Author Topic: Fees  (Read 8679 times)

jcbilling

  • Full Member
  • ***
  • Posts: 156
Re: Fees
« Reply #15 on: October 23, 2009, 11:13:16 PM »
I currently bill all of my clients on a percentage basis, and at this point will continue to until I have a client that is in a state that prohibits that.

When I have met with prospective clients, one of the biggest reasons they choose to hire a billing service vs. an employee is that they feel like they pay the employee whether or not the work is done correctly and promptly. Where as if a billing company is compensated for what they collect, they are more motivated to do a more accurate and efficient job.

I've been contemplating the idea of flat rate, but I'm not convinced it's the most fair way to go.

My question is, what are the benefits of not charging %?





Pay_My_Claims

  • Guest
Re: Fees
« Reply #16 on: October 24, 2009, 06:48:57 AM »
It can also be said (reason why they prohibit fee splitting) is that it is a motivation to upcode, file false claims etc.  As far as them hiring a biling service, there are many that have their own that can't bill or code. They are killing the home-based billing services. When I calculate what I charge as to what is reimbursed by the insurance company each month....I may WAYYY more than anyone billing on 7-8% fee schedule. The average biller in my area makes about 15.00 per hr Which is 2400 a month before taxes. Depending on a physicians revenue she is already making a % of his revenue. If he is bringing in about $30,000 a month she is getting paid 8% If a provider is paying me a flat fee of $2500 a month, he would have to go way above his average for me to lose money doing % billing, but the month he drops down to 20K, I still do well. I don't knock it, but I know % billers lose more than flat fee billers. I have a lot of % billers who get screwed royally

gderilus

  • Jr. Member
  • **
  • Posts: 77
Re: Fees
« Reply #17 on: October 24, 2009, 02:49:25 PM »
Wow Pay my claims, I just realized that your business name is almost the same as mine. My company name is AccuMed Billing Solutions, LLC. I'm still working on my website.

PMRNC

  • Hero Member
  • *****
  • Posts: 4217
    • One Stop Resources & Networking for Medical Billers
Re: Fees
« Reply #18 on: October 24, 2009, 03:59:50 PM »
Quote
When I have met with prospective clients, one of the biggest reasons they choose to hire a billing service vs. an employee is that they feel like they pay the employee whether or not the work is done correctly and promptly. Where as if a billing company is compensated for what they collect, they are more motivated to do a more accurate and efficient job.

This was and will always be an issue, but my response to this very thing is that who care.. who's business is it? I decided a long time ago that ALL of my time is worth getting paid. I have clients in other states where I can bill a % but I choose not to, my time is just as valuable and the practice STILL saves money, everyone wins. But again.. I do not justify what I charge or how I charge. You wouldn't challenge your cable company or your phone company and tell them you want to pay them on a % would you? If you did they would laugh but you'd be told the same thing. These are our rates and this is what we charge. I got tired of billing for just when I collected when it was the fault of the office for not doing their part that led to the lower reimbursement and let's not forget that more than half of what we do is education..not just billing, Every moment of my time is worth getting paid. If a provider does not want to compensate me then he won't hire me and I don't want them anyway.

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

jcbilling

  • Full Member
  • ***
  • Posts: 156
Re: Fees
« Reply #19 on: October 24, 2009, 11:11:18 PM »
Charlene -

I understand what you're saying about upcoding and falsifiying claims. Although I consider my services very professional and work hard to stay compliant, I realize there are billing services that are just trying to "get rich quick" and therefore give the rest of us a bad name. I guess I have a mental block because I have read so many marketing materials engraving in my head why % billing is beneficial to the provider.

Linda -

You make a good point about not getting paid on the claims that are not the fault of our billing. I have a client who has 3 offices that we bill for. The one office refuses to verify insurance benefits because the receptionist "doesn't have the time" and since the provider is out-of-network, we have so many claims going to the deductible and they don't collect the payment upfront. So the provider is losing money and so am I. I have talked to the provider multiple times about this and he shows no effort to change. It makes me so frustrated, because we spend time sending the claims knowing they won't get paid.

My next question is how do you determine what you charge a client on a flat rate plan? I know there are many factors, such as overhead costs, your time involved with the account, etc. Do you make a itemized fee schedule? Or do you just present a charge and negotiate...or do you not negotiate? 


