Medical Billing Forum

General Category => General Questions => Topic started by: jseverson on February 07, 2013, 09:36:40 AM

Title: billing a flat fee or percentage fee
Post by: jseverson on February 07, 2013, 09:36:40 AM
I need some help where to look in the statues for billing my customers a per claim or flat fee versus a percentage, I know I have read that I need to look under the state I am in.  I am in California what I have read before that we need to charge on a flat fee or per claim.  Where can I find this information. 
Title: Re: billing a flat fee or percentage fee
Post by: PMRNC on February 07, 2013, 10:39:55 AM
To the best of my knowledge, California does not have a fee-splitting law. To make sure you can both consult an attorney well versed in healthcare law/contract law and research the terms   California physician fee-splitting arrangements.     

In MY opinion, based on my experience, it makes sense to get away from these arrangements. In the long run you will not have to worry about this as I do feel more states are going to move towards this to combat potential fraud. The OIG already has frowned upon this type of fee schedule.   The other reason is quite simple. You should get paid for all your work. The days of marketing "You get paid when we get paid" is old and stale.   Getting paid for your time/work shows more professionalism.   PERCEIVED value is a much stronger marketing tactic.    J M H O
Title: Re: billing a flat fee or percentage fee
Post by: RichardP on February 07, 2013, 02:51:02 PM
Here is a start at finding a health care attorney:

But this is to the point:  (Find Division 2, Article 6 - left side - it will be Section 650 - right side)
California Business & Professions Code Section 650 states:

(a) Except as provided in Chapter 2.3 ...

(b) The payment or receipt of consideration - for services other than the referral of patients - which is based on a percentage of gross revenue or similar type of contractual arrangement shall not be unlawful if the consideration is commensurate with the value of the services furnished or with the fair rental value of any premises or equipment leased or provided by the recipient to the payer.

(c) The offer, delivery, receipt, or acceptance of any consideration ...