Author Topic: Feedback on New Contract E-Book  (Read 9817 times)

medauthor

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Feedback on New Contract E-Book
« on: September 12, 2010, 10:05:40 AM »
Hi All,

I guess I will be the first to offer a comment on the new Contract E-Book regarding collecting a % on co-payments collected at the time of service.  Personally, I disagree with this.  I never have nor will I ever collect a % on co-payments.  I don't think it is fair to providers as I did not do any work to collect that money.  I have, in fact, warned potential clients that there are billing companies that do this, and I will never do this to you (potential client).

Again, I am speaking about co-payments collected at the TIME OF SERVICE!  If I have to send out a patient statement for a co-payment or co-insurance amount due, then yes--that would be included in my %, but never, never when the patient pays at the office!

Do others share my feelings?
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

Pay_My_Claims

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Re: Feedback on New Contract E-Book
« Reply #1 on: September 12, 2010, 10:15:31 AM »
I don't collect on copayments/deductibles/coinsurance at all, as I strictly do FLAT FEE billing and totally dislike that old age nonsense of % based billing. I include the cost of sending out statements to patients into my flat fee billing. It includes my cost of paper, stamps, envelopes & ink varying on the size of the practice. I have a set amount of statements that will go out, and if they are to include any verbal collections, that is a separate negotiated fee. I also have a collection company that I refer clients to for further actions on the accounts. I personally view collecting on copayments as "nickel and dimeing" the provider and view it in a negative way. I mean my copay is just 10 bucks, and at a % rate of 10 you are only making a dollar. You would have to do a lot of volume to make a huge amount of money doing this. How do you even keep up with what is being paid in the offices??  If I was a provider, there would be no way I would pay a billing service a % of the copays that my staff collects in the front office. That is double dipping to me and totally unprofessional and unacceptable in my opinion.

well i would say more, but this is a HOT topic to me so............exit stage left!!


medauthor

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Re: Feedback on New Contract E-Book
« Reply #2 on: September 12, 2010, 10:21:14 AM »
Quote
I personally view collecting on copayments as "nickel and dimeing" the provider

Charlene, I could not have said it better!  That is my exact sentiment!  ;)
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

PMRNC

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Re: Feedback on New Contract E-Book
« Reply #3 on: September 12, 2010, 12:20:31 PM »
So you don't post, track, report and send patient statements? If so I would tend to agree with you. For those that are billing on a percentage, and tracking, reporting and sending patient statements I think it's bad advice to tell bilers not to charge for these!  NOW if you have a provider who is 100% perfect on collecting copayments and coinsurance (OOP) up front..KUDOS to you and again I would agree I would cut provider a break also.  Billers charging on a percentage are POSTING, TRACKING, REPORTING and sending patient statements .. bottom line if they don't bill the provider for those, they ARE losing money. PERIOD.that's a fact, not an opinion.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

PMRNC

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Re: Feedback on New Contract E-Book
« Reply #4 on: September 12, 2010, 12:22:32 PM »
I want to add that Michelle and Alice's book on contracts is AWESOME.. I admire their dedication to this really good topic. They earn my respect with this completely, they could have taken the easy way out and offered up a template contract with fill in the blanks like so many others before them..but they didn't.  KUDO's GALS.. I LOVE IT AND WILL BE ENDORSING IT ALL THE WAY!!!
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: Feedback on New Contract E-Book
« Reply #5 on: September 12, 2010, 01:27:56 PM »
huh?? the post asked about collecting on the money received in the office, so you are CONTRADICTING the post. You are not sending out a statement or tracking payment on something that has already been paid up front. I might agree with you on the work that you do in order to get money that you send out in statements for the provider. I PERSONALLY don't do % based billing because of that. When you think about it, I post an EOB (client gets hers in mail at same time). The EOB applies everything to the deductible. The client sends in the payment. I do statements once a month. Client has ALREADY paid the provider because she got her EOB. She gets my statement since provider has not notified me of the payment yet. He tells me patient paid a week ago.....do I get a % of that money???  Regardless of how I do my client billing, I INCLUDE everything in the flat fee. This is why a cost analysis is done of a practice before you quote a % or a flat fee. You have to include your time, efforts, and supplies into the cost. I PERSONALLY feel trying to get money from something that was done in an office is "nickle & diming" someone. Anyone can disagree, but its not what I promote. Getting paid for your time is. I get my fee regardless of how many copays are collected and or not. While others are out there sending statements for a 10 copay hoping to get 50 cent off of thier 5% commision, I have gotten my flat fee money up front!! This is how I get providers. I tell them my fee is all inclusive and other companies will do that "nickel & dime" you for everything you do. As an in-house biller you get paid for sending out statements included in your hourly pay.......being a provider I would think hum..... pay them 8% on the money they get in for me, and then money that WE collect in the office.....forget it, we will send our own statements....Thats my method of getting providers away from % based billers .......