PMRNC

  • Hero Member
  • *****
  • Posts: 4217
    • One Stop Resources & Networking for Medical Billers
Re: Fees
« Reply #20 on: October 24, 2009, 11:37:16 PM »
What I do is estimate the time I think necessary for each client on a monthly basis. I then determine my hourly rate (new billers will have this number lower, it should be based on experience, geographic location and education) then I deduct estimated costs and voila! my contract then has a clause that allows me to have a sliding scale so if the provider adds more work, that makes more work for me and I get paid more. It's quite simple but yes I hear you about the marketing stuff being drilled into your head. When I had my billing company setup a few years ago in PA I couldn't imagine charging anything BUT a %, but the more I researched, played the numbers..the more it worked. Then after you arrive at your monthly fee you get used to that way of thinking and you can justify it to the provider who questions it.  For example here in NY it is illegal for a provider to enter into a fee-splitting arrangement, but there are a lot of billing companies who either don't know of it or just ignore it because "everyone else is doing it" When I have a potential client that is using one of these billing companies, I use it as a marketing tool I tell the provider that it's not illegal for me, but for them.. and that my best interest is their practice not just my wallet, that usually sells them or they research and see what I'm talking about, and then they have become educated. 

I don't negotiate.. I used to, but I've been doing this too long to do that anymore. For the first few clients I can totally understand having a bargaining chip or negotiation, but I just don't anymore.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

  • Guest
Re: Fees
« Reply #21 on: October 25, 2009, 02:02:21 PM »
Charlene -

I understand what you're saying about upcoding and falsifiying claims. Although I consider my services very professional and work hard to stay compliant, I realize there are billing services that are just trying to "get rich quick" and therefore give the rest of us a bad name. I guess I have a mental block because I have read so many marketing materials engraving in my head why % billing is beneficial to the provider.

Linda -

You make a good point about not getting paid on the claims that are not the fault of our billing. I have a client who has 3 offices that we bill for. The one office refuses to verify insurance benefits because the receptionist "doesn't have the time" and since the provider is out-of-network, we have so many claims going to the deductible and they don't collect the payment upfront. So the provider is losing money and so am I. I have talked to the provider multiple times about this and he shows no effort to change. It makes me so frustrated, because we spend time sending the claims knowing they won't get paid.

My next question is how do you determine what you charge a client on a flat rate plan? I know there are many factors, such as overhead costs, your time involved with the account, etc. Do you make a itemized fee schedule? Or do you just present a charge and negotiate...or do you not negotiate? 



You would be getting paid if you charged a flat fee instead of %.

Pay_My_Claims

  • Guest
Re: Fees
« Reply #22 on: October 25, 2009, 02:08:01 PM »
What I do is estimate the time I think necessary for each client on a monthly basis. I then determine my hourly rate (new billers will have this number lower, it should be based on experience, geographic location and education) then I deduct estimated costs and voila! my contract then has a clause that allows me to have a sliding scale so if the provider adds more work, that makes more work for me and I get paid more. It's quite simple but yes I hear you about the marketing stuff being drilled into your head. When I had my billing company setup a few years ago in PA I couldn't imagine charging anything BUT a %, but the more I researched, played the numbers..the more it worked. Then after you arrive at your monthly fee you get used to that way of thinking and you can justify it to the provider who questions it.  For example here in NY it is illegal for a provider to enter into a fee-splitting arrangement, but there are a lot of billing companies who either don't know of it or just ignore it because "everyone else is doing it" When I have a potential client that is using one of these billing companies, I use it as a marketing tool I tell the provider that it's not illegal for me, but for them.. and that my best interest is their practice not just my wallet, that usually sells them or they research and see what I'm talking about, and then they have become educated. 

I don't negotiate.. I used to, but I've been doing this too long to do that anymore. For the first few clients I can totally understand having a bargaining chip or negotiation, but I just don't anymore.

I learned from it also Linda. My entire premise of doing medical billing from home is that every provider that I worked for, I KNEW I could do the job accurately and efficiently, and more time effective if it wasn't done in the setting I was in. More often Billers are Practice Managers, or they split their time doing front desk work. I know that if I could only do one provider in 8 hrs, it wouldn't be beneficial to work from home. If I could manage 4 providers in an 8 hr day, and at MINIMAL get paid the same as if I was working in an office (ex 2500 a month x 4 = 10k a month) The providers are happy, they are getting great service for the same or less than an in-house biller, and I get paid in a month what it takes others 4-6 months to make. I win, the provider wins. I really understand the reason behind the % billing, the motivation to do it, but lets be real. A BAD biller is a BAD biller. I don't like sales,and % billing is a sales position. I work each claim regardless of how I am paid because I enjoy my job, and I like to succeed. My knowledge will get me the $$ I deserve.

