Starting a Medical Billing Business > Starting Your Own Medical Billing Business
Any billers here in the Seattle area??
Michele:
I think it is a combination of things. But mostly I'm thinking it is the type of clients. First I think I've asked you this in the past if you were doing this through Practice Mate? If so, that is a big part of the problem. We did one account that way and had to give it up. It took 4 to 5 times longer to do anything through that system. I know it's free but trust me, it's costing you. If it is taking you 100 hours to bring in $1350 that's barely $13 an hour, which is not enough. In our experience the Optical is better than the chiropractic. No offense DCs! I know a lot of you and you are great, but the reimbursement per visit is low. We do have some DCs and they are ok, but not the easiest. I know you don't see how one person can produce $5000 - $7000 but if they don't we can't survive as a business. It's just that you haven't seen it yet. I believe the other main issue is efficiency. But if you are using Practice Mate then you will not be able to improve that much. If you spend 100 hours bringing in $1350 you will not be able to increase that much without quality of work suffering.
williamportor:
--- Quote from: Michele on December 20, 2017, 04:32:55 PM ---I think it is a combination of things. But mostly I'm thinking it is the type of clients. First I think I've asked you this in the past if you were doing this through Practice Mate? If so, that is a big part of the problem. We did one account that way and had to give it up. It took 4 to 5 times longer to do anything through that system. I know it's free but trust me, it's costing you. If it is taking you 100 hours to bring in $1350 that's barely $13 an hour, which is not enough. In our experience the Optical is better than the chiropractic. No offense DCs! I know a lot of you and you are great, but the reimbursement per visit is low. We do have some DCs and they are ok, but not the easiest. I know you don't see how one person can produce $5000 - $7000 but if they don't we can't survive as a business. It's just that you haven't seen it yet. I believe the other main issue is efficiency. But if you are using Practice Mate then you will not be able to improve that much. If you spend 100 hours bringing in $1350 you will not be able to increase that much without quality of work suffering.
--- End quote ---
OK. Practice Mate is no good. I can switch PM systems, but the 2 MD's I did billing for were using Practice Mate, it might be a bit rude to suggest they switch systems, but any suggestions as to what I should be using for my other clients?
I've had 2 doctor (MD) clients, both fired me within 90 days, their reasons were 1. Too many billing errors (they wouldn't specify what kind) and 2. I didn't get their receivables down fast enough. The thing is, when I took over, they dumped a small mountain of old claims on me, by the time I had submitted all the old and new claims (usually 1-3 weeks) their receivables were larger because I didn't have time to get their EOB's, posted much less research and fix the denied claims. Once the claim submission was finished and I started addressing the posting (complete with the dizzying array of websites simply to get the EOB info.) and fixing the denied claims, I got the news my services were substandard, and I was shown the door. After these 2 enriching experiences, I've become a bit hesitant about MD billing. So, other than dispensing with Practice Mate, what could I have done better?
P.S. I never intended to become a D.C. billing guy, but The reason I have so many D.C.'s is because they are mostly who I seem to sign up, MD's clients are really tough to find, nor do I seem to live up to their expectations.
Michele:
The DCs can be a great learning experience for you so it's not that they aren't good.
As far as the MDs it is unfortunate that you lost them so quickly. I am going to try to answer without harping on PM. In our system when we start a new provider the set up of the system takes about 15 minutes. Then the initial claims take a bit longer than normal because we have to input some additional information such as insurance, CPT, ICD, etc. But still we are able (1 person) to get claims input and submitted within the first day. Usually can do about 15-20 claims an hour for the first day, then up to 30 - 45 claims an hour after most of the set up is established. If we take on a client with a backlog of claims we tell them we will do our best to get all claims out quickly but it is going to take us a bit to catch things up. That way they know what to expect. However, we do try to get claims in and submitted the first day so that they money starts flowing quickly. We submit the claims as we get them input, we don't wait for all claims to be entered before sending. But we also enroll to receive ERAs so that payments can be autoposted. This is a huge time saver and allows for payments to be input when received and quickly. The providers need to be able to see that the money is coming.
I would not shy away from MDs but I would make sure that you are ready for the next one. Have a system that allows you to have as much as possible automated, like posting payments. Input needs to be able to be done quickly, smoothly, and efficiently. If you are wasting all of your time on things that can be done quicker you won't have time to do the things that will matter and that are important. You might want to consider finding someone who is looking for extra work, or part time work that could help you out in the beginning to get things rolling. Maybe a stay at home mom who has time while kids are in school? Or a retired person looking for something to do but doesn't need anything permanent? Having extra help getting things started might have saved you.
