5 Things to Look for in a Dialysis 3^rd Party Billing Company

The healthcare reimbursement industry is undergoing changes daily. Therefore, the need for professional billing services has never been more important to a dialysis facility’s bottom line. However, not all third-party dialysis billing companies are the same. The best companies utilize technology and industry best practices to effectively submit claims and improve cash flow. Choosing a third-party billing partner for your facility however can be challenging. Below are five key items to look for when considering a third-party dialysis billing company.

• Experience – As you may know, dialysis billing is complex and continuously getting more so. Experts in this field tell us there’s no substitute for experience, not even certification. There’s no harm in having certified billers, but experience and common sense are what counts. We understand that everyone has to start some place, but it is not recommended to put your facility’s revenue in the hands of a brand-new agency.

• Dialysis Specificity – A majority of claims are straightforward. However, the rest require an in-depth understanding of the dialysis industry, insurance, regulations, and having the knowledge to bill accordingly. When you couple this with things like low volume facility adjustments, case-mix adjusters and other dialysis specific billing nuances, you can see how having first-hand knowledge of dialysis specific billing directly effects your reimbursement.  If you can find a company with billers experienced in dialysis, it should weigh heavily in your decision.

• Bad Debt Collection – In addition to understanding the dialysis industry, it’s important to understand the processes and procedures associated with collecting Medicare bad debt. Many dialysis third-party billing companies will encourage a facility to simply write this bad debt off each year. This mistake could cost the facility tens of thousands of dollars depending on the number of patients.

• Communication – Partnering with a third-party dialysis billing company will take a burden off of your shoulders when it comes to running your dialysis facility. This doesn’t mean that the whole process will be completely hands off. It is important to take an active role in the relationship, so you can stay aware of the financial situation of the facility. It helps to partner with a company that can facilitate that communication. At a minimum, you should have monthly meetings to review the overall status of accounts, aging summary (A/R) and other key factors related to your facility’s billing. This will ensure that when it comes to the bottom line, there are no surprises .

• Stream Lined Processes – Finally, the cash flow is vital to keeping the doors open for your patients. Having a steady and predictable stream of income all starts with billing processes. Typically, your third-party billing company should have all charges submitted by the second or third business day of the month. This allows claims to be processed and paid in a timely manner. This also allows any claims that have been rejected to be fixed and resubmitted in a timely manner.

If you have any dialysis billing related questions or would like to have a conversation about Gaia’s third-party billing services, contact one of our experienced billing consultants today or click here for more information.