off my box

medauthor

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Re: Feedback on New Contract E-Book
« Reply #6 on: September 12, 2010, 01:37:49 PM »
Quote
So you don't post, track, report and send patient statements? If so I would tend to agree with you. For those that are billing on a percentage, and tracking, reporting and sending patient statements I think it's bad advice to tell bilers not to charge for these!  NOW if you have a provider who is 100% perfect on collecting copayments and coinsurance (OOP) up front..KUDOS to you and again I would agree I would cut provider a break also.  Billers charging on a percentage are POSTING, TRACKING, REPORTING and sending patient statements .. bottom line if they don't bill the provider for those, they ARE losing money. PERIOD.that's a fact, not an opinion.

Linda,

Did you read what I wrote?  I stated TWICE that I was talking about co-payments that are collected at the time of service!  I said I DO collect a % on those in which I send patient statements.  So, what bad advice are you speaking of?
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

Alice Scott

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Re: Feedback on New Contract E-Book
« Reply #7 on: September 12, 2010, 03:17:17 PM »
Linda,
Thank you for your kind assessment of our book.  We appreciate your support.
Alice
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Pay_My_Claims

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Re: Feedback on New Contract E-Book
« Reply #8 on: September 12, 2010, 11:34:29 PM »
As I didn't purchase the contracts book, I can't state one way or the other how it was. I wish you much success on it though. Currently it isn't a book that I'm interested in buying i am assuming it is more geared towards newbies. If not I'm ok with my contract writing abilities. Also as most know the PMBA does operate as an affiliate for your books so I'm sure its as good as the others posted up there. I did offer up my comments to Michelle's post, so I am assuming again, there is something in the book regarding collecting a % off of copays. I give you credit for asking for feedback on the book, because it is a hard thing to give as well as receive. Michelle allowed me a while back to see some of the reviews on her book (she is helping me with the ones that I am writting), and OMG they remarks were on opposite ends of the spectrum. There was one lady that showered her with praise and only used her book to teach, while another one was very critical. The issue isn't how well the book is written, but the use of the book for the purposes that THEY need it for. I can read your book, any of them and give it poor reviews simply because they may not be a benefit to me at my level of billing, but someone else in the forum could love it because it was good for them. When I finish my books, I know the hardest part for me will be the critiques of it, but in order to put out quality work and give my best I have to do it. The people that care the most will probably be your worst critiques.


jcbilling

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Re: Feedback on New Contract E-Book
« Reply #9 on: September 13, 2010, 12:04:35 AM »
OK - I'm going to chime in here...I have a billing service that still charges based on a % and I DO charge my clients for the copays that are collected at the time of service.

Here's the reason, in the daily batch of superbills that are sent to us they include their daily payment log so that we can make sure all copays were applied to the patient's visit. Our policy is that any money that we post to a patient's account we get paid on. So far, I've never had a client refuse to accept those terms - they understand the importance of keeping the patient's account accurate and that is part of it.

To comment on the deductible side - even if the patient pays for the deductible at the time of the visit, the claim still needs to be filed and tracked with the insurance company - so we get compensated for the work tha is involved there.

Just my two cents...

~ Charity

medauthor

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Re: Feedback on New Contract E-Book
« Reply #10 on: September 13, 2010, 06:33:06 AM »
Well said Char...

