Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => Topic started by: billinggirl on September 13, 2011, 08:23:17 PM

Title: Starting a new medical billing and collections company
Post by: billinggirl on September 13, 2011, 08:23:17 PM
Hello,
I need advise on how to get the first client.  We are specializing in Substance Abuse and Mental health.   Any advise is welcomed.  right now we are cold calling and faxing our brochures.

Thanks
Title: Re: Starting a new medical billing and collections company
Post by: Michele on September 14, 2011, 07:28:03 AM
Are you doing facilities or individuals?  I'm assuming your cold calling & faxing are targeted at providers in that specialty correct?  What kind of results are you getting now?  How many are you visiting/faxing in a week?
Title: Re: Starting a new medical billing and collections company
Post by: billinggirl on September 15, 2011, 07:31:15 PM
We just started calling facilities and just faxing. We are getting some that say fax us info or fax us pricing.  we havent done any visiting facilities yet.  Any suggestions?  we are speacializing in substance abuse facilities as in drug and alcohol rehab centers that offer detox, RTC, PHP and IOP services.  Inpatient mainly but also outpatient.  We will be doing verifications, and Utilization review for an extra fee.  The billing and collections will be based on a percentage.  still trying to figure out what to charge.  The going rate i hear in anywhere from 5% to 8%.  Any suggestions are welcome for the marketing and pricing.   Thanks
Title: Re: Starting a new medical billing and collections company
Post by: Michele on September 16, 2011, 07:25:32 AM
I would consider charging a flat fee based on the number of patients over a percentage.  Percentage is illegal in some states and it sounds like you are not going strictly local.  There are also lots of other benefits to charging flat monthly fee.  Do you have a website?  It would be good if you had a website and you could refer people to that on your fax, etc.  Allows you to include a lot more info without printing costs etc.  Also you can make it dressier than a fax.  There are ways to get names of all facilities in the US on the internet so since you are specializing in facilities I would keep targeting them.
Title: Re: Starting a new medical billing and collections company
Post by: billinggirl on October 16, 2011, 05:28:22 PM
Hi everyone,
Sorry for the late response. right now we are targeting the substance abuse and mental health field.  Mainly facilites that offer detox, residential and partial hospitalization.  We are getting quite a bit of response to send me a fax or mail me a brochure.   We also ordered your books which have been awesome as a training method.  We are 3 sisters starting out.  2 of us have 17 years experience from hospital billing, to medical clinics, podiatry and substance abuse and mental health.  We have the knowledge just need to better sell ourselves.  i'm great on the phone however, i work a fulltime job right now and the other two are focusing on cold calling.  Any help is greatly appreciated with our marketing techniques. 
Title: Re: Starting a new medical billing and collections company
Post by: PMRNC on October 25, 2011, 08:12:36 AM
I never ever, ever, send pricing.. If asked why I simply reply I'm not a restaurant with a "menu". I like to get in the door so that I can do a better analysis and come up with pricing fair to both my company as well as the provider, it also lends a more personal touch.  I also never fax at all unless asked or a fax number is listed in an ad. I know myself I have made complaints against companies for fax solicitations as they are annoying and waste of money! (JMO) If I am responding to an ad that asks for a resume, I actually do send a resume a long with a cover letter explaining my position as a company owner but the resume as requested is attached. No brochures, no flyers, UNLESS they ask for them. 

Just a small word of advice.. marketing only for substance abuse/mental health WILL put great limitations on your business in today's economy. Especially if there are 3 of you, it's going to require a lot more clients for a profit margin, not to mention a while to land that "first" one. JMHO.. 15 years ago I would have said go for it while the picking was hot.. but it's not that way at all anymore. Specialty billing normally happens LATER on after you have established your business and obtained a nice volume of clientele.
Title: Re: Starting a new medical billing and collections company
Post by: midwifebiller on October 26, 2011, 07:03:15 PM
I always send pricing as soon as I can. With everyone tightening their belts these days, it's nearly the first thing any potential client needs to know. If I can get them on the phone, I'll ask a few questions, then give them a range and let them know I can nail it down with more information if they want to move forward. We are moving from % billing to flat fees, so this calculating does take more time.

