How to Select an Offshore Partner for Insurance Follow-up – a Step by Step Guide

Offshore medical billing companies have become an integral part of the medical billing landscape.   And while they can’t completely replace a US-based medical billing company or an in-house billing department, they can be very effective at handling specific billing tasks.   If your medical practice has an internal billing department but is looking to supplement their efforts, hiring an offshore company to perform Insurance Follow-up – the process of managing claim denials and calling insurance companies to get the claims paid – can significantly improve the financial performance of the practice.

 If you or your practice is considering working with an offshore company, what follows is a high-level guide on how to interview and select an offshore medical billing company.

 1. Identify 3-4 potential partners:

  • Referrals from other medical practices

  • Google Search

  • LinkedIn Search

 2. Conduct telephone interviews with both their sales contact and the person who will be your day-to-day contact.

  • How comfortably can you communicate with them? Have them send you examples of their notes and exception reports.

  • How will they learn and keep track of your billing processes and rules?

  • How will they integrate and communicate with your in-house staff?

  • How do they manage HIPAA compliance?

  • Encrypted email system

    1. Encryption on file transfers

    2. VPN access to remote terminals

 3. What is their hourly rate?

  • Will they bill you for services in increments of “FTE’s” or simply by hours worked?

  • How easily can you add or subtract hours or workers if your workload fluctuates or circumstances change?

  • What kind of contractual commitment do they require? Can you terminate on 30 days notice? 90 days notice? 365 days notice?

  4. Get references from 2-3 other practices or US billing companies who are using them. Ask the same questions listed in Section 2 above.

 5. Consider which billing tasks they can do most effectively and which billing tasks you should keep in-house.

6. Once you select a partner, start slow!

  • Give them simple tasks to start with so you can test their competence, responsiveness, communications and ability to adhere to your billing processes and rules.

  • Review their notes and exceptions and provide feedback – they will improve significantly based on your feedback.

  • Add increasingly complex tasks over time as you get an understanding of their capabilities.

 7. Measure their performance and adjust accordingly.

  • Take a snapshot of your financial metrics before they start, and at least quarterly thereafter.

  • Depending on the size of the delinquent claims backlog and because of delays inherent in the billing process, it may take 4-6 months to see a material improvement in your practice collections. But over time, the number and amount of delinquent claims should decrease

  • If financial performance does not improve, be thoughtful about the possible reasons:

  • Is the follow-up team providing poor work product?

    1. Is your in-house staff failing to act on the information provided by the follow-up team?

    2. Is the billing process breaking down in other areas e.g. repeated use of improper modifiers and diagnosis codes that lead to claim denials?

 An offshore dedicated insurance follow-up team is one of the most effective tools available to improve financial performance.  The key to success is setting clear expectations for both parties, building the partnership slowly for a long-term relationship, and continually evaluating their performance and providing feedback to improve that performance. If you are willing and able to invest this time and effort, you’ll see significant improvement in the financial performance of your practice. 

eMed Partners is a US-based medical billing company with both US and offshore staff.   We provide full-service medical billing as well as Insurance Follow-up as an hourly service.  If you’re interested in outsourcing insurance follow-up but have concerns about the time and effort involved, please contact us directly at info@emedpartners.com. We exist to make outsourcing easy. 

Rusty Wilson is the founder and principal of eMed Partners, a full-service medical billing company for physicians and medical practices.
For more about our billing services: http://emedpartners.com/
To follow Rusty on LinkedIn: https://www.linkedin.com/in/rusty-wilson-520206/

Mike Moll