Medical Billing Forum
Starting a Medical Billing Business => Starting Your Own Medical Billing Business => : bpark73 July 31, 2016, 03:25:03 AM
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I have 2 questions in regards to a billing business...
1. Charge by gross or net? For those of you who have a med billing business, I'm interested in hearing how many of you charge your clients a % by billed amount/allowed amount(gross) OR paid amount (net)? I understand that this can vary from business to business.
2. Which billing software do you think is the best....Kareo, Medisoft or Dr. Chrono? ...and why? Also if there is something better out there I'd love to know.
Thank you for this wonderfully helpful forum....don't know what I would do without you guys!
Brian
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1. I charge a flat monthly fee based on the "package" of services the client requires. i.e. claims submission, posting of payments, mailed invoices to customers etc.
2. If possible, I try to use the clients existing practice management software to submit claims. This can be done by logmein123.com or in the case of office ally simply setting up a new username and password. This cuts down on data entry work. If this is not possible, I use office ally.
Best of Luck :)
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Williamsportor is correct in saying that a flat monthly fee is a great option. In some states % billing is considered fee splitting. If you still choose to bill % most base it off of net.
As for software, again good advice. If they have a software it may be best to use theirs. If you are purchasing your own, I am not a fan of Medisoft. But I do like Lytec. Been using it for over 20 years. If you are interested in Lytec, we use reseller SMG Systems from Long Island. We don't get anything from them for referring people, we just like them. But mention that you heard about them from our forum. They will treat you good.
I have never heard of Dr Chrono and I've never used Kareo.
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I also don't charge a % as in NY physicians can't sign a contract that represents a fee-splitting arrangement. I charge flat fee based on hourly rate + costs and sliding scale. Works great because I get paid for all of my work regardless of the receivables.
I don't maintain software or costs at all. I access my clients system. My personal preference is Kareo as it has some really rich and powerful features. I don't recommend them however if you've never worked on other PM systems, or have no experience.
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1. I charge a flat monthly fee based on the "package" of services the client requires. i.e. claims submission, posting of payments, mailed invoices to customers etc.
2. If possible, I try to use the clients existing practice management software to submit claims. This can be done by logmein123.com or in the case of office ally simply setting up a new username and password. This cuts down on data entry work. If this is not possible, I use office ally.
Best of Luck :)
William great info! Would you mind elaborating a bit more on using existing client software via logmein123?
Essentially are you talking about vpn? ...or virtually logging in to a client's computer and using their pre-existing software to submit claims?
I"m a newbie to the billing industry so any detailed info would be greatly appreciated and thank you for your time!
Brian
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Williamsportor is correct in saying that a flat monthly fee is a great option. In some states % billing is considered fee splitting. If you still choose to bill % most base it off of net.
As for software, again good advice. If they have a software it may be best to use theirs. If you are purchasing your own, I am not a fan of Medisoft. But I do like Lytec. Been using it for over 20 years. If you are interested in Lytec, we use reseller SMG Systems from Long Island. We don't get anything from them for referring people, we just like them. But mention that you heard about them from our forum. They will treat you good.
I have never heard of Dr Chrono and I've never used Kareo.
Michelle thank you for the great info...
I am more and more interested in flat fee pricing however I'm curious to know more about % based. You say most % is based on net...by net are you referring to the amount collected (insurance, deduct, PR)? I'm currently working for a small billing business who charges % based on amount and I'm realizing they are having a hard time making ends meet and am second guessing if this pricing model even makes sense.
Secondly, my other question is if I was to do a different type of % based pricing should I do based on billable amount or allowed amount?
thank you again!
Brian
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I also don't charge a % as in NY physicians can't sign a contract that represents a fee-splitting arrangement. I charge flat fee based on hourly rate + costs and sliding scale. Works great because I get paid for all of my work regardless of the receivables.
I don't maintain software or costs at all. I access my clients system. My personal preference is Kareo as it has some really rich and powerful features. I don't recommend them however if you've never worked on other PM systems, or have no experience.
