Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => : jcbilling September 14, 2009, 02:24:07 PM

: Termination Agreement
: jcbilling September 14, 2009, 02:24:07 PM
Hi:

I am completing a termination agreement for one of my clients, and am trying to figure out a fair price to charge if after we are no longer billing for the c;ient, their office needs a report or info researched on a patient, what would be appropriate to charge. Per hour? per report? if by hour, what's reasonable? $25 If by report, what's reasonable $15

Any suggestions?

 ~ Charity
: Re: Termination Agreement
: Pay_My_Claims September 15, 2009, 12:14:06 AM
Once I terminate, I terminate......
: Re: Termination Agreement
: PMRNC September 15, 2009, 09:04:41 AM
If they require reports within the standard reports I provide I don't charge, if they want a custom report I charge for that depending on what they want. If they want information or research from a particular claim I billed or worked I don't charge extra because it was a part of my services. I do charge for copies if they need them.
The terms of termination are in my general contract.
: Re: Termination Agreement
: jcbilling September 15, 2009, 12:56:39 PM
OK - thanks ladies!
: Re: Termination Agreement
: Pay_My_Claims September 15, 2009, 02:16:28 PM
If they require reports within the standard reports I provide I don't charge, if they want a custom report I charge for that depending on what they want. If they want information or research from a particular claim I billed or worked I don't charge extra because it was a part of my services. I do charge for copies if they need them.
The terms of termination are in my general contract.

You are wayyy to kind :-) I'm a meanie!! 
: Re: Termination Agreement
: lhough September 15, 2009, 11:54:59 PM
That is not being nice, that is good business sense.  Besides, look at it this way, what if you were the provider and for whatever reason you terminated your biller, you still may need reports or additional information on claims that the biller had already worked and you paid them for that work.  Wouldn't you want this information provided to you?  If you as a biller take the stance that "if they don't want me to bill for them anymore then they won't get any assistance from me on work I have already done" then you won't last very long. Word of mouth is a powerful marketing tool and if you get upset every time someone decides to no longer use your services then maybe you shouldn't be doing this.  JMO, but I try to treat people the way I would want to be treated.
: Re: Termination Agreement
: Pay_My_Claims September 16, 2009, 01:16:53 AM
That is not being nice, that is good business sense.  Besides, look at it this way, what if you were the provider and for whatever reason you terminated your biller, you still may need reports or additional information on claims that the biller had already worked and you paid them for that work.  Wouldn't you want this information provided to you?  If you as a biller take the stance that "if they don't want me to bill for them anymore then they won't get any assistance from me on work I have already done" then you won't last very long. Word of mouth is a powerful marketing tool and if you get upset every time someone decides to no longer use your services then maybe you shouldn't be doing this.  JMO, but I try to treat people the way I would want to be treated.

I can understand, but its just how I conduct business. You can look at it from many aspects. My aspect is clear. If I or the provider terminates the business relationship we have conditions will happen. EVERYTHING that should be sent to the provider will be sent. He will get his last monthly financial report, and his overall report, any documents etc etc. I don't have time to nickle and dime for a provider to get a report. He will have everything that I have to get whatever he needs. I have nothing he doesn't have. I have a friend who terminated a provider and is getting BOMBED by the current biller with questions because she was "nice" and tried to help. I personally don't want to spend my time running a report for what 25 bucks??? When I am "fired" I am fired, and when I quit, I quit. Its not like I am leaving anyone hanging, I haven't just shafted them and said "fu".

Think of it as a relationship. You break up, why keep calling them with the can I come over and watch TV. We can still be friends. No..not me, break up is just that. Ties have been severed. We no longer have a relationship. Even if you are paying me, for whatever reason, your dissatisfaction or mines we decided to end our business relationship. Yes it can and hopefully will end on mutually agreeable terms, therefore I will give you everything that will help you make a smooth transition from my services to your new service or biller. I bid you a fond adieu and wish you the best.

"paid them for that work"----Another reason I prefer a flat fee. Working for % when you terminate or are terminated...money will ALWAYS come in that you WON'T get paid for!!!

again, just my opinion
: Re: Termination Agreement
: PMRNC September 16, 2009, 10:29:50 AM
I sort of agree with both of you and I will usually provide the client with whatever they need for one simple reason, I don't like to burn bridges and it's not in the best interest of any business to do that. With that said I do have to say that I will never go back to billing a % for the very reasons you stated Charlene.. I've paid my dues and I want to get paid for all work I put in, I get to decide how many hours is needed to work on an account, how much I will make etc. and it does make termination go MUCH smoother!

