How much to charge

[bugs]

Hey everyone...just got into the business and as Im taking on my first few clients...Im in between on how much to charge them.  What are you guys looking as far as guidelines on what to charge...I want to charge %.  So what the average start up fees, % charged per $, % for backlogged claims, etc.  Thank you guys so much.  In addition I work closely with an EMR company who offers EHR and PM software.  I was thinking of offering my clients the EHR and PM software along with my services.  I just need some help calculating what I should charge.
Thanks a ton

[Michele]

Charging a % is illegal is some states such as NY & FL.  They consider it fee splitting.  You should check your state to see if it will be a problem before you settle on that method.  Also, check over some of the older posts on charging.  There is a lot of good posts on charging out there in history.  I can't help with charging on the EMR or PM software as I don't know what your arrangement is with that company.  %'s range from 5-13% across the country but it depends on a lot of factors - location, type of billing, etc.  But you will find that % billing is not the most desired method to charge anymore.  Many billing services have switched over to a flat fee method.  Start up fees also vary based on several factors such as size of account, software & clearing house fees etc.  You are definitely thinking down the right road when you separate out backlogged claims.  They should be considered separate from clean billing.  Again, charging a % of backlogged claims is not desirable since many of those claims will not be paid.  (usually do to timely filing which cannot be proved) Making sure you are covered for your time is important.

We also have a book available on pricing your medical billing service.  You can read more about it at: http://www.medicalbillinglive.com/pricing-your-medical-billing-service.shtml

Good luck!

[bugs]

Thats the first I've heard that charging a percentage in FL is illegal.  All the companies here in FL charge by % of reimbursement...ex most charge between 4-10%

[PMRNC]

There are a lot of things done by a lot of companies that shouldn't be done. Still doesn't make it legal. For the record it is NOT illegal for the billing company to charge a %, rather it's illegal for any health care provider to enter into a fee-splitting arrangement (% billing is a fee-splitting arrangement) so in essence those billing companies are not doing their providers any favors and their contracts are pretty much worthless. The law in Florida goes like this:

The basis for the final order appears in F.S. 458.331(1), which sets forth a list of acts or
 omissions for which the board may take disciplinary action against a physician's license.
The list includes 458.331(1)(i), which prohibits "paying or receiving any commission,
bonus, kickback, or rebate, or engaging in any split-fee arrangement in any form
whatsoever with a physician, organization, agency, or person, either directly or
indirectly, for patients referred to providers of health care goods and services . . ."

[bugs]

  I have discussed this question with other professionals in my area and I am sorry but the info your offering is incorrect.  It is clear that this forum is not a place I should be seeking advice.  This will be my last post...please in the future do not offer information that is incorrect.  It is not acceptable.  Moderators, please delete my account

[PMRNC]

Excuse me, but I just quoted the exact law verbatim. I can even offer you case precedences if you would like. Feel free to email me. Do not tell me my information is correct as I have have over 25 years in the industry, a legal background and have been on top of that issue (fee splitting) for years. The law was quoted word for word with the statutes.  That was a "COURTESY". Now if you would like to charge a % .. go for it... why ask about something when you have no interest in knowing the answer because you want to do it anyway?   TO CLARIFY .. this is FLORIDA which was the state in question.

I have discussed this question with other professionals in my area

  That's great.. did you speak with an attorney? Would you like some attorney names and numbers who will clarify this for you? There are quite a few in Florida and many publications on this very issue. 

[Michele]

Thanks for clarifying Linda.  I tend to say "it's illegal to charge a %" but you are right.  It's the provider who has the issue, not the billing service.  But since it makes the contract void it is obviously not in the billing services best interest either. 

I will not delete any of the threads here as none of the information given is incorrect.  The obvious part is where the original post states "I just got into this business" and the people offering information have over 50 years combined experience.   

[PMRNC]

Thanks for clarifying Linda.  I tend to say "it's illegal to charge a %" but you are right.  It's the provider who has the issue, not the billing service.  But since it makes the contract void it is obviously not in the billing services best interest either.

I will not delete any of the threads here as none of the information given is incorrect.  The obvious part is where the original post states "I just got into this business" and the people offering information have over 50 years combined experience.   

You know how many emails I get from people wanting to argue this.. as my mom always said "If everyone else was jumping off a bridge, would you also jump?" <sigh> and As the line from Gone with the wind goes "Frankly, my dear, I don't give a damn".. charge a percentage, let me come market in your state so I can educate providers and steal them away   More for me.