72% of providers use outsourced billing service, according to MAB survey. Use questions below to guide you in selection criteria definition.

  1. Billing Scope
  2. Billing Quality
  3. Billing Costs
  4. Billing Goals

Billing Scope

How many claims do you process today? What is your annual payment volume?

Billing Quality

What is your adjusted collections rate? What is the percent of your claims paid within 15 days and 60 days? What percent of your accounts receivable is above 120 days?

Billing Costs

  1. What is your personnel cost? Include benefits, training, replacement, motivation, vacations, conflicts, sick days, employee payroll, payroll taxes, insurance benefits, retirement plan contributions.
  2. Add capital investment in software and hardware, monthly maintenance, backups, disaster recovery, replacement, training, telephone systems and supplies.
  3. Include your own time required to follow up on especially complex cases.
  4. Read Case Study.

Billing Goals

Define goals in terms of required quality and costs. How much more do you expect to collect and how much faster? Which costs would you expect to eliminate? Include other goals such as reduced administrative overhead, more time for patient care, and more free time outside the office.


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