Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => Topic started by: kjoiner on April 11, 2013, 04:53:51 PM

Title: Fee Schedules
Post by: kjoiner on April 11, 2013, 04:53:51 PM
I've just signed my first client (family medicine, single provider) and she is in desperate need of help. She has not billed many claims for the past year since opening her practice because she was not credentialed and frankly did not understand how to submit claims for reimbursement. I have offered to help submit her retro claims, the problem is she does not have an establish fee schedule for her services - she says she knows them in her head but does not have them formally structured in a database. She also administers medications in the office and does not know CPT or HCPCS codes (she uses the NDC codes on the label of her injectables), or how much she should charge for her services.

I am considering subscribing to MDTools online program to help create 2 fee schedules (2012 & 2013) for her CPT and HCPCS codes - without getting too heavy into coding issues as I am not a certified coder. Has anyone used MDTools program? Are there other suggestions that may work better? Also, where can I find information to crosswalk the NDC codes to HCPCS codes for the injectable medications?

Any & all information is greatly appreciated!

Title: Re: Fee Schedules
Post by: RichardP on April 12, 2013, 12:07:38 AM
I suggest you hire a seasoned biller to help you get this new doctor set up.  Once you and the new doctor both know what you are doing, you can cut the ties with the seasoned biller and go it alone.

A doctor does not get paid because they work hard.  A doctor gets paid because either they know, or they hire someone who knows, how to get paid for the work already done.  Without knowing how to get paid for the work already done, doctors end up working for free.  New doctor; new biller.  You both need someone seasoned to help you get up to speed.  Too many details to work out to handle through a forum such as this.
Title: Re: Fee Schedules
Post by: kjoiner on April 14, 2013, 10:47:51 AM
Thanks for the suggestion!