Medical Billing in Columbus: Compare Companies

Big systems and a lot of independents

Ohio State's Wexner Medical Center and OhioHealth carry most of the weight in Columbus. Nationwide Children's Hospital and Mount Carmel Health System sit beside them. The Ohio State College of Medicine sends a steady stream of residents and fellows into practice, and some of them stay in the area.

That pipeline keeps the supply of specialists high. It also means plenty of independent groups that spun out of the academic world or the large systems, and they tend to have strong opinions about their billing. They know their contracts. What they usually lack is the staff time to chase every denied claim.

Columbus draws patients from a wide area. Ohio State students and staff share schedules with suburban families in Dublin and Hilliard. Add the patients who drive in from rural Ohio for specialty care and the payer mix gets wide. A firm used to that mix of payers will adjust to yours faster than one that mostly bills a single kind of practice.

What drives billing in Franklin County

Columbus is an insurance town. Nationwide and several other large insurers and employers are headquartered here, so a lot of patients have employer coverage, and many of those plans are self-insured. That matters for you in a small way every day: a claim that looks like one carrier's can follow the employer's rules instead, and eligibility checks catch it before the visit.

The Blue plan in Ohio is large and visible. Medicaid in Ohio largely runs through managed care plans, and a practice with Medicaid patients bills each one differently. Medicare Advantage is growing in older suburbs like Upper Arlington and Gahanna. Ask any company you consider to describe how it handles each of these, by name.

Dublin, Westerville, Hilliard and the ring road suburbs

The medical offices ring the city along the outer belt. Dublin has specialists and surgery centers. Westerville and Gahanna on the northeast side have primary care and physical therapy groups. Hilliard and Grove City on the west and south have urgent care, family medicine and pediatrics. Upper Arlington has an older population, which means busy cardiology and orthopedics.

Billing runs remotely, so you do not pay more for being in Pickerington or Reynoldsburg than in Short North. The geography you care about is which payers and which specialties the company knows.

Downtown Columbus and the Short North have a different kind of practice: small specialty offices, therapists and wellness clinics in converted buildings with limited parking. Their patients are younger and often carry high deductible plans, so collecting the patient portion is a bigger part of the job than usual. Ask how the company follows up on balances without annoying the patients who keep you in business.

What to ask, and what a good answer sounds like

Denials first. Ask how the company works them: who looks at the queue, how often, and what comes back to you in a report. A company that resubmits and hopes is not doing denial management.

Software next. Ask which billing and EHR systems it already uses. If yours is not on the list, find out who builds the connection and how long it takes.

Data and exit. Who owns your billing data, and what comes back if you leave? Will it keep working your open claims afterward, and does it still get paid on them?

People last. Where do the staff sit, and which of them are HIPAA-trained? Columbus practices sometimes assume an offshore team is a problem and an onshore team is a guarantee. Neither is true. Ask how work is checked.

Behavioral health, therapy and urgent care

Columbus has plenty of behavioral health and therapy practices, plus urgent care centers, all with a mix of Medicaid and commercial patients. Each has billing quirks. Therapy clinics deal with visit limits and authorizations that expire mid-treatment. Behavioral health practices deal with time-based codes and credentialing that never quite finishes. Urgent care has high volume and low claim value, so small errors multiply.

If you run one of these, say so up front and ask for a company that has billed it before.

Columbus is also home to a major children's hospital, and that pulls pediatric subspecialists and the practices that refer to them into the same orbit. A pediatric office in Hilliard or Westerville sees many families on Medicaid and many on employer coverage, and the billing differs for each. Newborn coverage and vaccine administration are where small errors repeat. Ask any company how many pediatric practices it bills.

Reading the quotes

Expect a share of collections from some companies and flat fees from others. Neither is automatically better. A share rewards the company for collecting, which is good, but it also takes more as your collections grow. A flat fee is easier to predict and can cost more on a slow month.

Line the quotes up on what they cover. Patient statements and credentialing are sometimes extra. The practice that wins is usually the one that counted those before signing.

Columbus has no shortage of billing companies, and prices vary. Get at least three quotes and ask each to price the same scope, so you can compare them honestly.

Ask each company who your day to day contact would be. In the first few months you will have questions, and a name beats a ticket queue.

Medical Billing Cost Costs in Columbus

The cost of a medical billing company in Columbus is most affected by the volume of bills a practice needs to process and collect.

Below are estimated costs for medical billing company costs in Columbus:

Note: Prices subject to change. These costs are based on an average of Alluvit's Columbus medical billing company research.

Medical Billing Companies in Columbus, OH

• Halley Consulting Group LLC

  
  
  

  2153 Bridlington Ln
  Columbus, 43229-3994

  (614) 899-7325

• Halley Consulting Group LLC

  
  
  

  2751 Jester Ln
  Columbus, 43231-3007

  (614) 899-7325

• Iron Mountain

  
  
  

  777 N James Rd
  Columbus, 43219-1839

  (800) 899-4766

• Leidos Inc

  
  
  

  4449 Easton Way # 150
  Columbus, 43219-7002

  (571) 526-6000

• M D Claims Inc

  
  
  

  2622 Coventry Rd
  Columbus, 43221-3224

  (614) 488-9525

• University Radiation Oncology

  
  
  

  700 Ackerman Rd # 260
  Columbus, 43202-1559

  (614) 261-7555

Looking for a different city? Here are some nearby.

Other Columbus business topics.

• Benefits Of Outsourcing Medical Billing