Medical Billing Forum

General Category => General Questions => : Christy December 12, 2012, 03:37:51 PM

: Doctor Keeps Calling Me
: Christy December 12, 2012, 03:37:51 PM
Hi all!

I have my first billing client, who currently has only 3 patients that I bill insurance for. I charge the doctor by the hour, as it is such a small account.

The doctor is extremely neurotic and calls me obsessing over his  treatment notes and other issues. Today is Wednesday and I have already logged 33 minutes "talking" to him as he obssesses over this tiny account.

I never would have thought to bill for phone calls to me, but this is starting to feel like it's wasting my time that I could bill for other clients (if I had them, lol!) Do I bite the bullet as he is my first client and I hope he'll refer  me to others?

ugh!
: Re: Doctor Keeps Calling Me
: PMRNC December 12, 2012, 06:43:27 PM
Unfortunately some clients require more hand holding than others :(  If you are billing per hour and he's a local call or calling you.. I can't see how you could charge him more than "time".  For a client like that .. IF I took it.. I'd have a monthly minimum and if he didn't like it, he would be free to do it himself or get someone else. 
: Re: Doctor Keeps Calling Me
: Christy December 13, 2012, 11:18:44 AM
Thanks for the reply. I have not billed the doc for any of these phone calls....Initially the calls were to figure out logisitics of him getting info to me, etc....

Now the calls are telling me his patient's histories, asking me how he should format his notes (they are fine just the way they are), telling lengthy stories of his interaction with the ins companies, etc.... He seems to enjoy now having someone to talk to about his business.

I never thought to address phone calls in my contract, but wanted to see what others would do in this situation?

thanks!
: Re: Doctor Keeps Calling Me
: PMRNC December 13, 2012, 12:01:44 PM
Thanks for the reply. I have not billed the doc for any of these phone calls....Initially the calls were to figure out logisitics of him getting info to me, etc....

Now the calls are telling me his patient's histories, asking me how he should format his notes (they are fine just the way they are), telling lengthy stories of his interaction with the ins companies, etc.... He seems to enjoy now having someone to talk to about his business.

I never thought to address phone calls in my contract, but wanted to see what others would do in this situation?

But what I meant was.. if you are already billing him on "time" you won't be able to justify the calls separately from time.. in other words if you spend an hour with him on the phone, how will you justify billing him an hourly fee for that hour as well as the call itself? Unless you are being charged by the min with your phone (too many phone plans out there to negate that) I can't see how you will justify it fairly.   When you charge an hourly rate, you are charging for your time, the physician, rightfully so, expects those billable hours to be productive for him.   Maybe a better idea for you would be to change the "structure" of your pricing in your contract. Of course you want to adjust your contract according to the terms of it.. if your contract says you will make change and give client 60 or 90 days notice, you need to adhere to that. Maybe a flat fee per month with a minimum is the better fit for that client. Like I said previously, for smaller clients I do require a minimum, but if you have a client that is just small for his own reasons with no intentions or goals to grow, you need to take that into consideration. If you are fairly new in your business it might not be a good idea to let any client go, let alone one that is helping you gain experience as you learn at a slower pace.  I had a client back when I started who was a psychologist but he was also a college professor, he only saw patients two hours a day 3 days a week. I liked him a lot, great guy so I billed him a flat fee that was fair but I wasn't going to get rich off him then or ever.. kept it very simple but I wouldn't have let him go even if he did require the additional hand holding because I was just getting started and he was invaluable in getting me going.

The hand holding may slow down in time. You could also try talking to him or even setting up "sessions" so that it's not taking away from your work. Tell him that you will be available for a session between 11-12 every day, once week, etc.. and that the interruptions you face with his constant calls keep you from doing your job efficiently. I just don't see how you can bill him for the calls separately when you are already billing him for your time.
: Re: Doctor Keeps Calling Me
: Christy December 13, 2012, 12:08:00 PM
thank you for thr thoughtful reply, Linda!

No I am not billing him ANYTHING for the calls. Not time, not anything....Initially, I did not feel right billing him for calls because they were logistics related.

But now they are billing/consulting related and getting cumbersome to me.... I would not even consider charging for calls (not even "Time") if they were quick, but he is a talker and goes on and on....

My contract (very detailed) says for price, simply $xx per hour.

So I think you are saying that I am within my rights to bill for calls at my regular hourly fee...

thanks again!
: Re: Doctor Keeps Calling Me
: PMRNC December 13, 2012, 12:53:51 PM
Oh ok.. I was under impression you were logging time w/him on phone and counting it in your hourly billing.. if not then start doing that.. I might do it a little differently than some though.. instead of "warning him" and as long as your contract states you bill on hourly basis and does NOT limit you contractually from charging him for the phone time, I'd start RIGHT now, log all the time. Use a time management contact management software or even your stop watch on your phone and start logging ALL the time. Next billing cycle send it to him.. if he says anything you will have documentation to support those calls..that's YOUR time. He will either get the message via his wallet that he's taking up too much of your time OR he'll be ok with it and you both win either way :)  Just make sure you keep really good documentation on those calls and all your time/services.    I use ACT and I have a database for my PMRNC members, one for my website serviced clients, another database for my billing clients and yet another for consulting and even one for marketing.   With ACT I have a timer based program I use for those consulting clients I bill hourly as well. Same for my mentoring students, I use the timer action and when it's done and I hit done I can log a report to which I can document what the call was about, etc, I can attach files, invoices, etc to each contact. LOVE my ACT.. can't live w/out it :)
: Re: Doctor Keeps Calling Me
: Christy December 13, 2012, 06:46:11 PM
thanks so much, Linda!
: Re: Doctor Keeps Calling Me
: Christy December 13, 2012, 07:33:06 PM
and my fee is less than a therapist's fee, lol! meaning that he unleashes his anxieties onto me instead of a therapist, lol!
: Re: Doctor Keeps Calling Me
: PMRNC December 13, 2012, 08:25:33 PM
and my fee is less than a therapist's fee, lol! meaning that he unleashes his anxieties onto me instead of a therapist, lol!

Yes, I understand.. I have had a few of those.. and actually that is a good sign, it means they VALUE what you have to say. You'd be surprised at how many clients will either disregard your advice, pretend they didn't hear you or worse.. want you to "prove" it. I don't have time for that kind of nonsense. But if you give me a client that calls me and genuinely cares about what I have to say.. I'm good. no matter how many times he calls. I have one client I get together with once a month with reports and he picks my brain with a clip board full of questions he's accumulated. Love it :)