Recent Posts

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91
New! / Happy Thanksgiving!
« Last post by Michele on November 22, 2017, 12:06:33 PM »
Just wanted to take a minute to say Happy Thanksgiving!  We personally are very thankful to all on this forum who help to make it a great place to get and share information.  We have so many people tell us how helpful the forum is.  It wouldn't be helpful to anyone without all of the information that you've all shared.  Thank you all!  We hope you all enjoy some time with family, friends and loved ones during this holiday.
92
Starting Your Own Medical Billing Business / Re: Question and notification
« Last post by PMRNC on November 21, 2017, 04:46:29 PM »
I don't haggle at all and won't budge. I state my fees and if they come back with something else or want to do something else I just wish them well and be on my way. I give them my business card and I warn them about things such as states that prohibit the physicians from fee-splitting. I just don't haggle and where there is one client that doesn't want to pay there are 3 that do.
93
Starting Your Own Medical Billing Business / Re: Question and notification
« Last post by Michele on November 21, 2017, 09:56:26 AM »
Believe it or not we haven't run into an issue with anyone refusing the flat monthly fee.  There is so much information out there now about percentage billing that most providers are aware, at least in the states where it is prohibited.  I think I would ask what the objection/concern to the flat fee is.  Then see if I could overcome it.  But it makes me think of other situations. When a provider is difficult to come to agreement about the fee/contract, they are usually difficult to work with.  This might be a warning sign.

I receive many requests to outsource part of our work.  It's really annoying.  Yeah, let me fire my nephew, my daughter's boyfriend, or my friend to give you work that you will not do to the level of quality we do it.  NOT.  We are like a family here (or kinda like the herd from Ice Age!).  My workers rely on this job to feed their families.  I don't blame them for trying to earn money either, but don't think I'm going to hand over my work to you.

Thanks for the heads up!
94
Starting Your Own Medical Billing Business / Question and notification
« Last post by williamportor on November 21, 2017, 09:31:30 AM »
What do you do when a prospective client wants you to do their billing, but will not agree to a flat monthly fee? I've run into this on more than one occasion. I won't do percentage billing, so my alternative plan is to charge by the claim (in other words by each HCFA submitted) then add on fees for each additional service, such as posting of payments, direct billing of customers w/ outstanding balances etc. Not a perfect system, I'll admit, but rather than lose the business to a competitor, this arrangement has allowed me to add 3 more clients that I normally wouldn't have. Does this sound reasonable? What do you folks do when a prospective client won't agree to a flat monthly fee? 

Also-

If any of you have a Linkedin account, please beware of a person named Daniel Lopez (I doubt that's his name!) He is a front guy for a company in India who is trying to obtain subcontracting agreements with American medical billing companies. His emails were getting pretty pushy before I designated his email as spam.   
95
Billing / Re: UHC Time frame for Claims Submission
« Last post by PMRNC on November 20, 2017, 09:05:11 AM »
Meaning if the provider's state is different from NJ line of biz plan (NJ Plan) the members state governs the filing deadline.

Note also that Timely filing limits may differ for ERISA plan members. If it is a group health plan under ERISA, the plan's benefit summary determines the timely filing limit and trumps the carrier's timeline.
 
Also even with an AOB if provider is NOT participating they will not receive payment, the patient will.
96
Billing / UHC Time frame for Claims Submission
« Last post by aajkaal on November 19, 2017, 06:54:26 PM »
New Jersey - 90 days from date of service OR 180
days from date of service if submitted by a New
Jersey participating physician for a New Jersey Line
of Business member.

What does "New Jersey Line
of Business member" mean ?
97
Coding / Re: Sending Dummy CPTs
« Last post by Michele on November 17, 2017, 07:24:24 PM »
I personally think the dummy CPTs would cause more issues then they would resolve.  I'm not sure what system you use but I would think there would be another way to accomplish this.
98
Coding / Re: Sending Dummy CPTs
« Last post by PMRNC on November 17, 2017, 01:58:12 PM »
Quote
Long story short, it would allow our auto-coding software to add LT and RT modifiers to lateral imaging CPTs.

I'd be really careful with this ...I'm still not seeing the point to the process of creating made up CPT's.. and I'd be very cautious in doing so.
99
Coding / Re: Sending Dummy CPTs
« Last post by rcmbilling123 on November 17, 2017, 01:11:08 PM »
It will vary depending on the insurance carrier but my guess is that it will kick out the entire claim.

But I too am curious as to the purpose.


What is the purpose of this?



Long story short, it would allow our auto-coding software to add LT and RT modifiers to lateral imaging CPTs.
100
Coding / Re: Sending Dummy CPTs
« Last post by Michele on November 16, 2017, 05:23:35 PM »
It will vary depending on the insurance carrier but my guess is that it will kick out the entire claim.

But I too am curious as to the purpose.
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