There are many things a provider could need when they terminate with a billing company and in good business you do need to suck it up because if you don't you have just shown the provider a reason for NOT outsourcing and it hurts our business in the long run. I'm not saying you are there for the new biller, to hold their hand, etc.. no way. I will NOT work with a previous billing company nor a new one, I do not get in the middle of other contractual relationships, however if there are things the provider needs THAT I WORKED on, he will get it and again, that's so I don't burn the bridge.

: Re: Termination Agreement
: Pay_My_Claims September 16, 2009, 12:02:38 PM
Yes, and I totally understand that no matter what you do, you should not burn a bridge (although you want to light fire under a lot of them). Everything regardless of the situation should be done professionally. I hopefully have made sure in my termination plans that all bases are covered. There could be something that comes up, because life happens. Listen to all the stories from all the long term billers who have been STUNG by providers who don't pay. Some will send partial payments because they rely on the "oh you can't bill me % its fee splitting". As Steve stated it may be ilegal in FLA, but they probably won't enforce it. You do it and then the provider doesn't pay because what..........courts will side for him.
: Re: Termination Agreement
: Steve Verno CMBS, CEMCS September 16, 2009, 04:31:03 PM
If I have to terminate, I dont burn my bridges. 

I do discuss fees associated with anything that is requested after the termination.  This could be due to subpoenas received for work I did or attorney requests for claims or statements.  It could also be for insurance info obtained while an account is at a debt collection agency.  It will be up to the debt collection agency or provider to reimburse me if I have to send a claim to WC, Medicaid or Medicare. 

But, If I leave, I want to do so on a good note.  This could result in referrals later on. 
: Re: Termination Agreement
: Pay_My_Claims September 16, 2009, 05:10:14 PM
I don't think my approach is "burning a bridge". How often do you find yourself having to research for a client? What information can you possibly have that would be needed by the provider? Its called planning to me. The basis of your business if financial. I am the keeper of the "AR"  Have in your termination agreement that any reprints of financial reports required shall be available at $xxx.oo per request. It will be enough for providers to maintain the documents that you provide. I am NOT against providing something for a provider, but I am not looking to hold a provider by the hand either. I'm basing my answer on what the posted stated. Her post reads as though you are "looking to continue doing some work". If you plan and prepare, you can have a termination be smooth and easy for both. During the time you are no longer billing, you and that provider should be doing a review on the information sent and establish if any additional information is required. Maybe I'm not getting it, but records for courts etc should be kept in the providers office. If a provider uses a billing service, those reports are crucial, and he should be maintaining them according to state and federal regulations.
: Re: Termination Agreement
: PMRNC September 16, 2009, 08:54:08 PM
I have to disagree with you a little charlene .. we are 50% practice management and 50% educators.. like it or not.
Doctors went to school to practice medicine, we know practice management. If you think you will have clients you won't have to hold hands with you are dreaming (lovingly said).

Even us old timers have to be prepared for hand holding.. it goes with the territory, it's part of the job. And I have had a few clients I have had to terminate and you are right about things coming up, they always do. Though my contract protects me I'm well aware that leaving a sour taste in a clients mouth is not going to be good business. If I billed it I work it and I see it all the way through, if there is a problem later with those charges I billed It's still my responsibility (not just contractually, but ethically) to finish it. And yes there is always something a terminated client needs.  ::) :o
: Re: Termination Agreement
: Pay_My_Claims September 16, 2009, 09:47:53 PM
I have to disagree with you a little charlene .. we are 50% practice management and 50% educators.. like it or not.
Doctors went to school to practice medicine, we know practice management. If you think you will have clients you won't have to hold hands with you are dreaming (lovingly said).