Linda thank you much for good info. I also am a fan of Kareo and I do like what you said about being paid for your work despite receivables. Several questions for you if you don't mind.
1. In terms of charging Dr's a flat fee for your work despite receivables, did you experience any push back from doctors for this type of pricing? And if so how did you respond to them?
2. In terms of accessing your clients software, can you elaborate a little more? Are you talking about vpn and or virtually accessing their computers from your location? How difficult is this to do?
Thank you again for your valuable input!
Brian
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1. I charge a flat monthly fee based on the "package" of services the client requires. i.e. claims submission, posting of payments, mailed invoices to customers etc.
2. If possible, I try to use the clients existing practice management software to submit claims. This can be done by logmein123.com or in the case of office ally simply setting up a new username and password. This cuts down on data entry work. If this is not possible, I use office ally.
Best of Luck :)
William great info! Would you mind elaborating a bit more on using existing client software via logmein123?
Essentially are you talking about vpn? ...or virtually logging in to a client's computer and using their pre-existing software to submit claims?
I"m a newbie to the billing industry so any detailed info would be greatly appreciated and thank you for your time!
Brian
When you use logmein you are connecting to their computer meaning that you are essentially using that computer to work. No one can be using that computer at the provider's office while you are on logmein. So you would be using the software on that machine to do the billing.
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Williamsportor is correct in saying that a flat monthly fee is a great option. In some states % billing is considered fee splitting. If you still choose to bill % most base it off of net.
As for software, again good advice. If they have a software it may be best to use theirs. If you are purchasing your own, I am not a fan of Medisoft. But I do like Lytec. Been using it for over 20 years. If you are interested in Lytec, we use reseller SMG Systems from Long Island. We don't get anything from them for referring people, we just like them. But mention that you heard about them from our forum. They will treat you good.
I have never heard of Dr Chrono and I've never used Kareo.
Michelle thank you for the great info...
I am more and more interested in flat fee pricing however I'm curious to know more about % based. You say most % is based on net...by net are you referring to the amount collected (insurance, deduct, PR)? I'm currently working for a small billing business who charges % based on amount and I'm realizing they are having a hard time making ends meet and am second guessing if this pricing model even makes sense.
Secondly, my other question is if I was to do a different type of % based pricing should I do based on billable amount or allowed amount?
thank you again!
Brian
Most % billing is based on the amount collected. That is the selling point. "We are paid based on what you are paid" giving the billing service incentive to work hard to make sure all is collected. However, that is exactly what makes it fee splitting as well. I have heard of others trying to do % based on billed amount or allowed amount but personally if I were a provider I would not agree to that. If I'm going to pay on % it is going to be what I collect. JMO.
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1. In terms of charging Dr's a flat fee for your work despite receivables, did you experience any push back from doctors for this type of pricing? And if so how did you respond to them?
No, I don't have any problem with it. Again, I'm in NY where physicians are not allowed to enter into a contract that "splits fees" so once I explain that to them if needed they are fine. I really haven't run into any provider who has a problem with it, all their other bills are paid based on the services performed as well, why would a billing company be any different. You don't see their accountants or lawyers charging a % <g>
2. In terms of accessing your clients software, can you elaborate a little more? Are you talking about vpn and or virtually accessing their computers from your location? How difficult is this to do?
You can do it a number of ways. All of my clients except two have server based systems to which I have my own HIPAA compliant access. For the other two I use logmein. This is a great thing for billing companies because i've seen many have to turn away clients because they couldn't convince the provider to make a transition to a new software. Conversions are not always easy and they are also time consuming. Using the clients software allows the billing company to immediately begin and there is NO downtime or conversion time. This is not a good model for a new biller who doesn't have experience working on various different softwares. Again, though it is a great marketing tool.
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1. I charge a flat monthly fee based on the "package" of services the client requires. i.e. claims submission, posting of payments, mailed invoices to customers etc.
2. If possible, I try to use the clients existing practice management software to submit claims. This can be done by logmein123.com or in the case of office ally simply setting up a new username and password. This cuts down on data entry work. If this is not possible, I use office ally.
