Medical Billing Forum
General Category => New! => : kwardbilling January 09, 2010, 12:28:30 PM
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Hello Michele: I am a newbie and have been looking at the books that you and your mother wrote. I would like to order one to see how they work for me. Unfortunately right now funds are a little tight. I have three clients right now and have been doing mental health billing for 3 years part time from home. I have recently lost a client, as he called my bluff. I know I was taking in a lot of money for him and he also had several other incomes, and he was paying me late (behind by 1-2 months), I told him we needed to set a goal to get caught up and I would be willing to let him make payments, but he called my bluff and dropped the service .....upsetting, but I was being taken advantage of. He kept telling me how he'll be lost without hte servie that I brought him in so much more money that he had collected on his own, but that he will be doing his own billing again. Now I am in need of picking up at least one to two more clients to fill his voice. I need some advice on which book to start with as I can't afford them all right now. I was thinking of geting the Mental Health billing Pack, or Taking your Mental Health Billing to the Next Level. I feel like I have a pretty good handle on the claims process, however, I liked the idea of the information on medicare and medicaid, not to mention just having a resource handy. After hearing a little bit about my background which book would you suggest I start with? Thanks for any info. Also I am from MA I don't know if that makes a difference.
Karen
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obtaining training material is great and helpful, but I also think you have some other issues you need to look into as well. did you have a contract #1? no matter how knowledgeable you are with the billing, providers will SCREW you. They know that there are more and more "at home" billing services and they will rotate us like whores in a brothel. I never allow them to go 2 months without payment. We always bill a month behind, but if payment has not been received by the 15th of the month, you are suspended. I don't do payment arrangements. If the provider is having financial issues, and I am bringing in his revenue, he needs a financial analyst to evaluate his practice. I only deal with how he can improve his revenue based upon how he files, and how he receives full reimbursement (correct coding, obtaining auths, up front collections etc) I also do flat fee billing as I don't have the patience for % fee, plus all the grey area laws about fee splitting. Also have you thought about broadening your horizons? Don't just do the mental health, unless that is the only thing you want to do. I personally love DME billing, but I have and will do general practice. I like podiatry and neuro as well since they both have moved over into doing DME billing as well. Podiatry is my new market as I am looking to show them how they can benefit by billing for AFO's as well. The reimbursement is great. Neuro's can do the CPAP's and make great profit if they dispense themselves. I need to get a couple of training books on some different specialties I haven't billed for as well
Good blessings to you
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Thanks for your response. I am working on a contract, as someone from this site just suggested that, up until now I wasn't too concerned, but I see it's necessary. Any suggestions of what I should put in the contract are always welcomed. I have been charging by the session, not by %, I like it that way, it's much easier to keep track of and also lets the counselors know exactly what they owe me so they have no surprises. It seems to be working well for me over the past three years. The software I own is for mental health, (Therapist Helper), so I hadn't thought about branching out yet. My contract isn't up on the software, and also I feel like I'm getting a good handle on the mental health. I had no background in billing before I started this, so I don't know a whole lot about coding etc. I don't know if you've seen any of my other posts, but I kind of fell in to this as I work at our local high school as an administrative assistant and one of the counselors asked me to learn billing and do it for him.....that's how this all come about. I am really enjoying it, love the independence, and I have that detailed personality! :) I am pretty sure that you can do chiropractic and physical therapy billing with my software, maybe something I should think about.....? Anyway,thanks for the response.
Karen
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what do you mean charge by the session? Do you mean you charge them a fee for each session you bill? This would be similar to my flat fee billing. Well as far as your contract is concerned, there are plenty of "sample" contracts on the web. I would still advise that a lawyer look over it for you. Remember whatever can happen will, so you want to cover all bases. You should include termination clause in your contract as well. I don't do yearly contracts myself. I charge a start-up fee (non-refundable) and bill a flat fee, so as long as either of us gives 30 day notice we can terminate the contract, which is basically a month to month.
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Thanks for the info. That's exactly what I do right now, a 30 termination notice is asked, although I hadn't had it in a contract. I am definitely doing that now. And yes, I charge so much for each session I charge. Same Idea as a flat rate.
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Karen,
Sorry for the delay! Last few days flew by. Anyway, Charlene is right, contracts are important. Honestly if you are already billing for mental health, I don't think our mental health book would help you much. It is for someone looking to get into mental health who hasn't had much experience in it before. I'm thinking that since you are looking to get more clients maybe the marketing book would help. It has 12 methods for getting new clients. Also, we just put out the first credentialing book on Medicare. We have found that our credentialing service gives us lots of referrals for the billing. If they are just getting credentialed they usually haven't thought much about how they will do the billing. Anyway, it sounds like you have a good start and are getting some important things straightened out. Best Wishes!
Michele
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Karen,
Sorry for the delay! Last few days flew by. Anyway, Charlene is right, contracts are important. Honestly if you are already billing for mental health, I don't think our mental health book would help you much. It is for someone looking to get into mental health who hasn't had much experience in it before. I'm thinking that since you are looking to get more clients maybe the marketing book would help. It has 12 methods for getting new clients. Also, we just put out the first credentialing book on Medicare. We have found that our credentialing service gives us lots of referrals for the billing. If they are just getting credentialed they usually haven't thought much about how they will do the billing. Anyway, it sounds like you have a good start and are getting some important things straightened out. Best Wishes!
Michele
Michelle, I just saw an ad for a biller and it stated "credentialing experience desired"
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When I started a few years ago a couple of clinicians had asked if I helped with credentialing. Unfortunately at that point in time I was totally new to the medical billing world and felt I had enough to learn with just learning how to submit claims correctly and efficiently. I think I do need to head in that direction now. Thanks for the ideas, I am going to look in to the book you are suggesting. Also, Michele one last question. You mentioned you are working on getting a new web based software I think you said in March, are you able to give us the name of the software?
