Reduce your compliance risks by ensuring that your contract:
- Includes a mutual indemnification clause;
- Guarantees that the billing company and its employees can legally bill Medicare;
- Assures that the billing company’s employees are familiar with all payer rules;
- Details the claims development and submission process;
- Requires the billing company to retain records and documentation related to your claims;
- Allows you to access and audit your claims data;
- Requires the billing company to notify you as soon as it detects aberrant billing patterns or questionable claims; and
- Includes a right to terminate the contract immediately if you have substantial compliance concerns that the billing company cannot address.
Your practice’s financial management is one aspect that you should carefully review to both save on expenses and generate revenue. Deciding whether your billing should be in house or outsourced will mainly depend on the size of the practice. In addition, the management style of the practice plays an important role when deciding between keeping your billing services in house or outsourced. If you like to closely monitor the business side of the practice, in-house billing is the best choice. But if you prefer to focus on patient care and not to have billing matters at the forefront of the practice, then outsourcing is the logical choice.
It is always a best practice to select the billing option that will allow your practice to operate efficiently and effectively. Whether your billing services are in house or outsourced, be sure that you will always have access to any and all information you need to make the best decisions that will affect the profitability of your practice.
If you have additional questions about billing and compliance issues, contact Antanya Chung, CPC, CPC-I, CCP, at (404) 633-3777, ext 818, or by e-mail at [email protected].
