Author Topic: Few Questions....  (Read 6117 times)

PMRNC

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Re: Few Questions....
« Reply #15 on: June 20, 2009, 06:03:26 PM »
Quote
It does not say "billing services can't charge a provider a % of fee's collected in the state of florida".

Your getting hung up on the "illegal" part and the part of the billing company

It is NOT illegal for us to charge physicians a percentage of collections.  It is illegal in Florida, Illinois, NY and possibly other states (still researching) for a PROVIDER to ENTER into a fee-splitting arrangement.  That's basically it in a nutshell.

Also you have to look at the full context again:
"paying or receiving any commission,
bonus, kickback, or rebate, or engaging in any split-fee arrangement in any form
whatsoever
with a physician, organization, agency, or person, either directly or
indirectly,
for patients referred to providers of health care goods and services

Being compensated a PORTION of an amount collected is benefiting from a patien't referral.. "INDIRECTLY"

Basically, the more patients the doc sees the more you get paid.. ie; fee splitting and indirect benefit

Believe me I've gone through every word with many attorney's.
Linda Walker
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Pay_My_Claims

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Re: Few Questions....
« Reply #16 on: June 20, 2009, 08:02:08 PM »
Linda, I think we may be close to saying the same thing, but our terminology is quite different. Let me say it this way. There are a few states that I won't bother with since I joined forums. NY, Florida & Illinois. I don't want to be caught up in trying to deal with the legal issues of fee schedules in those states. When I read the statute that you sent, and I read the case file, it personally confuses me. Not being someone who reads legal mumble jumble, I would by personal preference want an attorney to deal with any contracts or negotiations I pursue in any of the states I currently refuse to work. I would not enter into any agreement myself with any of the contracts I have already for these providers. When I read the case that was filed in Florida between a Management company and the physician, they found the management company to be within their rights to charge them a percentage of the revenue compensated, and I just wanted your opinion about that case. Trust me I don't know the ins and outs of the statute, but I do feel it can be confusing to me as well as others. As I read it is particular in some places that you can have problem if your flat fee schedule can be considered a percentage. IE if he brings in an average of 10K a week, and  your flat fee is 800 a week, it can be deemed as your are charging a % . I love North Carolina!!

ahad

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Re: Few Questions....
« Reply #17 on: June 30, 2009, 05:28:44 PM »
Hi everyone! I'm in the process of starting my own Medical Billing Company and I have a few questions!

1. I currently use NueMD at the medical billing company that I work for. Does anyone have any thoughts on using this software for an at home based company?

2. I'm trying to figure out what is the best way to receive super bills, pt info, reports, eob ect. from the Dr. Does a network work best or is it just as efficient to have all the information faxed?

3. If I use a different software then the Dr's is that okay? Do they need to provide me with any more information other then the pt info, insurance info and super bill?

4. Right now I work for a specialist and a lot of times the insurance requires medical documentation and reports. Do you think this is something I should have the Dr's send me for every pt. or should i request them from the Dr. on a need bases.

5. Does Office Billing differ a lot from Hospital Billing if the Dr. provides a super bill. I have only ever done office billing but I know a Dr. who sees pt both in is own practice and at the hospital?

Thank you so much!! This is a great website!!

Laura

rachel

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Re: Few Questions....
« Reply #18 on: July 13, 2009, 11:40:24 AM »
You will also want to make sure you are not in one of the states that prohibit physicians from entering a percentage based (fee-splitting) arrangement/contract.

I've always charged a setup fee, ranging from $100 to $3000 and more, depending on the practice, amount of work involved, etc. My startup fee is also like a security deposit (Only not refundable).
I will discount the setup fee as an incentive for the provider to sign my contract but have never waived it completely.

I am interested in finding out what a good way is to handle charging for old claims that have not been collected...I seem to be getting all dr's who haven't billed for over a year and I am going back and submitting for these but it is time consuming...should a larger flat fee or a larger percentage be more appropriate in this situation???

Pay_My_Claims

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Re: Few Questions....
« Reply #19 on: July 13, 2009, 12:49:04 PM »
Goodness!!! over a year!

PMRNC

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Re: Few Questions....
« Reply #20 on: July 13, 2009, 04:08:28 PM »
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I am interested in finding out what a good way is to handle charging for old claims that have not been collected...I seem to be getting all dr's who haven't billed for over a year and I am going back and submitting for these but it is time consuming...should a larger flat fee or a larger percentage be more appropriate in this situation???

This should be addressed in your contract. It should be clear. If you are claiming your contract starts on 7/1/2009 then the provider is going to just assume that is when you start. It's better to set a start date with a date of service. Anything prior is "old/aged" and you charge extra.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: Few Questions....
« Reply #21 on: July 13, 2009, 05:49:11 PM »
Yes, you definitely should be getting paid differently for 'clean up' and if you don't spell that out in the beginning the provider will think it is all the same.  We usually charge about 50% higher than our regular fee for old stuff.  For example if we are charging 7% for regular, we might charge 10% for cleanup.

Michele
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Pay_My_Claims

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Re: Few Questions....
« Reply #22 on: July 13, 2009, 05:59:31 PM »

Agreed!! Clean-up is HELL!!

PMRNC

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Re: Few Questions....
« Reply #23 on: July 13, 2009, 06:18:53 PM »
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Agreed!! Clean-up is HELL!!

See Charlene.. WE AGREE :) :)  <doing the little agreement dance>   ;D

You know I'm just playing with ya! xoxo
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

rachel

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Re: Few Questions....
« Reply #24 on: July 13, 2009, 06:21:20 PM »
Thanks for your input... :)

Pay_My_Claims

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Re: Few Questions....
« Reply #25 on: July 13, 2009, 08:20:34 PM »
Quote
Agreed!! Clean-up is HELL!!

See Charlene.. WE AGREE :) :)  <doing the little agreement dance>   ;D

You know I'm just playing with ya! xoxo

Wow!!!  :o