Medical Billing Forum

General Category => General Questions => : melissa_2004 October 07, 2010, 10:15:31 PM

: Client not sending billing
: melissa_2004 October 07, 2010, 10:15:31 PM
Hi all,

Have you had a client that does not send their billing to you on a regular basis?  How did you handle this client?  Do you charge a minimum monthly fee for clients in the event no billing has been sent to encourage they provide the billing in a timely manner?

Here's the story.  I have a client that is not good at sending their billing on a regular basis.  They are not billing any other way and are basically surviving off self pay clients and copays.  I have borderline stalked them to provide the billing and offered multiple options to make it easier.  This client was also months behind on billing when I first signed them and the problem persists. 

Thanks,
: Re: Client not sending billing
: Michele October 08, 2010, 09:58:17 AM
Hopefully your contract addresses timely payment.  I would probably insist on a sit down meeting and go over the terms of the contract.  I would explain that you have been very lenient with them but that you cannot continue.  You must be paid on time.  Also, I would explain that if he doesn't provide the billing on a regular basis that you cannot plan accordingly to make sure the work is done.


But honestly as I am typing this my brain is screaming "HE WON'T LISTEN!!!!"  You really aren't going to change him so if it's not working for you, you need to consider dropping him.  You are wasting more time on him than he is worth.  Maybe the threat of dropping him may get him to comply, but that is probably your only shot.

Good luck!   ???
: Re: Client not sending billing
: PMRNC October 08, 2010, 01:16:59 PM
I think she was talking about the client sending her the work.. not payment issue?

My monthly fee is minimum .. so if they don't send me any work.. oh well they still pay me. I have only had one client do this and all I did was say "Hey, your paying me but I have no work this month" and that did the trick.  Even though my monthly fees are based on variables that include my hourly rate, the client does not know that nor needs to know that.

I guess it depends on your contract.. if your contract has a minimum monthly fee than you should still be billing them. If you don't have such a clause in your contract, It will come down to how you explain that monthly fee (based on your time, etc)
so I think you will need to really look at your contract.  Have you tried talking with them?  I do have a clause that will allow for the provider to have a month in case they go on vacation.. I usually discuss this with them at the time they sign the contract, they have to provide me with 30 days notice for vacations over 2 weeks, and again it will only allow for one billing cycle to be skipped.
: Re: Client not sending billing
: melissa_2004 October 08, 2010, 05:01:59 PM
This is true.  The client is not sending me the work.  My rate with this client is a per claim fee (with the exception of aged items).  Soooo, no claims sent, no fee.  I have been working to review the contract and make changes going forward.  Good thing this client contract is up the end of this month.  I do have a timely filing clause but there is no minimum fee that was instituted.  Live and learn.  Won't do that again.  Flat rate. Flat rate.  Flat rate.  I do not want to do the math to see what I have lost on this 1 client.

I have spoken with her and she is struggling to get the information together to send me and keep up with it.  The serious accident was a brain injury and she takes a lot more time to do things than she has in the past.  I have offered to come into the office to organize and get it together for her.  I have offered for her to send me her calendar sheet with the appointment seen on a weekly basis and only provide new client forms if the patient is new or has information/diagnosis etc. that has changed and this has not helped either.
: Re: Client not sending billing
: Michele October 09, 2010, 11:09:18 PM
Sorry!  I missed that one.  I thought when you said 'months behind in billing' you were referring to your payment, but when I reread it, that is not what you said!  Linda gave great advice.  I would tell them the per claim is not working and switch to a monthly fee.  That way you have a guaranteed income each month, not dependent on whether they give you the work.

