills when they are in dispute about the amount billed. An imbalance in the amount paid by the insurance company and the amount owed by the patient will result in a disputed bill with the patient. To ensure that this does not happen, it is important that your claims are submitted correctly and in time by your billing provider.

Resistance to automation and technology

Automation and technology has changed the way we function – making things easier while providing maximum performance, speed and accuracy. If your provider is still using manual methods, or outdated technology, it may be time to look for another one.

Communication problems

If you are finding it difficult to get across to your billing provider on a regular basis, or not receiving responses to your queries – you may not be a priority for your provider. It is time to find a billing partner who will give you top priority.

Poor Transparency

Not getting the reports you require, hiding information or forgetting to share data are all signs that point to the need to change your billing provider. After all you cannot work with someone if there is any element of mistrust in the relationship.


Your billing provider is a reflection of your practice. The presence of any of the above mentioned issues indicates that it’s time to switch to a better billing company. Find a billing company that actually delivers what it promises such as the real-time figures on A/R periods, revenue collection, higher patient collections, etc.

The questions you need to ask when changing your billing provider are:

  • Is the billing provider the best match for your practice?
  • Can and will they grow with your practice?
  • Do they have the where withal to reach your goals?
  • Are they true teammates?

A medical billing company has to be on good terms with the payers – but at the same time has to have your back. MedConverge caters to the issues that arise for revenue cycle management. Our effective RCM system reduces the time between providing a service and receiving payment. With a dedicated team to take care of all your billing and collection work, MedConverge ensures that your revenue cycle stays in the pink of health.

About the Author:MedConverge

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