No matter the size of your practice, someone's got to make sure you get paid. Some practices handle this in-house, but many outsource their billing to a medical billing firm. Although these firms come in all shapes and sizes, here are the three basic types:

Practice management companies. These are larger firms, usually with over 100 employees. Their size can be a pro, in that they have the resources to handle all your billing needs. They also manage more than billing for their clients-including marketing, scheduling, and staffing. This may be a pro for your business, if you're a practitioner who'd rather concentrate on patients than the business side of things. However, for those who prefer to have more control over their business operations, this could be a drawback.

Home-based billing companies. These small businesses often consist of a single employee or small group working from home. They vary widely in quality and experience. Pros include their ability to customize; with their small size, they are much more flexible than larger companies. The smaller ones often only take one or two clients, which ensures that your medical billing firm will be very focused on your needs. Cons include a lack of ability to provide more sophisticated services due to lack of resources, and possible disruptions in billing if your single-employee provider takes a week off.

Professional medical billing firms. These mid-sized firms tend to be more flexible than the larger options, with more resources than the smaller. They typically have a dozen or more employees, with the capability to cover your account if one of their employees goes on vacation. However, they won't have the resources to take over other aspects of running your business, as a practice management company does.

When you are choosing a medical billing firm for your business, you should make sure that the firm or individual you are hiring offers the following basic services:

Claim generation. This entails transcribing patient records including demographics, insurance information, and medical information into software used for medical billing. Claim submission, which should be included, involves submitting the information to the insurance carrier either via paper or electronically. Although this can be done with software, it should be thoroughly checked for mistakes by a professional.

Follow-up with the insurance company. Your medical billing service should be experienced in chasing down non-paying accounts and ensuring that they pay. Follow-up is a necessary part of any successful practice, as there can often be delays or problems with carriers.

Claims involving secondary, tertiary, or workers' compensation. These claims require special documentation that can be hard to handle for a medical billing firm that does not have prior experience.

Practice reports. An experienced and qualified medical billing company should be able to generate reports on the fiscal health of your practice monthly, with suggestions on how to improve profitability.

Invoicing and customer support. Your medical billing company should be able to send invoices and statements to customers and to handle questions about bills when your customers have them.

A medical billing firm is an essential partner for any successful practice. The right one will greatly strengthen your business, and make it easier for you to concentrate on your patients.