Like Linda, I encourage you to branch out.  I have billed exclusively for midwives for 14 years now, but have recently had to branch out due to the economy.  I was definitely out of my comfort zone with these new providers, but it has been a welcome change/challenge and has helped our financial picture as well.
Title: Re: Starting a new medical billing and collections company
Post by: ruthie72 on October 26, 2011, 08:10:33 PM
Ok i know what the % base billing is, so what is the basis for the flat fee? What is the range? And how do you charge for like say, set up fee, collections, etc...I know most of you would not give me your prices, but can you at least give me an idea? Thanks so much
Title: Re: Starting a new medical billing and collections company
Post by: PMRNC on October 27, 2011, 06:31:03 AM
It's really not possible to give you a range, as stated before, speaking to the potential client, knowing their specialty, knowing the state rules for the state in which the provider is in (fee splitting laws), volume of claims, AR, time involved and necessary for that client, etc all has to be taken into account. I can say to you $200-$5000 a month but that isn't going to help you.   My flat fee is derived of my hourly rate, the amount of hours needed/worked for that client, sliding scale to account for new patients, overhead costs such as postage, clearinghouse, etc.  The costs of doing business should NEVER be included in flat fee structures, those costs for example would be attorney, books, educational resources, accountant, or any other cost used to do business in general. 
Title: Re: Starting a new medical billing and collections company
Post by: ruthie72 on October 29, 2011, 08:41:07 AM
Thank you so much..all of your advice is always really helpful!!
Title: Re: Starting a new medical billing and collections company
Post by: midwifebiller on October 29, 2011, 10:15:04 PM
Our set-up fee is $200. My competitions' (two other national midwife billing services) set-up fee are $400 and $700. I also give discounts to providers moving from my competition to our service.

Flat fees for our midwives have been fairly easy to figure out, since they have a course of care that ends 6 weeks after baby is born. We charge $230 per full course of care for both mom and baby, and pro-rate it if they transfer out of care before baby is born.

For our new non-midwife clients, I ask them how many claims they send per month and then figure about $18 per hour for billing, posting payments and working AR (I have figured out how long it takes me and my most efficient colleague to bill x number of lines and post x number of payments). If there is someone to talk to at the office about billing, I'll ask her how long it takes her to bill, post payments and work AR. The first time I figured this, I came in a little low, so we are breaking even with this client, but not making a profit.  The second time, I came in just right.  I added a clause to our Agreement that allows for readjusting of the billing fee three months after they sign on with us, so I can go higher or lower as needed.

I hope this helps.
Title: Re: Starting a new medical billing and collections company
Post by: ruthie72 on October 30, 2011, 05:27:54 PM
That really helped alot. thanks so much..can you share one more thing with me? What technically counts as your set up ? I am looking to start with small practices, and chiropractors..so i do not get overwhelmed right away.. since i am new at this....i appreciate your help. Have a great day
Title: Re: Starting a new medical billing and collections company
Post by: midwifebiller on November 01, 2011, 01:53:30 PM
Set-up for us includes:
*Creating a provider account in our billing program. We use HealthPac, which allows us to create our own provider accounts. (I have used other billing programs where I had to wait for the support team to set up a new provider account and then they charged me.) This takes me about 15 minutes.
*All forms--patient registration form, verification of benefits form, superbill and encounter form. This takes me about 10 minutes.
*Set-up for electronic billing. This is just a form I fill out and send to the clearinghouse. Two minutes.
*NPI registration (for new providers) with insurance companies.  This may take 30 minutes to fill out and fax forms to Aetna, UHC, Cigna and BCBS.
*30-minute phone conversation to teach them how to use the forms, how to work with a billing service and answer any questions.

We have started offering credentialing services also, but that is not included in the set-up fee.

I hope this information is helpful.
Title: Re: Starting a new medical billing and collections company
Post by: midwifebiller on November 01, 2011, 02:00:44 PM
Oops, forgot a few other things we do behind the scenes:
*Create a new account in QuickBooks.
*Add her to our email contact list and create an email folder for her.
*Add her to our Provider List (excel spreadsheet) for everyone's reference (there are six of us here).
Title: Re: Starting a new medical billing and collections company
Post by: PMRNC on November 01, 2011, 06:39:23 PM
I do take into all that was mentioned by Kelli in my setup fee, but I do something a little more creative because I've been USED before by provider's who want a quick clean up and get away without paying.. My setup fee actually ranges from $300 - $3000.  Big range..but here's why. I don't just look at my setup fee as a price for setting up.. it's also my "security deposit" and helps me weed out the "users"  My setup fee depends on the size of practice, the "CONDITION" (big one for me) of the practice, volume, services, costs, etc.  My setup fee also serves as a marketing tool as well. If I have a client on the hook I will reel them in by letting them have a discount off the setup (NEVER WAIVING IT... EVER!) if they sign the contract within 2 business days.  Kill 3 birds, one stone :)
Title: Re: Starting a new medical billing and collections company
Post by: ruthie72 on November 02, 2011, 09:40:31 AM
Thanks so much, and AGAIN you ladies are so helpful..i really hope to be able to sign at least one provider soon.  I was wondering, do you make up your own forms or is there a website that you get your forms from? I really appreciate you taking time out of your busy day to help me..Have a wonderful day and i will try to not big a pig pain in the butt.... ::)
Title: Re: Starting a new medical billing and collections company
Post by: PMRNC on November 02, 2011, 09:50:47 AM
If the office needs forms designed, I usually do them. In our members only area we have a huge array of forms also that can be downloaded and used as well.
Title: Re: Starting a new medical billing and collections company
Post by: midwifebiller on November 02, 2011, 05:56:26 PM
Nice touch, Linda!

