Back to Blog

3 Criteria for Selecting a Billing Services Provider

22 April 2014


Selecting the right billing service provider is easier with the right criteria in mind.

When small practices seek to improve their financial performance, they are often faced with the decision to outsource billing services or maintain them in-house.  If you are trying to make the decision to outsource your billing services, here are three criteria that will help you ensure your selection is the best for your practice,

1.    Fast, accurate claims processing

2.    Comprehensive billing solutions

3.    The right list of value-added services

These criteria will help you select a provider that reduces your expenses, increases collections and improves cash flow.

1. Fast, accurate claims processing

Top billing service providers submit claims using the Electronic Data Exchange (EDI), which substantially reduces claim-processing delays. Claims submitted electronically receive more prompt payment. Claims should have two distinct checkpoints, and any incomplete, incorrect or rejected claims should be quickly returned, corrected, and resubmitted. An integrated clearinghouse instantly sends email notifications regarding the number of claims accepted.  Your potential billing service provider should have the ability to track all claims at all times, reducing late filings or responses.

2. Comprehensive billing solutions

Well organized billing service providers will post and submit charges to insurances within 24 hours, reviewing them beforehand for accuracy and continuity. CPTs and ICD codes will be inspected to assure maximal reimbursement, using automated systems and processes.

Potential providers should also keep insurance information current, as well as patient demographics. The service should also relieve staff from patient billing questions and phone calls, as patients will be calling the billing service provider with any inquiries or concerns.

The work and effort associated with patient statements, payment posting, and collections, all should be handled by your billing service provider.

Statements should be generated each month, with reminder statements sent automatically after 30 days. A direct phone number should be provided clearly on each statement, funneling patient calls to their office versus your office. When claims are being resolved, your billing service should provide patients with high-quality customer service, answer patients’ questions, assist with the interpretation of EOBs, and work with their insurance companies.

3. Value-added services

Your potential billing service should also offer a number of value-added services that are integrated into their fees. Examples of these types of services include,

  • Monthly reports and recommendations for improvement
  • Verification of eligibility of benefits
  • Pre-authorization services
  • Provider credentialing
  • Electronic funds transfer / electronic remittance advice
  • Appointment scheduling and follow up
  • Front desk training

Whether it’s a necessity or choice to outsource your billing services, you should not leave your decisions to chance.  Using these criteria may not guarantee success, but it will help you select the best billing services provider for your practice.

ZH Healthcare provides comprehensive billing services that improve cash flow, increase revenue, and help you manage the financial health of your practice.  To find out more about ZH Healthcare and how their OpenEMR and Billing Service Solutions can help your practice visit