Transitioning to a New Medical Billing Company

You’ve chosen a new medical billing company but now the reality of the transition begins to weigh heavy on you.  The first thing to do is work with your new medical billing company to devise a transition plan.

The plan should clearly identify what will be done and who will do it.  Some medical billing companies already have a tried and true transition plan that they will lay out for you.  If your new medical billing company provides this type of direction, then you are way ahead and the transition will likely be fairly smooth.

One of the key things that needs to be done immediately is to re-credential the provider(s) with all insurance carriers.  This is a critical path and some carriers may take as long as 90 days to update their records.  Therefore, it is crucial that this process be started immediately.

Most practices have old AR that needs to be cleaned up.  There are some medical billing companies that will take over the old AR but most don’t like to because they are dealing with another biller’s mistakes, poor documentation and missing information.  You can, however, ask your new medical billing company if they are willing to take it over.  If they do, expect to pay a higher fee since it involves significant resources on their end.

There are some practices that have chosen to change billing companies but feel the current biller can close out the old AR.  If your practice falls into this category, then you will have your current biller work the old AR while the new billing company works all current claims.  The key thing is to pick a cut-over date and stick to it.  Undoubtedly, the carriers will send reimbursements to the wrong billing company so it is imperative that a line of communication be established between the two entities.  They will need to share information in order for the old billing company to close out the AR.

Generally speaking your new billing company will carry out the entire transition plan.  They will set up the clearinghouse, process all EDI and ERA applications, handle the re-credentialing and train your staff.  If they don’t provide these services, then make sure you know who will be handling every aspect of the transition.  You can’t afford for anything to fall through the cracks.

During the transition, it is a good time for you to consider what operational changes may be necessary in your office so that workflow is as efficient and accurate as possible.  No matter how good the billing company is they can’t collect on your accounts in a timely manner unless they have accurate and complete demographics, pre-authorizations in place and the insurance coverage has been verified.  You need to let your staff know who is accountable for these critical tasks.  This may be a real change for your office.  Your staff may take issue with these changes but the alternative is that collections will suffer, cash flow will be negatively impacted and your practice could fail.  So change is really the lesser of two evils and the path you must choose. The first step is the hardest and a well-conceived transition plan will definitely be a step in the right direction.

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