We've never been "used" that way before, but we have had a lot of trouble with new providers.  They don't seem to understand that it takes time to get them set up in an insurance system, it takes time for claims to grind their way through that system for the first time, it takes time before they actually start making a profit.  We actually had a 3-midwife practice ask us after three months in business, "Why aren't we making a profit yet? It's been three months!" (Their Medicare contract was pending, their Medicaid contract was pending, and their UHC contract was pending, so all of those claims were on hold.) Have you ever noticed that when anything goes wrong in the insurance world, it's always the biller's fault?  Anyway, we lost several clients after spending  several months getting them all set up (including the practice above). They weren't making enough money and decided it was our fault.  We now have a clause in the Agreement for any new practice that they must stay with us for one year.  It has helped quite a bit.

Live and learn...
Title: Re: Starting a new medical billing and collections company
Post by: midwifebiller on November 02, 2011, 05:58:52 PM
We also create our own forms.  I love excel and have several templates that I have created over the years.  Using the templates, it only takes me (or an associate) a few minutes to customize the form for the client.
Title: Re: Starting a new medical billing and collections company
Post by: PMRNC on November 03, 2011, 09:18:41 AM
Kelli, I had a minimum of 6 month's in my contract, however, you cannot enforce it if a client wants out and as long as they provide the notice necessary as stated in your out clause they can. My attorney has seen companies go to court and lose trying to enforce the terms, if a client is not happy they should have that "out" available or it's just going to cost you more in time/money anyway.  That's why my setup fee is also my security deposit and is NON refundable.
Title: Re: Starting a new medical billing and collections company
Post by: midwifebiller on November 03, 2011, 02:14:36 PM
I assumed it would be non-enforceable if it got right down to brass tacks (thank you for confirming this), but it has helped nonetheless. 
Title: Re: Starting a new medical billing and collections company
Post by: TLH on December 19, 2011, 05:15:41 PM
Can you zero out an account in Medisoft v12.

I have a provider that wants to start over in their software but want to zero out the patience account before the new year.

How can we zero it out?
Title: Re: Starting a new medical billing and collections company
Post by: PMRNC on December 19, 2011, 05:59:45 PM
You have to protect the integrity of the audit trail so you really don't just want to wipe it.  If there are balances to write off, the correct way is to write them off as per your office policy/compliance policy.  You never want to just wipe the file, if your audited that spells big trouble.
Title: Re: Starting a new medical billing and collections company
Post by: TLH on December 19, 2011, 07:41:43 PM
Okay, Thank You...That's what I told the provider but he insisted on doing it that way. I told him that he's responsible if he wants to do it that way and I'm not going to do that. How do I make him understand the importance of the audit trail.
Title: Re: Starting a new medical billing and collections company
Post by: PMRNC on December 19, 2011, 07:57:23 PM
Quote
Okay, Thank You...That's what I told the provider but he insisted on doing it that way. I told him that he's responsible if he wants to do it that way and I'm not going to do that. How do I make him understand the importance of the audit trail.

Is this a "client" or an "employer" makes a difference .. sort of.   I'll explain.   first of all, he should know the importance of all record keeping in his business and he should know that it's a potential catastrophe to mess with the audit trail.  The word "AUDIT" should be enough.   Now whether this is a client or not, anything YOU do "knowingly" (since you know it's wrong this applies) you are JUST as responsible, so if he's insistent and he's your "employer" you have him Log on to HIS account in the software and make changes himself to protect your self. Hopefully you have separate login's according to HIPAA compliance and for the sake of the audit trail  The audit trail is NOT only there to protect the integrity of the data, but to protect you for this very reason. Each user with the "need to know" access should log in with their own username/password. The reason is so that IF there is a problem, the problem can be traced back to the person entering it.   My best advice if you can't get him to do it the right way is to log off and let him assume responsibility and liability.  If this were my client I would flat out tell him I'm not making that kind of change period.
Title: Re: Starting a new medical billing and collections company
Post by: TLH on December 19, 2011, 08:25:35 PM
Thanks...It's a new client and I just told him we are going to do it the correct way or he needs to find someone else to do.

Thanks again
Title: Re: Starting a new medical billing and collections company
Post by: PMRNC on December 19, 2011, 09:36:43 PM
Always try and educate them first.. though most times I think they know it's just a test to see if they can pull your strings <g>  Seize the opportunity to educate him which he will appreciate in the long run... and if not, then he wasn't interested in doing things the right way anyway.