How Medical Billing Companies Ensure Reimbursement Payments

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Medical billing companies have to make sure that they will receive part of any money that is collected by or on behalf of their clients. This means that they can collect through cash payments, deductibles, copayments and even insurance reimbursements. There’s a reason for all of this. The first reason is that people who work in medical billing & coding do have to be paid. To work in medical billing is still to work for a business. Once there is a reimbursement that is owed, the company can then begin to make plans. Now, if for some reason the money doesn’t show up, then they’re in hot water. Here’s how medical billing companies guarantee that they get their reimbursement money.

Clear Patient Policies

One of the best and quickest lines of defense that billing companies use is to make sure that there are proper patient policies in place. The company should have an opportunity to see the agreement between the client and practitioner. Every patient should have a long, comprehensive financial agreement. The patient should agree to cover any costs that aren’t covered by the insurance. Then, the document that should be considered most important is one that dictates to the patient to turn over any reimbursement payable by an insurer.

Clear and Solid Expectations

Every practitioner may have a different way of billing. Some may have a deposit requirement, while others may require money at the time of the visit. It’s important for medical billing companies to have expectations of the provider. They should know what works best and seek clients who abide by those expectations.

Transparency of Fees

When it comes to out-of-network reimbursement, the best way to collect is to make sure that all of the fees are transparent. If a patient can’t understand what their services cost or who is responsible for the payment, it is going to be a challenge for them as well as the billing company.  It is on medical billing companies to make sure that their clients are providing the proper disclosures to patients. Surprise fees only occur when the client did not disclose the costs properly.

Collection Attempts

Now if all of the other rules have been followed, there is one line of defense left. This is simply an attempt at collection. Often, providers have to make an effort to collect the money. Usually, this is as simple as sending out a few invoices. The standard is about three, to try to establish communication with the patient. Now, if after the invoices are sent, there is no response or payment made, then it is within the provider’s rights to seek out the help of a collections company or to seek litigation.

Medical billing companies cannot go into business without a plan on how to collect insurance reimbursement checks. After all, there are quite a few different scenarios that could go wrong and lead to no payment. Without a line of defense, the company is at the mercy of the patient and the client. It’s important to make sure that the client has clear policies, is transparent about their fees, and attempts to collect on the company’s behalf.

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