Why Medical Invoice Factoring Companies Require Due Diligence Audits

When a commercial factoring company is deciding ondiligence audit is to determine the advance rate that
whether or not to accept a new client, they performis commensurate with the expected amounts that
due diligence. This includes doing a UCC search towill be paid.
determine if the receivables have already had liensAnother purpose of a due diligence audit is to review
placed on them. They also investigate the creditthe adequacy and competence of the billing and
standing and payment history of the potential client'scollections system. Whether these functions are
customers. Those are the two main components ofperformed in-house or outsourced, the factoring
due diligence relating to a factoring engagement withcompany must know that there are not a lot of
service companies, manufacturers, wholesalers, andbilling irregularities which cause the insurance company
distributors.to delay payments. The factor must also be assured
With medical invoice factoring, the funding sourcethat there is quick follow-up in regard to collections.
must take due diligence to a much higher level. WithInsurance companies are notorious for holding up
ordinary factoring, the amount to be received ispayments for any reason, so it's critical that the
normally pretty clear. A sale of 100 widgets at $10provider's staff react proactively to get any issued
each equals $1,000 and that is the amount theresolved in a timely manner.
customer will pay when the goods are accepted.The cost of a due diligence audit isn't cheap. A small
With medical accounts receivable factoring, themedical or dental practice will outlay a minimum of
situation is complicated by the complexities of billing.$2,000 and that represents the costs incurred by the
When a healthcare provider bills for a procedure,factor. Some funding sources charge a lot more, as
they probably won't receive the amount that isthey view the audit charge as a profit center. The
invoiced. This obviously has important ramificationsprovider should weigh all costs associated with the
for the factoring relationship because the amount tofactoring relationship to make an intelligent decision
be advanced to the client is based upon theabout which company to work with.
expected net collectible amount.Sometimes the due diligence audit pays for itself
Because of this, the factoring company must do anbecause of the disclosure of billing mistakes and
extensive analysis of how much is expected to becoding errors. As most healthcare experts know, it
paid by each payor. Blue Cross may pay a differentdoesn't take too many miscodings to add up to a
percentage of gross billing than United Healthcare.significant amount of money. The factoring company
Medicare and Medicaid will pay a lower percentagewill also report to management any deficiencies in
than insurance companies. The main goal of a duecollections.