The Smart Medical Practice

Is Your Medical Billing Company Negligent?


Medical Billing Software NegligentOutsourcing your medical billing can be a boon for your practice, but not if you’re with the wrong service. There’s significant variation in the way physician billing companies function, so unless you perform a thorough due diligence before you enter into a contract, you may not save the amount of money you expected. Worst case, you could end up in serious regulatory trouble.

We’ve written several posts on features to look for in a billing company, including state-of-the-art technology and complete reporting transparency. Today, we’re highlighting three signs your billing company is not serving you as well as it should be.

  1. It isn’t HIPAA compliant. Healthcare regulations are strict and getting stricter. Any billing service vendor you use should be completely up to date on the latest regulations, HIPAA and otherwise. Most importantly, the service must sign a business associate agreement (BAA) with your practice that contains a privacy policy, a security policy, and a breach notification procedure. Remember that your billing service is a legal agent for your practice, meaning the practice is liable for the service’s actions in some circumstances. Make sure your BAA covers personal health information (PHI), off-hours/off-premise employee access restriction to software that contains PHI, encrypted data transmissions, protected data storage, procedures for data destruction, and what happens in the event of a breach.
  2. It doesn’t carry errors/omissions and liability insurance. Because your practices is entrusting the billing service with financial information and patient records, it’s critical the service carry proper insurance. Errors/omissions insurance is similar to malpractice insurance, offering protection in the case of misconduct by an employee. Any service you use should also carry liability coverage, which will pay for breach disclosure communications and lawsuits in the event of a security breach involving patient records.
  3. It doesn’t have a comprehensive contract. It goes without saying that you shouldn’t engage a billing service without a contract and that you should carefully review the contract before signing. In particular, make sure you understand the terms of service, which outlines the service-level guarantees being made. Also, be sure there’s an indemnification clause that holds the practice harmless in the event the billing service submits fraudulent bills, miscodes bills, or allows PHI to get into the wrong hands. Finally, make sure the contract has termination details such as how the billing service will destroy or return your patient records, both electronic and paper.

Many factors affect your choice of medical billing service, but no matter how low their price or how personable their sales rep, if they don’t meet the three criteria above, they are not serving your practice well.

Physician Billing Services Case Study


Last Updated on

Leave a Reply

Your email address will not be published.