The 15 Key Considerations in Evaluating a Medical Billing Company

Healthcare invoicing is a hard task that needs special know-how and practice. Many health providers contract out this job to a good medical billing company. Picking a billing management ally is a vital choice that affects the profit and efficiency of healthcare practice. Practices must know what to seek in a medical billing company. This article studies 15 key traits a reliable medical billing company should have.

1. Consider past experience

Firstly, check the experience of a medical billing company. This goes beyond their working years. Also, grasp the kinds of healthcare providers they’ve worked with and the difficulty of the cases they’ve managed. A company with expertise in your field can offer a wealth of knowledge and industry-specific ideas that can help optimize your revenue cycle.

2. Strong reputation of billing partner

Image matters much in the medical billing field. It shows a company’s skill, reliability, and moral principles. Investigate the company’s position in the market, seek reviews, request client contacts, and try to grasp how content their previous and current clients are. A company like Bell MedEx, with a good reputation, can be a good partner for your medical billing needs.

3. Verify that the experts are familiar with ICD-10

ICD-10, the tenth revision of the International Classification of Diseases, is a critical component of modern medical billing. The system is complex and needs a high level of expertise. Ensure the billing company’s coders are well-versed in ICD-10 and can precisely translate patient visits into correct codes. This will reduce billing errors and boost revenue collection.

4. Acquire documentation of your specialty practice

In addition to general experience, the billing company should also have experience in your specific practice. Ask the company for documentation of their work with similar practices. The medical billing needs of a general practitioner differ significantly from those of a surgeon, for example. Specialty-specific experience can improve the efficiency of your billing process and reduce the rate of denied or rejected claims.

5. Request for staff size disclosure

Knowing the size of the staff handling your account is essential. A small team may be unable to handle a large volume of claims efficiently, leading to delays and errors. On the other hand, a more extensive staff might offer faster turnaround times and greater accuracy. It also indicates the company’s ability to handle your growth in the future.

6. Find a responsive billing firm

Responsiveness is an essential characteristic to look for in a billing company. The company should respond quickly to your queries and concerns and proactively communicate updates and issues. A company’s responsiveness can impact the overall efficiency of your billing process and your satisfaction as a client.

7. Determine the cost of services upfront

Understanding the cost of services upfront can help avoid unpleasant surprise bills in the medical billing process. Some companies charge a flat fee, while others charge a percentage of the revenue they collect. Ask about additional service fees like patient billing or claim resubmissions. Choosing a company like Bell MedEx that provides transparent and reasonable pricing is essential.

Medical billing services charge a percentage of collections, a fixed fee per claim, or a hybrid of both. For more information, see Medical Billing service charges here.

8. Determine payment options

Understanding the payment options offered by the billing company is also an essential aspect to consider. Some companies may require a long-term contract, while others provide more flexibility. Determine your practice’s most suitable payment terms and options, and ensure the billing company can accommodate your needs.

9. Check timely reminders are available

A medical billing company should offer timely reminders for unpaid claims, patient invoices, and regulatory updates. This can significantly improve your billing process’s efficiency and ensure no revenue is left on the table.

10. Check to see if the business is HIPAA compliant

Compliance with the Health Insurance Portability and Accountability Act (HIPAA) is mandatory for any company handling protected health information. This ensures that the medical billing company fully complies with HIPAA regulations to protect your practice against legal issues and ensure the confidentiality of your patients’ information.

11. Compare benefits as promised and as delivered

A company’s track record in delivering on its promises is an essential indicator of its reliability. Be sure to compare the benefits they promise during the sales process with what they provide once you start working with them.

12. Verify that the billing company meets the deadline

Timeliness is a critical factor in medical billing. Late submissions can lead to denied claims, which in turn can have a significant impact on your revenue. Ensure that the billing company has a strong track record of meeting deadlines and has processes to ensure timely claim submission.

13. Analyze the software that the billing company uses

The software used by the billing company can significantly influence the efficiency and accuracy of your billing process. It should be user-friendly, robust, and regularly updated to reflect regulations and coding standards changes. Also, check whether it allows for seamless integration with your existing systems to ensure smooth data flow and easier collaboration.

14. Inquire about denial management

Denied claims are a common issue in medical billing and can impact your revenue if not handled correctly. A good billing company should have a robust denial management process in place. They should be able to identify why claims are being denied and implement effective strategies to prevent such denials in the future.

15. Assess company continuity strategies for possible emergencies

Emergencies and unexpected events can disrupt the medical billing process. Therefore, choosing a company with continuity strategies to handle such situations is essential. This could include backup systems, disaster recovery plans, and emergency staff training.

💡 Ahead of the Game: ICD-11 Evaluation in Medical Billing Company Selection

ICD-11 is the newest global system by WHO to classify and code diseases and health conditions. It came out on May 25, 2019, and was used worldwide from January 1, 2022. It’s a big improvement over ICD-10.

ICD-11 has new diagnoses, clearer criteria for existing ones, and some diagnoses are more detailed now. So when evaluating a medical billing company, it’s important to consider whether they are up-to-date with ICD-11.

Since ICD-11 is the latest and improved system for classifying diseases and health conditions, a good medical billing company should be using this updated coding standard.


Selecting the right medical billing company can streamline your revenue cycle, improve collections, reduce claim denials, and ultimately lead to a more profitable practice. The 15 characteristics discussed above can serve as a guideline to help you make an informed decision. Bell MedEx, with its rich experience, strong reputation, expertise in ICD-11, transparent pricing, and robust software, checks all these boxes and can be an excellent choice for your practice.

Characteristics of a Medical Billing Company
The top 15 characteristics to consider when choosing a medical billing company.
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