Monthly Archives: August 2018

You’ve decided to outsource your billing. That’s wonderful news. Outsourcing lets you focus more on treatment and less on your back-office processes. But, there still is a risk your taking and its important to do your homework first. If you chose the wrong company and you could end up with more headaches than you may already have.

There are several important questions to ask third party billing companies. You may consider exploring each contender’s history, reputation, policies and procedures, and be sure you have a complete understanding of what they can and can’t do, are their staff certified, are the ones performing utilization reviews licensed or hold degrees, how many years in the industry? Food for thought before you choose. Armed with this information, you’ll make a more-informed decision that better meets your cost, process and compliance needs. 

How knowledgeable are their employees?

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. 

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.


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, charges and payment analysis, activity summaries and a key performance indicators reportThese 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 beginning 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:

  • Seamless,
  • 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.

If you’re looking for a reliable billing company contact us for a free consultation.