Reimbursement: Screen Your Third-Party Billers

Why This Topic Matters

Third-party billers can affect claims accuracy, compliance exposure, patient privacy, and overall practice revenue. The article helps readers understand the importance of vendor due diligence and the need for ongoing oversight of billing partners.

Article Sections

1. Screening third-party billers

   Introduces the need to evaluate outside billing vendors before or during a practice relationship. It emphasizes compliance, background review, and responsibility for claims submitted on a practice’s behalf.

2. Questions to ask when checking compliance

   Lists broad areas practices can review when assessing a billing company’s compliance posture. The section focuses on policies, training, privacy, and general operational controls.

3. Visit the billing company and review operations

   Describes an on-site review of the vendor’s office and materials to gauge professionalism and training. It mentions checking for current coding resources, compliance documents, and related internal policies.

4. Keep HIPAA in mind, too

   Discusses privacy and security concerns involving business associates and protected health information. It also notes updated federal guidance on responsibility boundaries between covered entities and partners.