Outsourcing your Medical Billing

Early in the process of starting up your Nurse Practitioner practice, or even after you have been open for a while, you will be faced with what to do about billing. Your options are limited: you hire someone to come in, you do it yourself, or you outsource the billing. My choice, when I first opened was to outsource and while I thought that I was making good choices, my experience was less than poor. Let me share with you what I’ve learned since then so you can avoid my mistakes.

When you are looking for a billing company to outsource to the first thing you want to do is ask around. Who are your colleagues using? Why do they like/dislike them? Check the forums and social media where they are likely to talk about billing, like the EMR support forums or the coding forums. And of course, you can check the NPBO™ forum. And don’t forget to network with colleagues at conferences and gatherings.

When you find companies that you are interested in, Google them. Look for complaints as well as praises. If it’s an individual, are they certified? And if they say they are, can you get proof? You’ll also want to check references, but not just those listed (few people will give you the name of someone who will give them a bad reference). Again, ask around about this company or person and try and find references that are not listed.

So what are some of the questions you should ask?

  1. What are their qualifications?
  2. How long have they been in business?
  3. How many people are handling the claims?
  4. How are follow ups handled?
  5. What happens when there is a denial?
  6. Who is managing the accounts receivable (AR)? How often is it evaluated and worked? Who is responsible?
  7. Communication Issues: What forms of communication are available? Is there a time difference? Is there a language difference?
  8. Do they specialize in a particular area of billing such as primary care or surgery?
  9. What kind of reports will you receive? Can you read them? Can you get help with them?
  10. Is the company familiar with your regional issues?
  11. Does this company know about NPs and are they familiar with some of the issues in billing for us? Are they familiar with your state regulations?
  12. What other services do they provide?

This is not by any means an all inclusive list, but it will get you started when thinking about hiring a biller.

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  1. http://offshoreally.com Hi Barbara ! Though my field is not NP, what caught my eye was how well-versed you seem to be in AR. Sharing with others the mistakes we made (or the difficulties we faced) is indeed a noble & courageous action – as your own profession. It’s a pity you had to go through tough times in outsourcing. Feel free to get in touch if you need any technical expertise.

  2. Hi Barbara. Great article. I have a medical billing business that specializes in credentialing and billing for Nurse Practitioners. I would love to refer and/or link this article on my site for information for Nurse Practitioners. Thanks! Take care!

  3. Barbara,

    You mentioned that you used office ally for billing. Did they actually do your billing or did you use Practice Mate where they teach you how to do your own billing? What did you suggest for someone just starting out small with only a few clients? Should I outsource or do it myself?


  4. Hi Teri,

    Office Ally has several products. One of them is Practice Mate. You can do your billing (they don’t do it for you) from the generic Office Ally, or use Practice Mate, which also allows you track payments, create patient statements and the like. And if you are just getting started, free is a great price. I don’t believe they actually teach you how to do any of this though there is a user manual.

    I believe it’s a good idea to do it yourself if you only have a few clients. First of all, you’ll know whats involved. It will help you when you do look for someone to bill in terms of what you’ll want them to be able to do, assess their skills, and then eventually know how to keep your eyes on what is going on.

    Lots of success to you,


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