Medical Billing Forum

General Category => General Questions => Topic started by: margemib on August 24, 2008, 02:25:26 PM

Title: per claim or percentage
Post by: margemib on August 24, 2008, 02:25:26 PM
I graduated from US Career Institute and I am hoping to start a small medical billing buiness from home.
I was wondering what the best way to charge clients per claim or percentage?
Also should I become a LLC, my husband thinks it is best, would appreciate any advice.
margemib  :)
Title: Re: per claim or percentage
Post by: Michele on August 25, 2008, 10:00:23 PM
   Good luck with getting started.

  As for what to charge, there is not a clear cut answer.  We charge a variety of different ways depending on the service we are providing.  In some cases we charge a percentage, in others we charge a per claim.  If we are providing a full service it is usually a percentage, but if we are just needed to submit the claim, with no follow up, etc, then we do a per claim.  We also have a couple other methods, such as a flat monthly fee.  You have to be careful, some states have laws on charging percentages, so you have to alter your wording a little.

As for the LLC, that is not my department.  Alice will be answering you on that tomorrow.

Title: Re: per claim or percentage
Post by: margemib on August 27, 2008, 10:32:41 AM
Thanks Michele,
Can you tell me, when I receive a response for a question I asked is there a way to let you know,
because I have not yet heard from Alice On having to become a LLC and what her thoughts are on this.
So I am thinking there was no way you know I received your input on the first question.
By the way I have two of your books and they are GREAT.
margemib  ::)
Title: Re: per claim or percentage
Post by: Alice Scott on August 27, 2008, 11:48:32 AM
Hi Marge,
Sorry I didn't answer your question yet.  I was completing our next book and I got pretty wrapped up in it. 

Thanks for purchasing our books and I'm glad you found them helpful.  There is such a lack of good information on getting started in this business that we really strive to write what is needed.

Now your question.  After ten years in this business our accountant insisted that we incorporate for tax reasons, but since then I've read some info on how much more you are protected by becoming an LLC and it can be done fairly inexpensively.  I don't want to advise you on what you should do in your circumstances, but both the corporation and the LLC do offer protection to you that you don't have with a partnership or single proprietor.  In your position I would definitely ask the opinion of your accountant or lawyer if you have one.

What I read recently says that corporations are not set up to protect your assets, they are intended to save you money on taxes.  An LLC will protect your assets.  I'm really not sure what would be best for you.

Hope this helps.
Title: Re: per claim or percentage
Post by: Michele on August 27, 2008, 03:31:15 PM
I see Alice has answered you now on the LLC.  Sorry for the delay, we were just putting finishing touches on our latest book.  I'm not sure if there is a way to be notified or not.  I just check all posts daily.  If I find out, I will post it.

Glad you find our books helpful.  It really helps us to know we are helping others.  That is why we are doing this.

Title: Re: per claim or percentage
Post by: PMRNC on September 26, 2008, 07:15:56 AM
Gettting back to the question on percentage vs. flat/per claim fee..
There are some states that prohibit a healthcare provider to enter into any fee-splitting arrangement, you'll want to check your state laws, some of the states are NY, Florida, Illinois and there are some states with "grey" areas.
The OIG also frowns upon billing on a percentage and I think the industry is moving away from it due to the OIG's pushing away from that sort of "fee-splitting" arrangement.
There are case precedents for the three states I mentioned.

Linda Walker
Practice Managers Resource & Networking Community (PMRNC)
Title: Re: per claim or percentage
Post by: jcbilling on September 28, 2008, 10:58:37 PM
I also graduated from US Career Institute and am now getting my business off the ground! Good luck to you, margemib!