Best of Luck :)
William great info! Would you mind elaborating a bit more on using existing client software via logmein123?
Essentially are you talking about vpn? ...or virtually logging in to a client's computer and using their pre-existing software to submit claims?
I"m a newbie to the billing industry so any detailed info would be greatly appreciated and thank you for your time!
Brian
Brian - I'm not sure what you mean by "vpn" but if a billing client has Office Ally or another web based practice management system, all you'll need is to have your client set up a new username and password for you. You can then access their system and use it to submit claims just as they do. If not, contact logmein123.com set up membership (normally about $100.00/yr) and you can then log in to your clients computer, just as if you were sitting in their office. You can then submit claims through their system as well. If neither of these things are an option, I'd suggest setting up your own office ally account. You can then submit claims through office ally. This can be helpful if your billing client is faxing the billing info to you, or if their system does not have claims submission capabilities.
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you'll need is to have your client set up a new username and password for you. You can then access their system and use it to submit claims just as they do. If not, contact logmein123.com set up membership (normally about $100.00/yr) and you can then log in to your clients computer
If you are a medical billing company, it's MOST advisable that you set and maintain your own login in order to be truly HIPAA compliant. Even the staff should NOT have your login credentials in order to maintain a truly compliant audit trail.
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If you are a medical billing company, it's MOST advisable that you set and maintain your own login in order to be truly HIPAA compliant. Even the staff should NOT have your login credentials in order to maintain a truly compliant audit trail.
Since it is their system don't they have to set up your login? Then you would change the password? Until they do that you don't have access to the system. Just trying to make sure it's clear. Maybe I am missing something.
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Since it is their system don't they have to set up your login? Then you would change the password? Until they do that you don't have access to the system. Just trying to make sure it's clear. Maybe I am missing something.
Whether you have your own system or they have one, the billing company owner SHOULD setup their Own login's, yes of course the administrator for the client would need to send initial login requirements but the billing company is then required to make sure their login is compliant. This is to protect the audit trail.
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Thank you all. Lot's of great nuggets of wisdom here.
The small billing company I work for is having clients fax over all patient info and superbills and from there we bill through in-house medisoft. In addition to the massive data entry task, I've also noticed a large downtime waiting for the provider's office to send information that is missing and needed. I feel like there's got to be a better way and I'm realizing what you guys are saying about the benefits of virtually logging into clients software to do the job.
Linda, going back to the flat fee topic. I noticed in a past post you mentioned about how you have potential clients fill out a thorough evaluation so you know exactly what to charge. If you're not comfortable with sharing that form, would you mind sharing what kind of important questions you ask that help you come to an accurate quote?
Thank you all!
Brian
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Even with the ability to log in to the provider's end of things, there may still be a large downtime in getting issues corrected. That is all on the provider and their staff. For instance, if someone entered the wrong insurance on the provider's end, and didn't bother to upload the insurance card into the EMR, you can go in looking for it, but if it isn't there, you are still putting in an inquiry, and waiting.
It really comes down to the provider and their staff, and how on top of things they are. You can have one with the best EMR and PM system out there, that you have access to, and you have a 100 inquiries out to them. Then you can have a provider who has no EMR or PM system, who faxes you the info, and you have 0 inquiries, because they are on top of things.
As far as data entry, unless you have an all in one EMR/PM system, or have an EMR that integrates fully with the PM system, you will still be doing the same amount of data entry.
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Since it is their system don't they have to set up your login? Then you would change the password? Until they do that you don't have access to the system. Just trying to make sure it's clear. Maybe I am missing something.
Whether you have your own system or they have one, the billing company owner SHOULD setup their Own login's, yes of course the administrator for the client would need to send initial login requirements but the billing company is then required to make sure their login is compliant. This is to protect the audit trail.
Linda,
Linda, in regards to flat fee pricing, I noticed in a past post you mentioned about how you have potential clients fill out a thorough evaluation so you know exactly what to charge. If you're not comfortable with sharing that form, would you mind sharing what kind of important questions you ask that help you come to an accurate quote?
Thank you again
Brian