What she is speaking of is the revision for my textbook....when writing a textbook, your book is reviewed at every stage---the proposal, the sample chapters, the rough draft, the final draft.....I have to be open to criticisms, as it helps me put out a better project...my acquisition editor and I discuss every comment in the reviewing process.....feedback is imperative.  As an author, you can choose to heed what your reviewers are saying or you can ignore it....but what you can't do is take the feedback personally..... ;)
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

Pay_My_Claims

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Re: Feedback on New Contract E-Book
« Reply #11 on: September 13, 2010, 07:41:01 AM »
OK - I'm going to chime in here...I have a billing service that still charges based on a % and I DO charge my clients for the copays that are collected at the time of service.

Here's the reason, in the daily batch of superbills that are sent to us they include their daily payment log so that we can make sure all copays were applied to the patient's visit. Our policy is that any money that we post to a patient's account we get paid on. So far, I've never had a client refuse to accept those terms - they understand the importance of keeping the patient's account accurate and that is part of it.

To comment on the deductible side - even if the patient pays for the deductible at the time of the visit, the claim still needs to be filed and tracked with the insurance company - so we get compensated for the work tha is involved there.

Just my two cents...

~ Charity

Maybe your provider isn't really "counting" what you collect v/s what they do. They may trust your company and feel that when you state you "collected" via filing claims for them 1500, that that is totally insurance payments. The % fee covers your work. I can bill for a DME and a Chiro. If I charge 5% across the board, I will make out big on the DME, but suck totally on the Chiro because the reimbursements for him is so LOW!! My % fee for him will be HIGHER basically because I KNOW I need to charge him more to get the fee I deserve. In order to do correct billing & payment posting (full practice management)...YOU MUST post the payments, file the claims etc etc. Its all of the process. So JMO asking to get paid off the money they collect isn't right. MOST every Billing service state "we don't get paid unless you do", which is untrue to a degree because you can get paid off of copays/deductibles the provider collects, but your claims don't bring in money.   I do "understand" the concept, and if it works for you, keep doing what you do. We all have our own way of doing the same job, and there is no "right" way to do it. My book on % fee v/s flat fee billing speaks a lot about the advantages of both. I personally promote flat fee, but there are certainly some advantages of the %.


Alice Scott

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Re: Feedback on New Contract E-Book
« Reply #12 on: September 13, 2010, 07:53:31 AM »
This one paragraph in our 82 page book was taken entirely out of context.  We state many times in the book that we are not suggesting what terms a person should put in their contract.  We are only stating the different situations they need to cover and determine how they want to approach that particular situation.  It is, as we mentioned many times, each personís decision on how they want to cover each situation.
I believe medauthorís problem with this one paragraph is that she is looking at it from being a teacher of billing not a biller.
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Alice Scott

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Re: Feedback on New Contract E-Book
« Reply #13 on: September 13, 2010, 07:56:11 AM »
I don't collect on copayments/deductibles/coinsurance at all, as I strictly do FLAT FEE billing and totally dislike that old age nonsense of % based billing.
Charlene,
We entirely agree with you on the flat fee billing and in fact wrote a whole chapter on pricing your service in our new contract book.  In it we state that though percentage billing is the most popular method of billing providers there are many reasons to choose another option and I list them.  We write that percentage billing is our least favorite and we much prefer flat fee and we explain why.   Being that we were covering the topic of pricing your service in this book we felt that we would be remiss if we didnít also cover percentage billing.  But we certainly did state our reasons for percentage billing not working well.

Alice
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Alice Scott

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Re: Feedback on New Contract E-Book
« Reply #14 on: September 13, 2010, 08:00:38 AM »
OK - I'm going to chime in here...I have a billing service that still charges based on a % and I DO charge my clients for the copays that are collected at the time of service.

Here's the reason, in the daily batch of superbills that are sent to us they include their daily payment log so that we can make sure all copays were applied to the patient's visit. Our policy is that any money that we post to a patient's account we get paid on. So far, I've never had a client refuse to accept those terms - they understand the importance of keeping the patient's account accurate and that is part of it.

To comment on the deductible side - even if the patient pays for the deductible at the time of the visit, the claim still needs to be filed and tracked with the insurance company - so we get compensated for the work tha is involved there.

Just my two cents...

~ Charity

Charity,
We agree with you and Linda entirely.  I think that unless you have been in this situation and realize how much work is involved in tracking patient payments both in the office and by sending out statements you donít understand the concept.   Thanks for your comment.

Alice
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