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Starting Your Own Medical Billing Business / Re: Patient Credit Card Payment
« Last post by Michele on November 13, 2017, 07:17:15 AM »
I'm not sure how square works other than they have the attachment that can be used for swiping cards.  Do they also have a system that you can log into from a computer to process manual payments?  If they do, then you would just log in and manually punch in the information for the payment.

We have different set ups with our providers depending on their system. We have some providers that don't take credit cards so they ask us to process the payment (we have a merchant system ourselves) and we credit them the amount of the payment minus a 3.5% fee (the cost of accepting the credit card). 

Some of our providers that take credit cards directly in the office prefer to also take the call so we refer the patient to call the office directly.  Some providers wish us to take all payment information and then give it to them in their office to process.
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Starting Your Own Medical Billing Business / Patient Credit Card Payment
« Last post by Powerade_993 on November 12, 2017, 04:34:49 PM »
If a patient calls to make a payment on their account by credit card, how does this work? Do I need an addition software to process this payment? In my situation I will be doing all the billing out of the providers EHR system. This software is capable of posting the payment but not capable to actually processing the payment. The providers have square attached to their phones and iPads for collection of payment....I canít imagine I refer the patient to the provider for the processing of this payment.
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Starting Your Own Medical Billing Business / Re: Fees
« Last post by PMRNC on November 12, 2017, 11:43:54 AM »
If you search this forum, you'll find a lot of posts about what and how to charge. Some states have fee-splitting prohibitions that don't allow physicians to enter into contracts on a % rate. I am in one of those states (NY) I charge flat fee which is based on an hourly rate.
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Starting Your Own Medical Billing Business / Fees
« Last post by Jennmarie42 on November 10, 2017, 11:42:19 AM »
So I am curious as to what going rates are and I am having a terrible time finding them. Wondering if anyone can give me examples of how they bill and rates? (i.e. Flat rate, hourly or percentage)
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General Questions / Re: DME - Modifier Help, Please
« Last post by Michele on November 10, 2017, 07:05:00 AM »
Are the items for the same leg/foot?  If they are for separate limbs then they are looking for the RT/LT modifier.  If they are for the same limb, I'm not sure.   By description they do seem to be inclusive but since they reviewed and stated appropriate modifier could be submitted it sounds as if they agree that they could be allowed separately.  I found a list of DME modifiers, but I'm not seeing one for this situation.  Maybe you will spot it:

 https://www.cgsmedicare.com/medicare_dynamic/modifiers_dme/results.asp

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General Questions / Re: Medical billing question
« Last post by veronicadorovon on November 09, 2017, 11:31:07 PM »
It totally depends on the type of the claim, amount to be claimed, span of the insurance plan and many other things. Try to verify your claim and then send it again.
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Starting Your Own Medical Billing Business / Re: Phone/Fax Business Services
« Last post by PMRNC on November 09, 2017, 04:05:04 PM »
I would make sure your compliance plan includes your phone, fax, email process, this will eliminate any concerns.

My compliance plan includes a stand alone fax, email and phone.. it doesn't include language or interpretation that my daughter "won't answer the phone". I'm not trying to be a stickler but many starting out don't think they need to have a compliance plan and this is one such example to show you do need one. Not saying your daughter will answer the phone but there should be compliance plan in place to explain the process and how the process is compliance. This will only help you as a billing company that works from a home office.
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I have never been to a doctor that gave out a collections policy. Interesting.

There should be a financial policy given to all patients which should be ONE policy for all patients and balances.


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We have an internal policy, 3 statements and then rebills are added. Then several more chances are given before we proceed with small claims.

"several more chances" may not be compliant with FDCPA. Most billers do not understand that once they send that one bill stating "further actions will be taken or anything similar that they are, from that moment on, bound by FDCPA. It only takes ONE patient to know consumer law to call you out on it and win.  All of my clients have policies in place that spell out what will happen after three billing notices.. we follow through with the action and follow that ONE procedure to the letter.

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We recently took the first two rounds of delinquents to small claims and the judge had us mediate with them. We were able to obtain court ordered payment plans and can pursue judgment if they default. On 3 of the cases, we needed the court order because the statute of limitations were about to expire. To my knowledge we have not violated anything, but I certainly will look that up and ensure we are in compliance.

Right, it's not the duty of small claims court or a judge within small claims to point out FDCPA, but if you get ONE patient that knows their rights under FDCPA and shows up in small claims, they will win HANDS down. The laws of the FDCPA are more to protect the consumer than the debtor. You are not a debtor until you make that initial threat to "proceed" whether it's small claims, a collection agency or direct credit reporting.
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General Questions / DME - Modifier Help, Please
« Last post by PippiT on November 09, 2017, 01:25:07 PM »
Can L4361 & L1971 be billed together? I am not finding anything in the NCCI Edits and google leads me to believe they possibly cannot, but I cannot find a straightforward answer.

Originally the claim denied L4361, NU, RT as being inclusive with L1971, NU, RT. I sent in an appeal with notes backing up that they are two separate items. It was denied but that a corrected claim with an appropriate modifier could be submitted.

I submitted a corrected claim with the 59 modifier on the L4361, NU, RT and it denied again that it is inclusive of the L1971. I'm at a loss. I looked back and we have never billed these two codes together. So I began searching if they can be billed together but I am not finding anything.

Any input/insight? Thank you.
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You would only violate if you do not follow through with the threat. Sounds dumb really being penalized for putting your hands in the air and saying "oh well" but basically you MUST follow through with the action you threaten (small claims, collection agency, etc)   

My clients always had better luck with small claims than collection agencies. MOST times the patient gets the small claims notice and pays ;) so we are only out the filing fee.

I see! I honestly don't know if the person before me ever threatened. But since I took over, I have followed through. I have had a couple patients pay when they got the notice. That is certainly the goal/hope is that court can be avoided.
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