Medical Billing Forum

General Category => General Questions => Topic started by: margemib on January 28, 2009, 07:15:09 AM

Title: Fee
Post by: margemib on January 28, 2009, 07:15:09 AM
Hi Michele
I am trying to figure out what to charge per claim & per Statement, I am in PA, does this matter.
Can you give me a Idea.
margemib ???
Title: Re: Fee
Post by: Michele on January 28, 2009, 06:25:45 PM
When you say per statement I'm assuming you mean a patient bill.  It doesn't so much matter what state you are in as much as what type of area you live in.  Rural, city, etc.  Also, the type of claims are you submitting.  I can say the average per claim fee is from $1.50 to $5.00. 

I've never looked into charging a fee for patient statements.  I do know the cost of mailing a patient statement is about $1.25 (postage, envelope, printing, etc.).

Hope that helps.
Michele
Title: Re: Fee
Post by: Pay_My_Claims on January 28, 2009, 09:16:40 PM
When you say per statement I'm assuming you mean a patient bill.  It doesn't so much matter what state you are in as much as what type of area you live in.  Rural, city, etc.  Also, the type of claims are you submitting.  I can say the average per claim fee is from $1.50 to $5.00. 

I've never looked into charging a fee for patient statements.  I do know the cost of mailing a patient statement is about $1.25 (postage, envelope, printing, etc.).

Hope that helps.
Michele


Thats about the correct fee in my area Michelle. Ours was "included" in the package with our Mysis program that I used
Title: Re: Fee
Post by: margemib on January 29, 2009, 07:08:55 AM
Hi Michele,
I do mean patient statements.
Do you do patient statements at all, if so how do you charge for statements?
margemib ???
Title: Re: Fee
Post by: Michele on January 29, 2009, 07:41:24 PM
If we are doing a full service (insurance billing and patient billing) we just charge a % on all collected whether from insurance or patient.  No separate charge for pt statements.

I've never done just patient billing or charged separately for patient statements.

Michele
Title: Re: Fee
Post by: Pay_My_Claims on February 03, 2009, 05:55:15 PM
If we are doing a full service (insurance billing and patient billing) we just charge a % on all collected whether from insurance or patient.  No separate charge for pt statements.

I've never done just patient billing or charged separately for patient statements.

Michele


how do you charge for balances after the claim has paid (ded/coins/)? Would you charge a % on claim you processed, and also what you bill the client and may or may not receive?  This is what I am looking at, and please you can give me some feedback its very welcomed.

-Claims submissions-% or per fee on claims submitted or paid (i'm leaning towards the fee)
-resubmitted claims same fee if its attributable to the provider (incorrect insurance information, etc) If I have to refile because I didn't use the correct mod, or transposed a number
-patient statements, a flat fee per each claim sent (soft collections) invoices sent monthly, utilizing a collection code, as per his policy when they get to a collection code (pre set) accounts are sent to a collection agency of his choice.
-training employees how to do upfront collections, insurance benefits, medicare/medicaid rules, difference in plans, ref, approvals etc Seminar fee
-Full Patient Management all inclusive (monthly flat fee)
* Monthly AR reports are included in all aspects of the billing service*

Title: Re: Fee
Post by: Michele on February 04, 2009, 06:41:29 AM
If we are not doing patient billing, then we don't collect on the balance after insurance pays.  We have a special provision in our contract to allow us to collect on amounts applied to the deductible if we don't do the patient billing.  If a claim is applied to a deductible, we did the work, but if we don't bill the patient or if there is no secondary, then we don't get credit.  Therefore we specifically mention that in our contract. 

We bill some clients per claim but most %.  If we are billing % and have to refile there is no separate charge, we get paid when the claim gets paid.  Patient statements are included in the %.  When we do patient billing, we collect on all patient payments, including ones made at time of service, since we have to track it all.  That makes it worth the money to send the patient statements.

Hope that helps
Michele
Title: Re: Fee
Post by: Pay_My_Claims on February 04, 2009, 03:20:17 PM
I def understand, so who does the patient billing for your providers?
I guess I'm more set on a per claim charge except for DME i'm doing % on those providers.
Also if it the claim applied to the clients deductible and the physician "technically" hasn't gotten paid for that do you still get a % on what he didn't actually receive.

Thanks.
Title: Re: Fee
Post by: Michele on February 04, 2009, 08:29:17 PM
Some of our providers chose to keep the patient billing inhouse.  That is fine with me, but I don't concern myself at all with if the patient pays.  We post the insurance payment and adjust off the balance (we actually have a method that shows what the patient should have paid in case the provider needs to ask us to explain).  If we don't do the patient billing, and a charge gets applied to the deductible then we do charge a % on the deductible.  I know there is a chance the provider won't get paid, but most do and if we didn't we'd go broke every January.  They couldn't get paid by the patient if we didn't bill the claim and get the statement showing deductible.  It's not ideal but it has worked for us for over 15 years. :)

Michele
Title: Re: Fee
Post by: Pay_My_Claims on February 05, 2009, 08:17:01 AM
Thanks for the insight.
Title: Re: Fee
Post by: margemib on March 11, 2009, 11:49:56 AM
Michele what is a average amount to charge if you are charging %

margemib
Title: Re: Fee
Post by: Michele on March 11, 2009, 08:44:47 PM
The nationwide average is between 5% and 11%.  Most billing services I'm familiar with are somewhere between 6% and 8%. 

Michele
Title: Re: Fee
Post by: margemib on March 12, 2009, 04:24:52 PM
Michele,
I spoke to a provider today, it was a chiro. he asked some questions and said what do you charge, I said whatever would work best for you % or per claim, he is not ready to change over but is keeping my card. I was thinking should I give them a option like that or not.
Also one of his questions was do you know if we soon all providers will have to change over to electronic, I said I'm sure it will soon happen, have you heard of any news on this?
margemib
Title: Re: Fee
Post by: Michele on March 12, 2009, 06:39:10 PM
Hi,

  There is not a 'national mandate' but many carriers are already mandating electronic billing.  Most Medicare carriers as well as many others.  For example, our local BC mandates it if you do over a certain number of claims per month.  Another local medicaid HMO also mandates it, unless you file papers stating why you cannot submit electronically.  It is just the direction things are going, and there are so many benefits.

   It is ok to give the provider a choice, but only if you make it clear that you are finding the best way to charge for his needs (and yours).  Don't make it seem like you don't really care which way, or it isn't important to you.

Michele
Title: Re: Fee
Post by: margemib on March 13, 2009, 08:26:07 AM
Thanks Michele!
Title: Re: Fee
Post by: PMRNC on March 16, 2009, 06:46:41 AM
Here's another tip if you run across a provider who wants to keep portions of his billing in-house in order to save money..
You could explain to him that having two sets of books is a big "no-no". In the case of an audit or an IRS problem there should ONLY be one set of books. By the time he enters the data from YOUR reports to his accounting software he's not saving much time and time = money. Usually when I tell a doctor this they never realized that and I work up the cost savings and they usually end up having me take it all :)

Linda Walker
PMRNC
www.billerswebsite.com
Title: Re: Fee
Post by: Michele on March 16, 2009, 07:14:40 PM
We actually run into many providers who want to 'save money' by keeping a portion of the billing in-house.  It drives me crazy.  If they only knew!  Anyway that's a good thing to point out to them.

Michele