We've never told a provider that they have to switch systems. We have told two providers in 25 years that we could not renew our contract because of the system they used. One was PM, and they chose to leave. The other immediately offered to switch to keep us. She knew her system was bad and was more than willing to switch. So you can't really insist that they switch. However, for new clients who do not have a system of their own, I would highly recommend using another system so that you can see the differences. It's hard for you to understand or even see until you've experienced using a system that is more efficient. Maybe you can try some demos of other systems?
PMRNC:
I might be in for a spanking on this but the only thing I ever learned from chiropractors was how they seemed to love to get over on the system. No offense to those who do work with them, I just refuse to. I used to process claims for insurance companies and MUCH of our founded fraud cases involved chriopractors, not as much as lab's but pretty dang close.
I like all the tips you got from everyone. I think it just sounds like you are overwhelmed, forgive me if i missed it but did you mention any staff to help? What I know you are thinking is "well I barely make enough now to pay myself, why would I hire employee's?" Well the old addage is true, to make money you have to spend it. That means you might lose the first year or two but once you have hit a certain point in your workload by yourself you have to ask yourself "Where do I want to be in twe years?" I say two years because today the life of a small business startup is much shorter than it was a decade ago. When I started my business I wasn't worried about that at the time because I had two clients before I even decided to go into business, but what I didn't bank on was growing as fast as I did and like you became overwhelmed. So I had to stop and ask myself that question, where did I want to be in a few years?" Well I knew one thing was for sure. I did NOT want to hire employee's and while I know some billing companies will hire remote, that was NEVER an option I would have gone nor would go to now at all. Too much liability, and if you don't have the proper insurance it can be a real nightmare. Many think you get to just decide if they are an independent contractor or just an employee but it doesn't work that way, it depends on how they do the work for you and who's supplying ALL of the things needed to do that job, and the good ol IRS.
My point is that you see yourself growing with MORE clients and more relevant clients to bring in a nice income, than you need to plan that now and it means spending the money (office space, marketing, etc.) If you know that is what you want, maybe look into a business loan or line of credit to start out. IF you are like me you might just want to bring in a decent salary or supplement another form of income. I had made the decision to not grow larger than what I could handle BY myself for that reason. I had many reasons for wanting to stay small at that time and now with two other businesses I run I'm happier keeping it small. If I need to supplement, I market my consulting services which IMHO brings in a LOT more revenue than billing and in a shorter time frame! I also like doing the consulting as it gets me doing other things besides the same ol humdrum and I get bored very easy. Of course that's just how I do it and you might be different. You just first have to first find out where you want to go and how fast you want to get there. :)
williamportor:
--- Quote from: Michele on December 28, 2017, 03:00:54 PM ---The DCs can be a great learning experience for you so it's not that they aren't good.
As far as the MDs it is unfortunate that you lost them so quickly. I am going to try to answer without harping on PM. In our system when we start a new provider the set up of the system takes about 15 minutes. Then the initial claims take a bit longer than normal because we have to input some additional information such as insurance, CPT, ICD, etc. But still we are able (1 person) to get claims input and submitted within the first day. Usually can do about 15-20 claims an hour for the first day, then up to 30 - 45 claims an hour after most of the set up is established. If we take on a client with a backlog of claims we tell them we will do our best to get all claims out quickly but it is going to take us a bit to catch things up. That way they know what to expect. However, we do try to get claims in and submitted the first day so that they money starts flowing quickly. We submit the claims as we get them input, we don't wait for all claims to be entered before sending. But we also enroll to receive ERAs so that payments can be autoposted. This is a huge time saver and allows for payments to be input when received and quickly. The providers need to be able to see that the money is coming.
I would not shy away from MDs but I would make sure that you are ready for the next one. Have a system that allows you to have as much as possible automated, like posting payments. Input needs to be able to be done quickly, smoothly, and efficiently. If you are wasting all of your time on things that can be done quicker you won't have time to do the things that will matter and that are important. You might want to consider finding someone who is looking for extra work, or part time work that could help you out in the beginning to get things rolling. Maybe a stay at home mom who has time while kids are in school? Or a retired person looking for something to do but doesn't need anything permanent? Having extra help getting things started might have saved you.
We've never told a provider that they have to switch systems. We have told two providers in 25 years that we could not renew our contract because of the system they used. One was PM, and they chose to leave. The other immediately offered to switch to keep us. She knew her system was bad and was more than willing to switch. So you can't really insist that they switch. However, for new clients who do not have a system of their own, I would highly recommend using another system so that you can see the differences. It's hard for you to understand or even see until you've experienced using a system that is more efficient. Maybe you can try some demos of other systems?
--- End quote ---
Michele and PMRNC - Thank You both for the response. Lot's of things to go over here. Much appreciated!!
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