No, if they are my clients......yes I know I hold their hands..I do it now with the providers that I work with, I am only speaking of termination. I have seen and REFUSE to deal with what some of other billers have dealt with after termination. My entire point is and it is how I choose to conduct my business is that I will not be going back and forth months later trying to find paperwork for a provider. I have to keep up with 3 providers information, and I know others who have more. I believe at one time you were dealing with 9 or 13 on your own. I believe that termination of services is just that. I released you, you released me. I can not think of anything that a terminated provider would need that he would not already have. We advertise monthly reports and quarterly reports. He has the last full AR noting any outstanding balances that his new service will take over, or his new biller. 30 days notice should consist of the transitional time of moving his practice back to where he wants it to be. Check list of things he needs in order to do this or that. Every billing service should have a record keeping system (state and federally mandated) and adhere to that. Unless someone can tell me of something that I have that the provider doesn't want, and until I run into that situation, I can't believe you should or have to be doing work months later.

Termination: upon termination of services, all financial and pertinent reports shall be given to the provider for his records. Provider has 30 days after termination to request any additional or duplicate reports . After 30 days any additional reports shall be available to the provider at a fee of $xxx.00 per report. Any research shall be at a rate of $xxx.00 per hr payable at the time of service.

If you are going to do it for the provider to keep your bridges unburned, incorporate it in your contract. There is no difference in writting it down than it is 3 months later and you are trying to determine how to charge. Its like you said Linda, some contracts are only a few pages long. Preparation is the key. If it could happen, cover it. Again. I'm not saying be heartless and unprofessional, but I personally just feel termination is termination. I will make any of mines professional and do all I can to make things go well (which we know not all will). I'm not burning a bridge, I am building one somewhere else. Also on that note, you can leave amicably and still have unpleasant things said about you. I have a friend who terminated a client because she failed to pay her. She had her on a payment plan to catch up her past due amounts and would resume once she caught up. She was used as a reference and the potential provider was slammed with falsehoods from the other provider. Nothing in business is clean cut or guaranteed. That bridge was left in-tac and not burned, but she got royally screwed by someone she bent over backwards to help.
: Re: Termination Agreement
: NYMBS October 14, 2009, 01:29:06 PM
I just terminated my first provider due to non-payment for 5 months (I was being too nice).  I gave him a 30 day notice and returned all of his charges and payments. 

Two months later, his attorney sent me a letter requesting a list of all the doctor charges.  They are accusing me of causing him lost revenue and threatened to sue me if I don't comply.  I sent the data on a CD immediately.

Now, the office manager is asking me for a list of the patients who had outstanding balance.

When should I stop responding?  How serious should I take the attorney's threat?  The provider still owes me a significant amount of money.

All suggestions are needed.  I'm really concerned.

Thank you.
: Re: Termination Agreement
: Pay_My_Claims October 14, 2009, 01:59:50 PM
Have you retained an attorney??
Do you have E&O insurance

: Re: Termination Agreement
: NYMBS October 14, 2009, 02:07:10 PM
No, I have not retained an attorney.  I don't have E&O insurance.
: Re: Termination Agreement
: Pay_My_Claims October 14, 2009, 02:36:31 PM
I would consult with an attorney IMMEDIATELY!!
: Re: Termination Agreement
: NYMBS October 14, 2009, 03:17:07 PM
Thank you.  I will.
: Re: Termination Agreement
: PMRNC October 14, 2009, 06:17:46 PM
E&O won't help you now as it may be a pre-x incident (depends on state and how policy is written)
But DO seek an attorney..    Are you in NY? Were you billing him on a %?  If you were, mention this to your attorney, they in turn can make the decision to let the provider's attorney know that if this goes to court the provider could be sanctioned for entering into an illegal fee splitting arrangement.. this won't get you paid though if it goes to court as your contract will become null/void however it might be a bargaining chip since it's the doctor that broke the law NOT you. But last and not least and most important...LET YOUR ATTORNEY DECIDE THIS. And do not be shocked if you have to educate the lawyer on the fee splitting provisions, however NY is pretty clear so he should know about them. Call your state bar association for a referral if you don't have a lawyer.  DO NOT DO PREPAID LEGAL. I know many billing companies burnt worse by using prepaid legal representation.
: Re: Termination Agreement
: Pay_My_Claims October 14, 2009, 11:52:01 PM
I HAD a friend try to get me into that pre-paid legal ish........
Great advice btw
: Re: Termination Agreement
: PMRNC October 15, 2009, 09:08:47 AM
Yeah if you notice most people get so excited over prepaid legal and they love it... UNTIL they have to use it. LOL
In this business if you get a court order or a letter from a doctors attorney, you don't want to wait for the "next available operator". LOL