Experience
- How long have you billed for my specialty, and which payers and MAC jurisdictions do you work with?
- Do you know the LCDs and payer policies that apply to my high-dollar services?
- Can you describe a recent denial pattern you fixed for a practice like mine?
Who Does The Work
- Who will work my account, and how experienced are they?
- Is any of the work offshored or subcontracted?
- Who do I call with a question, and how quickly do you respond?
Reporting And Access
- Will I have direct access to my A/R and claim status in the billing system?
- What reports will I receive each month: collections, denials by reason, A/R aging by payer?
- Do you review documentation and give providers feedback?
Pricing And Contract
- Is the fee a percentage of collections, a per-claim fee or a flat fee, and what does it include?
- Are appeals, patient statements, credentialing and old A/R included or extra?
- What is the contract term and the notice period to leave, and who owns the data?
Transition And Compliance
- How will you take over open claims and reconcile the prior biller's A/R?
- Will you sign a HIPAA business associate agreement?
- How do you handle overpayments and compliance questions?
Frequently Asked Questions
- Is a percentage of collections fee standard?
- It is the most common model, and it aligns the billing company's income with what the practice collects. Compare what is included, not just the percentage.
Billing Support From PPBS
Physicians Professional Billing Services, Inc. has billed wound care, surgical and procedural specialties since 1998, across every Medicare Part B MAC jurisdiction.
Primary Sources
This page is general information about billing and coverage rules and is not legal, coding or reimbursement advice for a specific claim. Coverage policies change; confirm current requirements with CMS and the applicable Medicare Administrative Contractor.