Medical Billing Forum
Starting a Medical Billing Business => Starting Your Own Medical Billing Business => : malyandy December 14, 2016, 09:05:40 PM
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I'm starting my own billing business and would like to know, when filling out box 24F on the CMS 1500 form, will the provider provide me with the charge amount in the day sheet or will I have to find out the charges myself?
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1. If you will be remotely accessing the provider's PM system, their fee schedule will be already loaded, so you won't have to do anything.
2. If you are using your own PM system, you will have to obtain the provider's fee schedule from them, and upload/input their fees into their account in your system.
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I'm starting my own billing business and would like to know, when filling out box 24F on the CMS 1500 form, will the provider provide me with the charge amount in the day sheet or will I have to find out the charges myself?
This depends on your contract with the provider, it also depends on your position and in services you will provide for your client.
Some have said it depends on your access of the remote system.. but I disagree... it depends on the services you will be contracting with and what your contract says. Your contract MUST state the responsibilities of both the billing company and the provider. This really has NOTHING to do with your PM system.
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I'm starting my own billing business and would like to know, when filling out box 24F on the CMS 1500 form, will the provider provide me with the charge amount in the day sheet or will I have to find out the charges myself?
It looks like you are asking how you would know the fees for the services that the provider is billing for. If you are billing for a provider (since you stated you are a billing service) the provider has to tell you what their fees are. If I missed the question please let me know. :)
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Thnks Michele you have answered my question.
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Most billing software packages have a place where you can store the Procedure Code (CPT) and attach a dollar amount to it. Then when you process a fee slip for a given patient, when you type in the CPT code(s), the dollar amount automatically appears.
But, as Michelle stated, you initially get the dollar amounts from your client.
Periodically the carriers will increase the amount paid for a given CPT code, and its easy to miss this unless you are constantly asking the various carriers what their payment amounts are. Therefore, the client will be underpaid until you discover that the payable amount has been increased.
We avoid this by attaching to the various CPT codes in our billing program a dollar amount that is generally 20% or so higher than what the doctor charges (an amount he usually determines by looking at what the carriers will pay for that code). This process requires us to write off a certain amount when processing payments. But, we always capture the increase in payment(s) made by the carriers as soon as they happen. We then change the dollar amount attched to the CPT code(s) in our program to 20% higher than the new payment amount.