Author Topic: Fees and Reimbursements  (Read 5041 times)

arathbone

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Fees and Reimbursements
« on: May 09, 2008, 05:38:49 AM »
Hi,
What is the standard percentage rate for biller payment?  I will be meeting with my first client in June to discuss this. He currently prepays a set amount for each claim and is not very happy with the service that business provides.

Also,
What is the standard mode of operations for Accounts Receivable?  Do I set up a bank account and deposit the reimbursement checks after I post them, or do I send them to the client?

One last thing.
I have seen on many posts that you have answered that you use clearinghouse software instead of a clearinghouse. What is the name of that product and where can I purchase that.  I will be using Medisoft if that is relevant.

Thanks,
Angela

Michele

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Re: Fees and Reimbursements
« Reply #1 on: May 09, 2008, 06:30:20 AM »
Hi Angela,
   Congratulations on your appointment.  Most billing services charge a % of what they collect.  The standard percent is between 6-9%.  You need to take a lot of things into consideration when setting your %.  What area of the country you are in, what specialties you will be billing, etc. 

   Most of our providers receive their payments directly and send us copies of the eobs.  For the providers who's checks come directly to us, we photocopy the eob & send original eob & check directly to provider once a week. 

   Regarding the clearinghouse software, the one we use only works with Lytec or Medisoft.  What version of Medisoft are you using?  I can get you a price for the clearinghouse software.  We love this option for submitting electronically and we hooked up with the company who owns it so that we can offer it to our members.  (Same price as theirs - we don't mark up!)

Thanks and Good Luck!

Michele
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PTBILLER

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Re: Fees and Reimbursements
« Reply #2 on: May 09, 2008, 11:55:16 AM »
Michelle, Could you email this information regarding Medisoft and submission software also??  pmckewen@charter.net   Thanks!!
Pam McKewen

arathbone

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Re: Fees and Reimbursements
« Reply #3 on: May 09, 2008, 09:20:20 PM »
Michelle,
I will be using the Medisoft version 14 Advanced.
Thanks,
Angela

MMBS1

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Re: Fees and Reimbursements
« Reply #4 on: August 27, 2008, 02:14:10 PM »
Hi Alice and Michele-

I notice that with many of the questions that are asked regarding how much to charge, it is always mentioned to take into consideration the area that the provider is in. Can  you please clarify this. I am having trouble figuring that out in order to figure out what to charge. I was going to do this based on what services I am providing. Is this written somewhere how to figure this out?  :-\

Thanks!

Ashley

Michele

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Re: Fees and Reimbursements
« Reply #5 on: August 27, 2008, 03:42:13 PM »
When I say, "take into consideration the area the provider is in"  I mean a couple different things.  For example, NYC vs Smalltown USA.  All things in NYC tend to be more expensive, where small towns tend to be less expensive.  I'm not saying you should charge NYC providers more straight across the board, or small town providers less.  Just that you do need to take into consideration the geographical location.  Sometimes it won't matter, sometimes it will.  There are a lot of other things to consider as well, like services provided, specialty, volume of claims, etc.

Hope that helps!  Nothing is black and white anymore!

Michele
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MMBS1

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Re: Fees and Reimbursements
« Reply #6 on: September 06, 2008, 10:40:55 AM »
Hi Michele

Yes that helps. It makes perfect sense. I guess my brain was on overload from the information I've learned in the past 2 weeks. Thanks!

Ashley

heritagemedicalbilling

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Re: Fees and Reimbursements
« Reply #7 on: October 30, 2008, 08:47:25 AM »
Michele

Does the 6-9% include any coding or straight billing?

Diane

Michele

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Re: Fees and Reimbursements
« Reply #8 on: October 30, 2008, 08:53:53 AM »
We do some simple coding occasionally when billing and we just charge our regular fees.  But if it gets to be where we are actually coding all claims, then we may need to negotiate a higher fee with the provider.

Michele
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billingfromhome428

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Re: Fees and Reimbursements
« Reply #9 on: February 10, 2009, 12:31:50 PM »
I have had a potential chiropractic client ask for a tier percentage plan.  Basically start charging him 8% and then in 6 months if his receiveables have increased by "x" then his percentage would decrease by "y".  I have never worked with this before and I am not sure what the variables should be.  I was thinking like if the average monthly was 5k and in 6 months his has increased to 10K reducing the percentage to 7.5%.  Does that sound fair?  I apperciate any and all input.

Thanks!
Cara

Pay_My_Claims

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Re: Fees and Reimbursements
« Reply #10 on: February 10, 2009, 12:39:16 PM »
I have had a potential chiropractic client ask for a tier percentage plan.  Basically start charging him 8% and then in 6 months if his receiveables have increased by "x" then his percentage would decrease by "y".  I have never worked with this before and I am not sure what the variables should be.  I was thinking like if the average monthly was 5k and in 6 months his has increased to 10K reducing the percentage to 7.5%.  Does that sound fair?  I apperciate any and all input.

Thanks!
Cara

That sounds a little backwards to me. I think that you would want to start him lower and then increase the % rate. My scenario...new biller, physician is leery, I offer him a discounted rate of 5% then after 3 months if his revenue has increased and his AR decreased I go to 6% if it rises after 3 more months we go to the top charge of 7%. Why should you get less if you bring him in more money???


Michele

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Re: Fees and Reimbursements
« Reply #11 on: February 10, 2009, 05:52:04 PM »
If 8% is your normal fee then I wouldn't go down if the receivables go up, especially for a chiropractic account.  I would only consider going down if it were a higher end provider, surgery, etc, where you are getting higher reimbursements per claim. 

Pay_My_Claims has a good point.  If you are the reason the receivables are increasing then you definitely shouldn't take a cut after doing a good job.

If you really don't have a choice then I think the 7.5% is fair, but make sure you're not cutting your own throat.

Michele
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cquinn

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Re: Fees and Reimbursements
« Reply #12 on: October 01, 2009, 11:15:17 AM »
I was under the impression % was not legal for billing purposes.  Can you help clarify.  Iam in Florida and have a potential psychotherapist client.

thanks.

Pay_My_Claims

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Re: Fees and Reimbursements
« Reply #13 on: October 01, 2009, 11:17:37 AM »
Uggh Florida, and yes I think you are correct that you can't bill percentage wise in Fla.

cquinn

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Re: Fees and Reimbursements
« Reply #14 on: October 01, 2009, 11:59:35 AM »
What is a reasonable fee per claim to charge for psychotherapy?