Author Topic: What to charge?  (Read 2008 times)

DavidZ

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What to charge?
« on: September 23, 2009, 08:22:36 AM »
What do you usually charge a client to do a Follow-up on unpaid insurance claims?

PMRNC

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Re: What to charge?
« Reply #1 on: September 23, 2009, 10:28:38 AM »
If you are billing based on a percentage of collections, this would be included because it goes with FPM.
If you are billing by claim, then again your claim costs should be calculated into your per claim fee.
If you are billing on flat rate or hourly rate.. same apply's

The only time you would charge (IMO) would be if you were billing on a "PER" service fee..

And as always, consult your contract.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

DavidZ

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Re: What to charge?
« Reply #2 on: September 23, 2009, 10:52:03 AM »
This was just a question from a provider that is not on a contract with us yet, to see what would the cost be.

Pay_My_Claims

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Re: What to charge?
« Reply #3 on: September 23, 2009, 12:14:48 PM »
This was just a question from a provider that is not on a contract with us yet, to see what would the cost be.
it would all depend on what he is expecting. The closest I do to this is cash recovery, and I base this upon the outstanding AR, the age of the claims, and the type of payor and services rendered. I charge a FLAT fee and offer no guarantee of payment. This is a very time consuming task, and documentation is key for me. I give constant updates on claims. When all claims are finalized, paid, or all appeals exhausted, they get the final report.

cquinn

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Re: What to charge?
« Reply #4 on: October 12, 2009, 10:16:36 AM »
I have a meeting with a potential client tomorrow.  He is a general surgeon.  I am in Florida and have been informed that I cannot bill by percentage, as it is considered fee-slipping.  I am a little confused on how or what I should charge this type of physician.  I have spoken to a dr (chiro) friend of mine and they are telling me that since I am not collecting the insurance checks, I should be able to charge the % rate and it is not considered fee-splitting, I am just charging my fees. 

Can anyone let me know if how the insurnace checks come in actually make a difference in how "fee-splitting" is determined?  Also, would appreciate any input from people who bill general surgeons on what they charge.

thansk.

PMRNC

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Re: What to charge?
« Reply #5 on: October 12, 2009, 10:39:55 AM »
Your friend is wrong. Florida is very clear on what constitutes a fee-splitting arrangement. You get a percentage of what they collect ..there's no Grey area.. your "splitting the fees". Also your friend would be interested to know that it would be the provider who is acting ILLEGALLY not the billing company, they just wouldn't have a valid contract to stand up in court, the provider can be sanctioned.   

It really is NOT difficult to find out what to charge a client. When you figured out a percentage you wouldn't (or I hope not) pick a number from the sky. You are accumulating the same data needed to formulate your charges, minus expense, time, and what you want or should be making (level of experience should determine this).  So many billing companies seem to have a problem converting their minds over to a non-% way of charging and I think it's just a mental block because it's actually easier to formulate and even better, easier to execute and/or terminate. If you are billing a % of receivables and you terminate the contract (or the client does) your left with a few months of clean up, a chance the provider won't pay you, and if you are in a state where it's illegal for the provider to enter into a fee-splitting contract you don't have a contract .. it's null/void so you could be left being owed a lot of money. Charging a flat fee, monthly, hourly, etc is all EASIER and the best part.. YOU get paid what your worth because your initial pricing is based on what you want/expect to make.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

MBP

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Re: What to charge?
« Reply #6 on: October 12, 2009, 10:42:30 AM »
I am curious to see the responses, i bill for gen surgeon in michigan, i am actually an employee in her office paid hourly and i feel quite underpaid :-\ she was without a biller for 4 months and gosh, i am still sorting through things. it was so difficult to get organized. i had no reports or anything from previous biller just most of the eobs, as the surgeon and the ex biller didnt end on good terms. i dont even know what pm was the ex biller using, had to start from scratch. can't compare with other types of providers, but for me this was "a bit" frustrating at the beginning when i was trying to get into it and actually understand it. took quite a few rejections first... learning on own mistakes  ;)