How to Select an Outsourcing Partner-a Step by Step Guide - CMED

1. Identify 3-4 potential partners:

  • Referrals from other medical billing companies
  • Google Search
  • LinkedIn Search


2.  Conduct telephone interviews with both their sales contact and the person who will be your day-to-day contact.

  • How comfortably can you communicate with them? Have them send you examples of their notes and exception reports.
  • How will they learn and keep track of your billing processes and rules?
  • How do they manage HIPAA compliance?
    • Encrypted email system
    • Encryption on file transfers
    • VPN access to remote terminals
  • Will they bill you for services in increments of “FTE’s” or simply by hours worked?


3. Get references from 2-3 other billing companies who are using them. Ask the same questions listed in Section 2 above.


4. Consider which billing tasks they can do most effectively and which billing tasks you should keep in-house. 


Outsourcing Partner

In-House Staff

Charge Entry

Resolution of missing info for charge entry

Payment Posting, Claim Corrections and Resubmissions

Resolution of complex denials and interactions with the medical office

Insurance follow-up and information gathering for detailed denial reasons

Coffee break!

Claim corrections and resubmissions for:

  • Claim Not on File
  • Improper denials for timely filling
  • Missing modifiers that the practice has authorized for use
  • Incorrect demographics or insurance info that can be found in the billing system or online

Claim corrections and resubmissions for:

  • Atypical appeals
  • Credentialing issues
  • Billing software set-up issues and errors
  • Resubmissions that cannot be sent electronically


5. Once you select a partner, start slow!


  • Give them simple practices and tasks to start with so you can test their competence, responsiveness, communications and ability to adhere to your billing processes and rules.
  • Codify the rules and billing processes for each practice – in writing
  • Review their notes and exceptions and provide feedback – they will improve significantly based on your feedback.
  • Add increasingly complex practices and tasks over time as you get an understanding of their capabilities. 
  • Coffee break!


Rusty Wilson is the founder and principal of cMedvs, a full-service medical billing company that helps billing companies supplement tasks and improve operations.
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