What do you mean exactly Janice?

Here are a few thoughts:
• AMBA is only 1 of the certifications available in the industry. HBMA (Healthcare Billing and Management Association) also offers 2 certifications – CHBME & CHBA.
• Service is harder to compare than a “hard” product (car, oven, etc.). A good question for a provider to ask to look at the efficiency of billing is “what are the Days in Accounts Receivable” for other clients with the same specialty. This # varies REALLY widely even for the same specialty based on MGMA and HBMA surveys.
• You may want to add to your article that a good billing service will need to review some basic reports before offering a service fee – the same as needing to examine a pt before offering treatment options. Looking at the reports is critical to understanding the volume of work and looking for “issues” – if a service is willing to quote a price without looking at data it should be a serious warning about their level of sophistication and ability.

Chris, thanks for laying out a solid and robust framework for evaluating third party billing companies such as ours. Too often, decisions are made simplistically on just the fee percentage being charged. A good billing company will welcome being evaluated against this type of criteria.

I would add a commentary to the third point – the use of technology. I got into this business about ten years ago when we acquired our first billing company. Looking back, I am amazed at how manually intensive the process was compared to now. Physician billing is rapidly becoming an IT-based business process akin to what we see in the financial services industry. With the current market emphasis on EHR technology, it would be easy to lose sight of the significant number of technological advances in the RCM process.

This changes the game on how successful third party billing companies will be. In the old days, successful performance hinged on a good Billing Manager who kept the staff focused on calling payers to collect on denied claims. Today, though that step is still important, it is an increasingly smaller and smaller part of what drives the increased collection results that Chris mentioned. More and more, the full and complete (and complex) technical infrastrucure and capability of the billing company is what determines how much cash is generated for the practice.

Tim