Starting a Medical Billing Business > Starting Your Own Medical Billing Business



Dear Michelle and Alice
I am researching Home Medical Billing Business, have received your ebook and have a few questions. I currently work for a Rehab Hospital/Home Health Care facility in the Business Office. I have been in this field since for almost 5 years. Still much to learn. I have already procured the medical billing course through Allied Medical Schools online training. Will begin that in the next couple of weeks. I have a client waiting for me to start up, my Chiropractor. He said he prepays for their service and they do not do follow up. Should not be too hard to make him happy.
1. For his billing, which is mostly office visits, would you recommend charging a per claim fee - From office visit to patient billing? I was thinking 5.00 or 6.00 per claim for office visits.  Say, if I were to obtain a surgeon client, I would want to charge a percentage instead of per claim fee.
2. When billing a provider, how are you notified of their payments; patient and insurance?
3. I have gathered that fees are based on amounts collected from insurance companies, but when billing patients, Do you charge a separate fee for patient billing? Would this be a per patient fee or a percentage?

That's all for now, I'm sure that I'll have more questions as I read through the book again.  Oh, and thanks so much for sharing your knowledge with us wannabe's.

Hi Angela,
   Congrats on your decision to venture into the field.  I'm glad you've found our book helpful.  In answer to your questions:

1.  SInce the current billing service your chiropractor has didn't do any followup, it sounds like that is an area of concern for him.  Personally we only charge a per claim fee if there will be no followup and if we are not tracking any payments.  The reason we charge the % is so we have incentive to make sure all claims are paid and paid correctly.  That is a big selling point for us.  If we have a situation where the just need to get them claims submitted, but don't want the followup, then we will do a per claim.  $5 or $6 per claim is high for a chiro since many insurances only reimburse approx $30 per visit.  That comes out to about 20%.
2.  It is crucial that the provider gives you copies of all eobs, both paid & unpaid.  Also, you must come up with a system for them to report patient payments to you.
3.  When we do patient billing as well as ins billing, we still charge just 1 percentage of both.  When we run our monthend reports, we just add the patient payments in with the insurance receivables and calculate from that. 

It's really nice that you are going into this with a client already in place.  The 1st client is always the hardest to get!

Good luck

Am I understanding from your response Michele that you only charge your providers 1% of collected receivables??  I charge 7% and thought that was about the lowest amount billers charged.  I bill insurance and patients and on my invoices to providers, I charge 7% of the total amount they received that month. 

Also, I do by business from home and we have a P.O box where all EOB's, checks from ins. and patients are sent.  Then I record and send payments on to the providers.  (I file paper claims for now however)  except Medicaid. 

Alice Scott:
Sorry for the misunderstanding.  No we don't charge just 1%.  I meant that we charge the same percentage with the patient billing.  We also charge 7% on most accounts and we too feel this is low. 


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