Does it pay?

[DavidZ]

Do most home billing businesses use electronic submittion?
If you submit a $50 bill or under, using a clearinghouse that will charge you .35-$1, how does that pay?
What do you do in this case?

[Michele]

There are still many out there not doing electronic submissions, but I really don't know how they survive.  In this day and age, electronic submissions are mandatory by many companies.  Your concern is the exact reason that it is important to find a good clearing house.  You cannot afford to lose money by submitting electronically.  Your best bet is finding a clearing house that at least some of your claims are no charge to offset the lower end claims.

Michele

[PMRNC]

I wouldn't say there is one billing company out there NOT doing electronic claims..how could you NOT? Why would you not?

Also don't focus on electronic claims..that's old news..everyone files electronic, how you make your money will depend on your services OVERALL.. the money is in full practice management. If you intend on trying to break into this business just filing claims, I can save you a lot of time and advise you to instead sell Avon or Pampered Chef.. Not meaning to be harsh, but just REAL.

[DavidZ]

I see the reality, thank you.

[Michele]

I agree with you Linda, but I'm still amazed that I run into services NOT doing electronic billing.  Even as I type this I'm thinking 'WHAT!!!'.  If I didn't see it for myself I probably wouldn't believe it.

Michele

[Pay_My_Claims]

I find a lot of DME companies because of the paperwork that don't file. The DME company that I work for currently only does medicare electronically. We do submit medicaid via the NC Medicaid website electronically, but thats it. I will process any claims I work electronically using the payors website, (uhc, tricare etc)

[PMRNC]

I agree with you Linda, but I'm still amazed that I run into services NOT doing electronic billing.  Even as I type this I'm thinking 'WHAT!!!'.  If I didn't see it for myself I probably wouldn't believe it.

Well send me a list so I can market in their area.. LOL
Seriously..this is a doggy dog industry.. I can see the doctors wives doing all paper claims to save every nickel they can..
even still..?? 

[Pay_My_Claims]

Amen on the dog eat dog, and I don't want to be in the inside of the dog looking out. It is more than just billing services that will get you the money. You have to compete and be able to give more.

[Michele]

I've always wondered how they convince the providers to sign up.  I know it's about being a full practice management service, not just submitting electronically, BUTTTTT, how do you do a good job without doing at least some of your claims electronically......Medicare.... at the very least.

Michele

[Pay_My_Claims]

Not always..anything that can be outsourced, can also be done in-house. What does a billing service offer in "full practice management" that can't be done in-house, or vice versa?? We will never replace the complete people element in the medical field (at least I hope not). For me the key is growth within your company. We have 3 different locations with the DME company I work for. He has 2 billers, but he really only needs 1. They also do case management, so that occupies their time. The actual time it takes to "submit" the claim isn't long, its the gathering of information, cmn, lmn, admc approval that takes forever. Taking over the billing at a DME company thats my approach. (high end rehab dme). My fee is xx for claims review, submitting claims, documentations, payment posting, however it is xxx for authorizations etc. We bring in over 100k a week in this industry, so even on a low percentage basis of 3%, I could make 3k a week with this one provider.