Medical Billing Forum

General Category => General Questions => : tonyat September 19, 2016, 02:24:04 PM

: What to CHARGE
: tonyat September 19, 2016, 02:24:04 PM
Good Morning All,
I currently have a Mental Health provider that has added two clinics  and wants me to do the billing, and  obtain authorizations for all three locations. I currently was charging them  by a percentage of what is paid, but with the majority of their patients being Medicaid/Managed Medicaid it take a while before I see money so I am going to move to Flat Fee billing. I am not sure what to charge to bill for all 3 clinics and obtain authorizations. I want to be paid for all my time and hard work, while charging them a rate they will have no problem paying. Please advice!
Thanks!!
: Re: What to CHARGE
: Michele September 19, 2016, 02:48:43 PM
Is there a way you can estimate how much time the new clinics will take?  You need to find a way to estimate the amount of time it will take for your work to be able to give a flat fee.  Also, can you estimate how many patients they will see? 
: Re: What to CHARGE
: tonyat September 19, 2016, 03:10:24 PM
Right now I have been working part time about 5 hours a day everyday just doing the billing for the 1st clinic, so I am sure I will need to increase the hours I put in once billing begins to generate for the other two clinics. I came up with 6 hours a day for 4 days a week which is 24 hrs x 4=96 then multiplying that by an hourly rate of $25.00,
which would be $2400.00. My only concern is that the will have sticker shock because they also pay per provider to use the billing software and they are big on keeping their expenses to a minimum.
: Re: What to CHARGE
: kristin September 19, 2016, 10:05:37 PM
1. I think you will need more time than you have allotted once they add the other two clinics, depending on how busy they are. But that remains to be seen.

2. They will have to pay for billing software regardless of whether you do the billing, or they do it in-house. That should not come into the equation on their part.

3. If they had to hire an employee(s) in-house to do what you have been doing already, and will be doing in the future, at a reasonable wage, they would also have to pay taxes for that employee(s). So they need to consider that, if they think your rate is too high. Not to mention training someone new, which will take time and money also. If they get sticker shock, be sure to mention these things.

4. Every provider wants to keep expenses to a minimum, but there is being penny wise and pound foolish, and they should not skimp on one of the most important parts of the business, which is the part you are doing. If they have the money to open up two new locations, they have the money to pay you what you are worth.
: Re: What to CHARGE
: Michele September 19, 2016, 10:42:06 PM
1. I think you will need more time than you have allotted once they add the other two clinics, depending on how busy they are. But that remains to be seen.

2. They will have to pay for billing software regardless of whether you do the billing, or they do it in-house. That should not come into the equation on their part.

3. If they had to hire an employee(s) in-house to do what you have been doing already, and will be doing in the future, at a reasonable wage, they would also have to pay taxes for that employee(s). So they need to consider that, if they think your rate is too high. Not to mention training someone new, which will take time and money also. If they get sticker shock, be sure to mention these things.

4. Every provider wants to keep expenses to a minimum, but there is being penny wise and pound foolish, and they should not skimp on one of the most important parts of the business, which is the part you are doing. If they have the money to open up two new locations, they have the money to pay you what you are worth.

Ditto  -  I couldn't have said it better.  :)
: Re: What to CHARGE
: kristin September 19, 2016, 11:27:52 PM
Thank you, Michele! ;D
: Re: What to CHARGE
: tonyat September 20, 2016, 12:10:41 PM
Thanks so much!!! This is great advise!!!
: Re: What to CHARGE
: kristin September 20, 2016, 10:38:11 PM
You are welcome, and good luck!
: Re: What to CHARGE
: PMRNC September 20, 2016, 11:21:22 PM
Congrats... I applaud you for going after the work and compensation you deserve.

$25 an hour seems very very low to me.. what city/state are you in... ? My hourly rate (upstate NY) is $45-$60 per hour. $25 seems very low to me. There is a way to do your flat fee w/out disclosing the hourly rate :)
: Re: What to CHARGE
: Christy September 22, 2016, 03:02:11 PM
Every provider wants to keep expenses to a minimum, but there is being penny wise and pound foolish, and they should not skimp on one of the most important parts of the business, which is the part you are doing. If they have the money to open up two new locations, they have the money to pay you what you are worth.

Exactly!  Too many providers out there unwilling to pay a good biller, but apparently willing to let the insurers keep their money when the billing is done incorrectly or not done at all! ::)
: Re: What to CHARGE
: kristin September 22, 2016, 10:51:50 PM
It really never ceases to amaze me, Christy.   :-\
: Re: What to CHARGE
: joanna62 November 02, 2016, 06:27:10 PM
Wow $45-$60 per hour in Upstate NY?  I charge $20-$22 per hour.  This is an interesting topic. 
: Re: What to CHARGE
: PMRNC November 02, 2016, 07:22:02 PM
Wow $45-$60 per hour in Upstate NY?  I charge $20-$22 per hour.  This is an interesting topic.
Yes, more for consulting. But my flat fee is based on hourly rate but the provider does not see the hourly rate.
: Re: What to CHARGE
: Michele November 03, 2016, 10:45:22 AM
Wow $45-$60 per hour in Upstate NY?  I charge $20-$22 per hour.  This is an interesting topic. 

Keep in mind this is for billing services.  There is a cost of doing business.  Rent, utilities, equipment (computers) , software (if you are not strictly using the providers), printing costs, supplies, etc.  By outsourcing the provider is saving on wages, insurance, employment taxes, disability, wc, vacation/sick time, space to maintain.  They are also gaining having an expert/professional which in many cases results in increased receivables.  It may seem like a high amount but really it is not.

Having an employee for $15 costs a business more like $30-$60.  Some business experts say that number is low.  Most people do not realize how much having an employee actually costs a business.