15 questions
How do I compare medical billing prices for a part-time practice?
Ask for the fee at your expected collections, not a full-time practice example. Check the monthly minimum and whether provider count changes the charge. A minimum can determine the bill even when the advertised percentage looks low.
Link to this answer ↗Who handles credit balances and patient refunds?
The agreement should identify who finds overpayments, documents them and obtains approval for refunds. Do not assume the billing company may issue money on the practice’s behalf. Agree a reporting and authorization process before service begins.
Link to this answer ↗Can a billing company submit secondary insurance claims?
Ask specifically about secondary and tertiary payer work. The provider should explain how it receives the primary payer response and tracks the remaining balance. Confirm whether coordination-of-benefits problems require action by your staff.
Link to this answer ↗Can medical billing providers manage patient payment plans?
Some support installment arrangements or payment tools. Ask who approves the terms, who contacts the patient and how missed payments are handled. Payment processing charges may be separate from the billing service fee.
Link to this answer ↗Will a billing company handle workers’ compensation claims?
Check that service separately. Workers’ compensation billing can involve different documentation and payer processes from standard health insurance claims. Ask for relevant capability and an explicit inclusion in the proposal rather than relying on a general specialty list.
Link to this answer ↗Can outsourced billing support telehealth appointments?
Confirm support for your specialty, payer mix and telehealth services. The practice remains responsible for accurate clinical documentation. Ask how the billing team flags missing information and keeps its billing procedures current with applicable payer requirements.
Link to this answer ↗Who updates payer fee schedules in the billing system?
Identify the person responsible for loading and maintaining fee schedules and checking payment discrepancies. Ask whether the service includes that work or only posts the amount received. This distinction affects how useful payment reports will be.
Link to this answer ↗Can I keep patient payments going directly to my practice?
Ask how funds move before signing. Distinguish access needed to reconcile payments from authority to receive or move money. Confirm bank account ownership, payment processor arrangements and any permissions the billing company requests.
Link to this answer ↗Does a billing service reconcile electronic remittances?
Ask whether the team matches remittance advice to deposited funds and investigates discrepancies. Posting an electronic remittance alone is not the same as completing reconciliation. Request a sample report showing how unmatched items remain visible.
Link to this answer ↗Who pays clearinghouse transaction charges?
The billing provider may bundle clearinghouse services or bill them separately. Check claims, eligibility checks and statements individually. Request the charging unit and any allowance so that a small headline fee does not conceal usage costs.
Link to this answer ↗Can billing providers work with several tax IDs?
Discuss each practice entity and provider group during pricing. Ask whether separate accounts, reporting or payer enrollment work changes the charge. A single management dashboard does not necessarily mean a single contractual or billing arrangement.
Link to this answer ↗What happens when a payer requests supporting records?
The billing team should explain how it logs the request, alerts the practice and tracks the deadline. Clinical records normally need input from your staff. Agree who submits the approved material and who follows the claim afterward.
Link to this answer ↗Can I approve patient statements before they are sent?
Ask for a statement sample and explain your preferred review process. Confirm the sender name, payment instructions, frequency and escalation rules. A provider’s default patient communication may not suit the way your practice handles balances.
Link to this answer ↗How should a new doctor be added to a billing service?
Give the provider the intended start date and identify enrollment or credentialing work early. Confirm additional fees and reporting changes. Keep credentialing milestones separate from the billing company’s own onboarding timetable.
Link to this answer ↗Does outsourced medical billing require a BAA?
When a billing company handles protected health information as a business associate of a covered practice, a business associate agreement is generally required. Have the practice’s responsible adviser review the arrangement, including subcontractors and access controls, before records are shared.
Link to this answer ↗