Top Questions You Should Be Asking Your Medical Billing Concierge

A consultant for a medical billing concierge service can take your practice to the next level of claims, collections and patient payments. And it’s not just billers; they offer high-touch, personalized support that can give you what you need to run the revenue cycle more effectively. Yet, all concierge billing services are not the same. Your vetting of a provider should include the right questions. Having good communication from the start can help ensure you select the best fit for your practice in terms of goals, specialty, and workflow. But here are some questions every provider should ask when it comes to hiring their medical bill consultants.

Medical billing and consulting is highly specialized. All specialities — dermatology, orthopedics, mental health, and more — have their own codes, modifiers, and various payer-specific oddities. Ask your billing concierge what specialties they have previously addressed. Someone experienced in your particular line of service will have already dealt with common coding mistakes, payer denials, and know how payment works.

The more knowledgeable your billing concierge is about your specialty, the quicker he or she can spot billing risks and sources of lost revenue. You’ll spend less time training them and more time reaping the rewards of their expertise.

Denials are a fact of life, but the way your concierge billing service stop up these holes is the difference. Question them on how they manage the process around appeal and resubmission of denied claims. Do they follow trends in denials? How soon do they respond? How many of those denials do they win back?

Learning their process is a great step to determine how proactive they are. You’re looking for a billing concierge service that doesn’t just submit claims, but that is proactive in monitoring them and helping to shrink your denial rates over time.

Good billing decisions are only as good as your data. But for your medical billing concierge, make sure you’re asking what their reporting and analytics looks like. Will you receive regular summaries? Do they have dashboards for real-time KPIs (like days in AR, charge lag, net collection rate)? Transparent reporting allows you to evaluate performance and make informed choices.

Transparent reporting enables you to assess performance and make informed decisions. It also builds trust. A good concierge billing partner will guide you through the numbers, clarify variances and leverage the data for more intelligent strategies.

Your Billing Concierge is an extension of your practice. That means communication is key. Inquire about how frequently you team will meet with them, if they have a point of contact and through what platforms your will communicate. Do they provide telephone support to patients? 

The Most Difficult Part I have found technology to be one of the most difficult aspects of medical billing and consulting. The best concierge billing service will be accustomed to using numerous EHRs and PMs. Inquire if they’ve used your software before and if they will require access or log-in credentials.

You should also state how information is exchanged between your system and theirs. What about your employees? Are they responsible for submitting documents or is the system automated? Seamless integration eliminates rework and can help to speed up turnaround on claims.

It is very time-consuming and just a part of how getting paid works. Some medical billing concierge services also do provider credentialing and payer enrollment. Inquire re whether they help with initial Apps, re-apps, as well as, keeping an updated CAQH profile.

If you are a new practice, or are expanding with new plans, then consolidating billing and credentialing in one place makes the process more efficient and minimizes errors.

Security is a must in medical billing and consulting services. Inquire about your concierge provider’s methods for safeguarding patients’ health information (PHI) and confirming HIPAA compliance. Do they use encrypted email? Secure cloud-based portals? Role-based access control?

Ask for their internal rules too. (and) Do they provide regular data security training to their staff? Are audits conducted? A good, reputable concierge billing service should have clear responses and a strong infrastructure to protect your and your patients’ data and privacy.

Revenues are lost due to patient responsibility as never before. Inquire with your medical billing concierge how they process patient statements, balances and installments. Are they sending statements by mail, reminders by email or have an online payment portal?

Also consider how much your front desk will need to be involved. A quality concierge service will manage patient billing while keeping your staff in the loop. Communications as well as workflows need to be transparent and cordial in order to avoid losing patient goodwill during the billing process.

Every practice is different. Some require end-to-end billing, others may need coding or collections assistance, or something in between. Inquire with your billing concierge about bespoke service packages suited to your volume, specialty, and in-house capacity.

Also consider scalability. Will they be able to grow with you if your practice grows or takes a different direction? A concierge service that gets you and where you are now — and can grow with you — has long-lasting value.

Price My own mailer via UPS today was nearly $20. Most charge a percentage of collections, and a few offer a flat price or tiered pricing model. Ask what comes with their pricing, and confirm there are no additional fees for appeals, credentialing or other types of services.

Just as important as transparency in performance is transparent pricing. Your billing concierge should be able to lay out the fee structure, making the case for how they support your financial well-being.

A medical billing concierge is an investment that will allow you to optimize your revenue cycle and grow your practice strategically. However, not all hosts offer the same level of care, contact, and expertise. If you accomplish that, you will be well on your way to hiring a billing partner who is a good fit for your practice.  Because a great concierge will not simply process claims, they will serve as a valuable member of your extended team, enabling your practice to grow, thrive, and remain focused on providing excellent care.