Author Topic: Help!  (Read 7383 times)

carnilent

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Help!
« on: September 17, 2009, 07:48:08 AM »
I started with my first client in May of 09.  ( family practice )

Since the beginning it started off on the wrong foot.   The girls at the office ( 2 of them) are totally
uncooperative.   they fax over the superbills,  with little or no patient demographics.
which causes us to produce a list of patient names that need complete demographic info. when this list is faxed over we are told she already faxed the info to us.   ( which we have not received anything )

On July 17, we had a meeting with the Dr. and her staff ( 2 ), we advised that we needed for them to send us complete demo. information on every patient.

They don't even tell us when payments have come in so that we can post them.
 ( we get reports from ins co. saying they are paying)  All payments started coming in August.

 I have spoken with the Dr. and she says that her staff is trying their best,
 but she is aware that they are not giving us the appropriate information that we need.

 What can we do at this point?     I have superbills in folders that can't be billed because of no demographics info.   If I fax a list of the names to the client's office they get all bent out of shape because they have to pull the chart.


Any suggestions will be apreciated.

carnilent  :-\



Pay_My_Claims

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Re: Help!
« Reply #1 on: September 17, 2009, 08:17:20 AM »
They may feel threatened. You need to convey your position is to assist. Ask for their input on implementing a plan of action that will help them be able to get you the information you need without interfering too much with thier daily routine.

Do you have the insurance information??? Often you can get all the information you need from the insurance carriers system when you verify the plans (if you are doing that). I'm not suggesting that this should be the answer to your problem, but it can be a way to assist you until you can iron out the issues you are having. Being it is family practice you should start seeing a lot more of repeat clients who are already loaded in your system

If they are using a system generated SuperBill that doesn't include client demographics you should have all that included. If it does have it on the superbill and it is an issue of not updating the system, that is where you will need to get some direct assistance from as well.

The superbills that I get have the ins. info, demo, and all pertinent info on it, so I guess I'm blessed

carnilent

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Re: Help!
« Reply #2 on: September 17, 2009, 09:10:54 AM »
thank you.     Their superbills are hand written and they have to fax us a copy of the patient's face sheet
along with copy of the ins. card ( which we don't get all the time. )

 
thanks for helping.


carnilent  :)

PMRNC

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Re: Help!
« Reply #3 on: September 17, 2009, 09:52:19 AM »
I have had unorganized clients with unorganized staff and this is where you become the "educator". What I usually do is go in for a meeting with a complete description of the problems AND solutions. For example one of your problems is receiving the EOB's. For this I would actually go into the office and create a work flow which would guide the office staff every step of the way.. an Out box next to the fax machine with a coversheet all ready to go works well, they put the EOB's after being opened, check being detached and deposit logged into the "out" box face down. The daily coversheet is first in the box. Another problem they have are the handwritten superbills. Offer to create them one or point them to a reference where they can order them.   Organize everything in easy to implement steps and then set up your meeting. Fax over a copy of what you will be going over with them ahead of time to let them prepare.  Use your judgement on whether you should charge for this as a consult. I usually offer them the consult with a 10 day clause that if they don't get their act together the consult fee will be charged.  If after all of that they are still not compliant, refer to your contract and act accordingly, some practices are just so resistant and they are not willing to be taught and you just have to let them go.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

carnilent

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Re: Help!
« Reply #4 on: September 17, 2009, 10:14:19 AM »
thank you.    their staff is very reluctant to any ideas,  we haven't even been able to send them our first invoice.   Because we do not have the EOBs.   I might be setting them up with a monthly flat fee for billing services.   ( I wasn't aware of the florida split fee law. ) 



 carnilent  :-\

PMRNC

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Re: Help!
« Reply #5 on: September 17, 2009, 10:26:41 AM »
Well the first thing I would do if I were you would be to correct your contract AND your method of charging FIRST! Going flat is good because you can then decide what you want to make for your time.. you can then explain this method to the provider thereby offering him an incentive to get the office to work with you. For example you might be spending 30 hours on this account and possibly 10 of those hours could be saved just by having them get their act together.

The formula I use is

Decide on hourly rate
Deduct Costs (clearinghouse fees, forms, postage, etc)
Hours per week this acct will take

You can create a sliding scale based on increase of hours by account or by the account itself.

I like this method MUCH better than % because I am getting paid for everything I do which is especially helpful when you do come across those types of clients.  Hitting them in the "pocket" usually does the trick. When I charged on a % I used to increase the % for accounts I had to research due to the practice not sending me what I needed so they usually learned pretty quick <g>  For chronic offenders that I just can't seem to educate or get to cooperate I begin charging them another fee based on the extra work I had to do from them not sending me what I needed.  Of course all this has to be spelled out in your contract.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: Help!
« Reply #6 on: September 17, 2009, 10:38:56 AM »
Good ideas Linda. Organization and preparation are very key. Good blessings to you C.

carnilent

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Re: Help!
« Reply #7 on: September 17, 2009, 01:36:38 PM »
very good,  thank you  :)

carnilent

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Re: Help!
« Reply #8 on: September 17, 2009, 06:24:52 PM »
How do I go about letting my client know that we are going to change to a flat rate?
Do I let her know about the split fee law?

carnilent  :-\

PMRNC

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Re: Help!
« Reply #9 on: September 18, 2009, 06:04:13 AM »
If your contract is not able to be changed according to the terms then yes I would present the issue by writing a letter.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

carnilent

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Re: Help!
« Reply #10 on: September 18, 2009, 06:38:01 AM »
Thanks Linda.

carnilent

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Re: Help!
« Reply #11 on: September 18, 2009, 05:18:24 PM »
I'm stuck with the hourly rate. I am confused as to what rate to charge.

I'm trying to charge my client an hourly rate that is below what she would pay someone to work in her office.     Right now I am spending 40 hrs per week  9am _ 5pm mon - fri.

What would be the going hourly rate for a medical biller in Florida?
is it between $12-$15.?   

 

carnilent  :-\

Steve Verno CMBS, CEMCS

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Re: Help!
« Reply #12 on: September 18, 2009, 07:12:56 PM »
You have at least 2 choices.

Meet with the doctor again (without the two staff members).  Show numbers of lost income.  yours and his.  Show him how his staff could open him to possible audits, and investigations.

terminate your relationship with the doctor.
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Pay_My_Claims

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Re: Help!
« Reply #13 on: September 18, 2009, 07:46:15 PM »
I'm stuck with the hourly rate. I am confused as to what rate to charge.

I'm trying to charge my client an hourly rate that is below what she would pay someone to work in her office.     Right now I am spending 40 hrs per week  9am _ 5pm mon - fri.

What would be the going hourly rate for a medical biller in Florida?
is it between $12-$15.?   

 

carnilent  :-\

I'm not sure what the rate is for FLa, but I know what my rate is and my worth. What are you doing to cause you to spend 40 hrs on 1 client?? This is something you need to address in order to make your business successful as well.

carnilent

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Re: Help!
« Reply #14 on: September 19, 2009, 04:29:07 AM »
You're right, I need to make some changes.   


 Thanks