PMRNC

  • Hero Member
  • *****
  • Posts: 4217
    • One Stop Resources & Networking for Medical Billers
Re: Fees
« Reply #23 on: October 25, 2009, 02:17:44 PM »
Quote
I don't like sales,and % billing is a sales position. I work each claim regardless of how I am paid because I enjoy my job, and I like to succeed. My knowledge will get me the $$ I deserve.

I COULDN'T HAVE SAID IT ANY BETTER!!    ;D :D ;) ;D
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

jcbilling

  • Full Member
  • ***
  • Posts: 156
Re: Fees
« Reply #24 on: October 25, 2009, 02:45:13 PM »
You all mention the slidng scale...how does that work? Do you review certain reports every quarter and determine if the fee goes up or down? based on reimbursements? how does that work?


PMRNC

  • Hero Member
  • *****
  • Posts: 4217
    • One Stop Resources & Networking for Medical Billers
Re: Fees
« Reply #25 on: October 25, 2009, 04:41:17 PM »
Very simple, this might vary depending on the client/specialty, work, etc but I have a set amount lets say 10 for example; for every 10 additional patients added there is an additional charge, again this fee comes from working the numbers to come to my hourly rate. I say 10 because that's about the equivalent of an hours work.. some clients it's 5, some 20.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

  • Guest
Re: Fees
« Reply #26 on: October 25, 2009, 09:13:17 PM »
i do quarterly and yearly reviews.

MBP

  • Jr. Member
  • **
  • Posts: 85
Re: Fees
« Reply #27 on: October 26, 2009, 08:39:22 AM »
Charlene, you are talking about how many providers you can bill for in what time. i am new to billing and i am getting faster and more efficient the more i learn, but i still wonder if i am as effective as possible (considering the level of my experience). you said billing for 4 providers in 8 hours, how many claims daily or weekly/monthly, do you take care of? i know if varies by the specialty of the provider but i would just like to get an idea so i can compare my efficiency to a person who has been in the field for a while and is good at it. i cant really calculate my productivity yet as i am still sorting through a mess my provider got into after not having any biller for 4 months and that is very time consuming and confusing.

Pay_My_Claims

  • Guest
Re: Fees
« Reply #28 on: October 26, 2009, 10:23:15 AM »
Yes, it varies a lot depending on volume and specialty and SIZE of clinic. I prefer and really want to move to doing 100% DME billing. I really love that as opposed to medical billing. The time it takes for DME depending on what they ask (claims submissions v/s auth's and submissions) can determine how much time it would take for me to do them. The provider that I work for has 3 companies and is HUGE. If I had to be honest about it and do it from beginning to end, he would be my only provider without help. I would however make the money and make it well because I would be replacing 6 employees. This is how you have to determine cost as well. If you go to a provider and they have 3 billers, I wouldn't want to charge him the same as if he only had 1, that would be shooting yourself in the foot.
I can at minimal work 4 providers of average clinics that are in the gen med specialty. This would be doing full practice management. DME billing, I can manage about 6.

PMRNC

  • Hero Member
  • *****
  • Posts: 4217
    • One Stop Resources & Networking for Medical Billers
Re: Fees
« Reply #29 on: October 26, 2009, 08:20:07 PM »
here is a tip and it's a good way to not only measure your efficiency but create your very own Policies & Procedures along with a company manual which I think is important in case something were to happen to you.
To start, get yourself a 3-5 subject spiral notebook. Begin logging your time and procedures per client. Do this for about 6 months and review it, you will have a good idea of how much time you are spending on each client as well as where your time can be better spent. Basically keep a diary of everything even phone calls from patients or with your client, that counts as time spent on their account. What makes it difficult to figure out in a standard day is that every practice is different. For example I had a client that only saw patients twice a week so he was only generating 10 claims a week but yet he was terrible at getting his OTR's out, he missed authorizations, when I sat down to figure all this out I found those problems and ways to fix them efficiently so that I only had to spend 2 hours a week on him as opposed to 5 or 6 which was way out of line with his production. When you are all done and within 6 months you also have the beginning of a good policies & procedures guide for your business :)  Makes it easy if you need someone to step in and help or take over someday.. always plan for the unexpected!
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com