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The software is called Xena. If you are interested in sitting in on an online demo let me know.
As for the credentialing, the book should be up now. We released it yesterday.
I have always found that it helps if you are experienced in many things, as opposed to one. It is good to be great at one, but if you can help out in other areas too, it makes you more valuable. The credentialing for us, started out as just to help out our docs. Then we realized, there are lots of docs out there that need the credentialing that we don't bill for. It's really taken off for us.
I'm not surprised by the add Charlene. Some offices have providers coming and going on a regular basis and they need their billing department to be able to handle adding/deleting providers.
Michele
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Michele, am I understanding correctly, that you don't charge for the credentialing service? I would possible be interested in watching the demo of the software Xena. I just upgraded Therapist Helper that I use. So far I've been happy, but it isn't a web based service, although I believe at some point they are headed in that direction. I am from MA and they are just 20 min from me which is nice.....but I'm always open to suggestions, maybe next year at renewal time..
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We DO charge for credentialing. When we first started doing it just for our providers we didn't charge. It was very time consuming and that's what made us realize that we had to charge. Once we started charging we realized we could make some money doing it for providers we didn't bill for. We do give our providers a discount on credentialing, if we do their billing.
Michele
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got it.....can you give me a ballpark about what billers charge for credentialing services....
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It varies depending on the carrier. Medicare apps usually have a flat rate from $125 - $225 depending on whether it's a group or individual, CAQH can be from $125-175. Individual carriers depends on the paperwork involved.
Michele
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I actually just sent Alice an email, should have read this post first I guess. I couldn't find a book entitle credentialing on the web site.......also, if I remember correctly an email came out with information about the book and also about a competition to win one, but unfortunately I must have deleted the email......would you possibly have that information to foward on to me? Thanks in advance. Also, is the credentialing book just for medicare/medicaid or a general guide on all general carriers? Credentialing is totally new to me, so sorry for all the questions, but one more.....is the fees you listed just to file for the paperwork and then you add your fee on top of that?
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The book coming out now is just on Medicare credentialing. We are going to follow with others. There is a competition on winning one. I will email you the link.
Michele
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The book coming out now is just on Medicare credentialing. We are going to follow with others. There is a competition on winning one. I will email you the link.
Michele
hey, where is my link :-(
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Hello Michele: thanks for your response about the credentialing book. I am new to blogging, where exactly do you submit the blog, to this site? Or is there another area I am unaware of?
thanks for any help
Karen
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It was in the newsletter, I will send you the link too!
Michele
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YOu can post a submission at:
http://solutionsmedicalbilling.wordpress.com/2010/01/12/medicare-enrollment-completing-the-855i/
Good luck
Michele
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Credentialing is a great add on service but it is done at different level of "tiers" Basic credentialing does not entail much, those charging a full credential fee/hourly rate should set that rate depending on the level of credentialing they are doing. Most who offer this do not understand there are other layers of it beyond submitting applications. I have the ability, knowledge & experience to take it further with contract and fee schedule review and negotiations. If you have NEVER done those parts it would be a dis-service to your provider to not recommend someone to do that portion of the credentialing, therefore your rate should not be of a high end to allow the practice to afford the other full service of credentialing.. There is also "de-credentialing" many carriers have specific guidelines for opting out of a network, rules to follow, procedures to render, etc.
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VGP (Very Good Point)
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Hi Michele....just wanted to let you know that at some point I may be interested in the online demo of Xena, also I am planning on getting the credentialing book, however, I am waiting til I have a little more income, need to curve my expenses until I grow a little more. I have two psychologists that have small practices that I am doing billing for right now, I have two that are seriously considering my service, if they sign up, I will feel much better about spending the money and hoping to spread my wings a little. Does Xena have their own clearinghouse for electronic claims, or do you need to purchase that seperately? Right now I use therapist helper and it's all included...? thanks again for all the info, this site has been extremely helpful.
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When you are ready let me know, I can help you get it set up. They do not have their own clearing house but they are going to give you options. For example, they are using Availity which is free, so no cost to the user, but they are also going to be set up with others. If there are any fees, the user will be responsible. But the user has the choice of which clearing house they want to use.
Don't forget, we are having a contest to give away one of our free books. It ends Feb. 2nd. You can post your entry on our blog:
http://solutionsmedicalbilling.wordpress.com/2010/01/12/medicare-enrollment-completing-the-855i/
Michele
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Hi, thanks for the info, I did post a blog hoping to win a copy of the book. I hope I posted it in the correct place...anyway, do you know when you are announcing a winner? Thanks again for the info. I need to find out the exact date of my contract ending with Therapist helper. I know it's in March some time. I'll be in touch about Xena. Another quick question for all of you on this site. Have any of you ever met up in person? I know most things can be communicated over the internet, but just was wondering if any of you have ever visited each other's offices etc.?
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We will be announcing a winner Feb 2nd. I haven't met anyone else yet on the forum but who knows! Maybe someday. I think it would be fun.
Michele
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Hi,
Can you send me the link for the credentialing book? I think I am overlooking when searching the page for books to order.
Thanks,
Melissa
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Hi, here is the link, although you can just click above on the product page ....same thing. It's the second one down... Or I'm sure Michele could help you with this one...
Karen
http://www.medicalbillinglive.com/medical-billing-products.shtml
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Thanks Karen. I thought there was a general book on credentialing. I will wait for that one. ;D
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We are working on a whole line, but only have the Medicare CMS 855I book done so far. Will make an announcement when the others come out!
Thanks
Michele