Michele
: Re: Client not sending billing
: melissa_2004 October 10, 2010, 03:58:02 PM
Thanks so much for all of your responses!  Have you had any clients that had a problem with the flat rate billing? 
: Re: Client not sending billing
: Michele October 10, 2010, 11:58:02 PM
We have several clients on flat monthly fees and it works great for both of us.
: Re: Client not sending billing
: PMRNC October 11, 2010, 09:10:56 AM
Same here, not a single problem with it. MUCH easier than % and it's nice to be paid for all efforts :)
: Re: Client not sending billing
: gderilus October 18, 2010, 03:18:00 PM
I have a client who's not sending me the EOB's  and that makes it very difficult for me to do my work right and for me to get paid. I called the insurance company to follow up and they told me payment was made to the provider. When I called the provider, she told me she didn't receive any EOB's and got no records of them. I know she has misplaced them because the office is so unorganized. What should I do in this situation? Should I still charge her my percentage since the insurance companies say the checks were sent to the provider. Would it be fair to charge her without receiving any EOB's from her. I don't want her to come back and say she never received payments why Do I charge her.

What if I add a clause in my contract that says they will still get charge even if they don't send the eob's since I can find out how much they get paid from the insurance company. Would I be able to do that for future reference.
: Re: Client not sending billing
: PMRNC October 19, 2010, 08:49:50 AM
Things like this really depend on whether you address it in your contract or not, that's why it's so important to have an attorney go over your contract so that things like this are addressed for you to refer to when you need it. If you don't address this in your contract you will need to sit down with the client, address the problem, and come up with a solution and amend your contract to include these types of things. Without knowing what your contract says there's not really much we can guide you on other than telling you how we do things. I address issues of provider responsibilities in my contract and what takes place if they do not send me the work, etc etc.  I also got rid of percentage based billing partly due to this very problem. It might be a better fit for you to make that change to a more fair way of billing so that you are compensated for the time you are spent chasing down the payments.  Just a thought.
: Re: Client not sending billing
: Michele October 19, 2010, 10:04:17 AM
Linda made some very good points.  If we call an insurance carrier and find out the payment was made, we get a check number, verify the address it was mailed to  and verify if it was cashed.  We also verify the name the check was made out to.  If all match, we notify the provider and record the payment.  We don't wait for them to find the eob.  If we need it to file a secondary, we notify them and note the file that we are waiting for provider to provide us with the eob to file.
: Re: Client not sending billing
: PMRNC October 19, 2010, 11:40:05 AM
If we call an insurance carrier and find out the payment was made, we get a check number, verify the address it was mailed to  and verify if it was cashed.  We also verify the name the check was made out to.  If all match, we notify the provider and record the payment

And there is another big reason I quit billing on a %!! All that takes time and in doing so your not being reimbursed for all that time. Time=money, everyone in business knows and accepts that.
: Re: Client not sending billing
: Michele October 19, 2010, 10:04:18 PM
We do that whether we charge a flat fee or %.  We are strongly moving away from % too.  We completely agree!!!!
: Re: Client not sending billing
: gderilus October 21, 2010, 10:35:02 PM
Thank you ladies, I guess I have some work to do in my contract
: Re: Client not sending billing
: QueenAlicia November 02, 2010, 08:23:49 PM
I am getting some good pointers on contracts.  I am currently in the process of putting mine together.
: Re: Client not sending billing
: PMRNC November 03, 2010, 12:28:12 PM
Alice and Michele's Book "How to create a Kick-Butt Contract" is AWESOME and I highly recommend it to everyone..NEWBIES or OLDIES <g> I GUARANTEE no matter how great you think your contract is, you will pick up tips in this book you didn't know!
: Re: Client not sending billing
: Michele November 03, 2010, 02:44:39 PM
Thank you Linda!    :D  We learned A LOT while writing it and have revised our contract as well.  Especially thanks to input from others!  (like you)

Michele
: Re: Client not sending billing
: ste November 05, 2010, 08:43:11 PM
I have run into this problem of "what happened to the check?" The insurance faxed me a photocopy of the cleared check and on the back of the check was the provider's signature. The signature matched the signature on my contract which was proof by my standards, so I included the check in the monthly reimbursements. It was a hassle and I too am moving away from percentage based fees.