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It’s the lifeblood of any private OB/GYN practice: the billing function. Without an effective billing department, you simply can’t sustain your practice. More and more private practice OB/GYN’s are outsourcing this critical function to improve the bottom line, and their ability to focus on patients.

5 Questions Every OB-GYN Should Ask Before Committing to a Medical Billing Company

5 Dec 2018

It’s the lifeblood of any private OB/GYN practice: the billing function. Without an effective billing department, you simply can’t sustain your practice. More and more private practice OB/GYN’s are outsourcing this critical function to improve the bottom line, and their ability to focus on patients.

But with so many medical billing services out there, but how do you know which one is right for you? Here are five basic questions to ask before you make your final decision.

#1. How Knowledgeable, Experienced And Technically Proficient Is Their Staff?

This is obvious, but it’s key. Given the complex nature of medical coding, experience is hugely important.

Start by finding out how long the company has been in business. If they’ve been in operation for less than ten years, they may not have the chops to get the job done.  

Don’t be afraid to ask who, specifically, will be doing the coding work.

  • Are these staff members certified?
  • Are they proficient in the highly technical ICD-10 and CPT (Current Procedural Terminology) protocols?
  • What’s the company’s hiring criteria for staff members?

Medical billing professionals should be meticulous, detail oriented, highly skilled and have heavy experience in the industry.

Ask if they serve a broad range of clients in diverse locations and if they have experience dealing with a wide variety of insurance carriers. They should be well-versed in the various insurance plans on the market, from Medicare and Medicaid to public and private packages. They should also have extensive experience working with private OB/GYN practices.

If you get the feeling the company’s unbelievably low rates are the result of hiring inexperienced, untrained data entry clerks— run.

Medical Billing  Company vs. In-House Billing: Which Is Best for Your Ob/Gyn Practice?

#2. How Do They Manage Changing Healthcare Legislation and Compliance Guidelines?

Ask if the company invests in the continuing education of its staff. Because the healthcare sector is in flux, with laws changing frequently, it’s not enough to have a passive attitude towards keeping current.

Medical billing companies should be enthusiastically proactive about keeping abreast of the latest federal and state healthcare laws, and the protocols and compliance requirements that support them.

If you’re handing off this critical function, you need to know you’ll have no compliance headaches down the road.

#3. What’s Their Accuracy Rate?

Medical billing codes are the foundation of an effective receivables pipeline. Errors--- even small ones like misspelled names or incorrect dates of service -- can mean a longer billing cycle, which affects cash flow. As bills are submitted, rejected, edited and re-submitted, your OB/GYN practice still has to keep the lights on, even during a cash crunch.  

Do your due diligence and find out how committed to accuracy the company is, and whether they have procedures in place to keep errors down to a minimum.

5 Questions Highlighted-01-02

#4. What Specific Results Can I Expect?

Thing like hiring policies, experience levels, and accuracy rates mean nothing without concrete results.

Ask what percentage, on average, do they recoup of the total revenue available from insurance carriers? The success of your OB/GYN practice rests on effective insurance billing, so an anemic percentage should give you pause.

How aggressive is their attitude towards collecting outstanding receivables? Do they seem likely to leave money on the table?

A good medical billing company should have the tenacity to bill and rebill insurance carriers until you’ve collected what’s owed you, in full. In many ways, this is is a game of attrition and your medical billing company should be nothing short of relentless on your behalf.


Additionally, your billing company should be transparent with you throughout, so you can see exactly where you are in the process and what’s behind your aged receivables numbers.


Don’t be afraid to ask in hard numbers, how much in total they’ve billed and recouped from insurance carriers for their clients.

#5. How Do They Structure Their Pricing?

You have to be savvy about asking the right questions when it comes to fee structures. Lots of companies use the bait-and-switch method to get you in the door, quoting one price and then assessing additional fees once you’ve started working with them. (If they charge you for the quote, that’s a good indication this is how they do business.)

For example, some companies may offer to assist with the re-credentialing process, but they won’t tell you they also charge for this service. Some will charge additional hourly fees for consultations, or add on overhead expense reimbursements like postage.

Ideally, for peace of mind and budgeting purposes, look for a company that bills a flat percentage rate for all services provided. That way, you’re not surprised with big bills for services you didn’t realize would cost you extra, and you get the right help at the right price for your OB/GYN practice size.

Look For The Whole Package: Service, Expertise And Experience At A Price That Makes Sense

Your medical billing company should understand your needs as an OB/GYN as well as an entrepreneur, and take the stress and burden of the billing function from your shoulders. Heartland Medical Billing & Consulting has the experience, training, and expertise to deliver worry-free medical billing services so you can focus on your patients and on growing your practice. Let’s talk today.

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About the Author

Stacey Dill

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