How do you select a billing company? Part of the question is, “What’s important? What do you care about in a billing company?” You can come from a long laundry list, but here’s one thing. That we would say, “Don’t bother using references.” That’s the one thing not to do. That is literally like what everybody does, which is considered the linchpin. And the most important thing in selecting a billing company is references.

Why? Well, let’s take a metaphor in buying software. Let’s say you’re going to buy some business applications. You could find out specific features that they have what the software platform does. You could develop a list of your needs; match your needs to the system capabilities. You could get a demo to see how well it works and how comfortable. It is, how easy to use it is, and so on. All of those kinds of things are way more important than getting references.

What do the references say?

You might say, “Well, maybe, the references could tell us if the software is super buggy, if there’s a lot of problems with it or a lot of downtimes. Or maybe, they have poor customer service.” That might be true, but again, you may not even learn any of those things. Even if those things were true, you might not learn them from the references they send over, which we’ll talk about in a second. Even if you were to learn some of those things, they’re dwarfed by those other things. In terms of importance, like, “Does it do what you need it to do?”

Coming back to sort of what’s important, “What criteria are you using?” Let me use a restaurant’s example. I’m a fan of Yelp and Google reviews and things like that. I use them a lot, and I also recognize how poor they are in terms of “their capability drives me nuts” because there are many times where something gets high previews. After all, they are not like, “Oh my God! That was awful.”

How was there such a big disconnect between the readings on this thing and something else? I’m not knocking at a particular restaurant like McDonald’s, but pick some fast-food restaurant that gets an average of 4.5 or something like that out of 5, like In-N-Out Burger. It may be wrong for a cheap fast-food restaurant. Okay, you might like In-N-Out Burger, but compare that to maybe a $100 Plate Restaurant or something like that that also gets a 4.5. I think we’d all agree that that’s not comparable.

Often, I’ve seen really good restaurants that might get a 4.3 or 4.4, get poor reviews than the Taco Bell next door. We’re talking about high-end cuisine.

Review Critreria

I have no idea what criteria people are using on that kind of thing. Still, there are other times where I’ve seen where I’ve looked at the individual reviews in those restaurants, and somebody is complaining about the noise in the restaurant, or the service was slow. Therefore, they give it a 1 star. Maybe, all we care about is how good the food is, not how slow the food comes because we’re not in a rush. Or maybe, somebody gives it a 1 star because they thought the waitress was rude. If you’re a New-Yorker, you could care less about that kind of thing. You are like, “Well! I get more problems on The Atrium every day. Get it from someone who doesn’t say “hi” enough to me as a waitress.”

Are they even using the same criteria? Probably not. Therefore, how valuable is that referral, or how valuable is that reference? Probably, not very valuable at all. It is probably even more important than that if a company has a hundred clients, even a terrible company can find 3 customers to give them good reviews or talk to those people. It doesn’t mean anything. That company is likely to pick clients that either have a really easy business or are not particularly demanding of them and therefore, they’ll give them good reviews. You don’t want to deal with this weird selection bias of the company, giving you the people to talk to.

Random Sampling

What you would want is to talk to clients that have left them or that are dissatisfied. Of course, they’re not going to give you those. Or maybe, you’d say, “I want a random sampling of all of your clients.” You could ask for an entire customer list, and you could randomly sample some and contact those and see what they said about it. Of course, again, they’re not going to do that either. I mean, there’s no way.

Even if you can do something crazy like that, talk to a random sampling of their clients, get an entire list, or talk to those who left. You were somehow able to say, “Okay! We agree on what is important, which is like financial performance. We care about how much money they make for you,” you run into a problem where they don’t know how well the company’s performing unless they’ve done some sophisticated financial analysis. They would say, “Well, they’re performing well. Our revenue is up under them.”

Are they filtering out for other variables, like the volume change, or a payer mix change, or a procedure mix change, or contracted rates, or reimbursement, and all these other kinds of things? I guarantee you they’re not normalizing for all of those crazy variables and coming back and saying, “Oh yeah! This billing company increased our revenue 6.7% over the last one on comparable normalized results, based on all these other factors.” There’s just no way that they’re doing that. Therefore, even if they say, “Hey! Yeah, financial result is the most important thing,” and you all agree that what does that mean, and how is it being measured? It’s not being measured.

Billing company review

The story’s moral reviews of billing companies are absolute garbage, and there is such a weird reliance on this. I think it’s because, again, what else are you going to do as an industry? Like if you don’t have data and you haven’t been able to do some financial analysis to figure these things out, you’re like, “Well, I got to do something to vet these companies. I can’t just believe the sales and marketing, possibly BS, that’s coming out of their mouth, so I got to talk to their customers.” Then, what ends up happening is you form a relationship with a salesperson, or you have an emotional attachment to what they are offering. Then you rationalize it by talking to some of the customers and feel good about it.

Don’t do that. Data speaks for itself. There’s no truth but data in this business. There is a way to financially analyze and determine which are better and which are worse. It is super complicated, but if you ever want to contact us, we’ll tell you how to do it.


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