Author Topic: PA & fee splitting?  (Read 3689 times)

blhoffman

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PA & fee splitting?
« on: April 09, 2010, 08:59:02 AM »
I'm not sure if PA has a fee splitting law or not. I've done several searches and could not find anything. Any help would be appreciated.

I did check my competition out in my surrounding area. There are fourteen in my phone book, some are very far away from my city which was a surprise that they paid to advertise in our book. Out of the fourteen only four had websites. I googled them. I checked out their content and found that they all do it on a percentage - none are flat fee.

So that had me wondering about the fee splitting law I read about on this forum. Thanks for the help.

medauthor

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Re: PA & fee splitting?
« Reply #1 on: April 09, 2010, 10:14:11 AM »
Here is an article that states there is no law against fee-splitting in PA....scroll down

http://aaronbeny.com/regulations/PDFs/39_PA.pdf
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

Pay_My_Claims

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Re: PA & fee splitting?
« Reply #2 on: April 09, 2010, 10:54:20 AM »
AWWWWWW medA u r a newbie!! LOL

medauthor

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Re: PA & fee splitting?
« Reply #3 on: April 09, 2010, 02:42:16 PM »
Why do you say that Pay_My_Claims?? 
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

Pay_My_Claims

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Re: PA & fee splitting?
« Reply #4 on: April 09, 2010, 02:44:47 PM »
OMG look at your status it says Newbie...how does it feel to be a virgin again...ROFLMAO!!

blhoffman

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Re: PA & fee splitting?
« Reply #5 on: April 09, 2010, 03:00:09 PM »
If I wanted to do flat fee, how would I present that when all my competitors do percentage?

I like the idea of knowing what I will be paid each month. I've heard some people say they have had situations where the providers did not forward the remits and if that is the case, they would never know how much was collected really and what they should be paid.

medauthor

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Re: PA & fee splitting?
« Reply #6 on: April 09, 2010, 03:15:31 PM »
Charlene can help you with that....she is the Queen of Flat Fee!!  :)
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

PMRNC

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Re: PA & fee splitting?
« Reply #7 on: April 09, 2010, 03:21:49 PM »
I bill on a monthly basis and I love it, i would NEVER go back to percentage billing. What I do is a practice analysis of the potential client. I then figure out my costs, my hourly rate and voila.. a flat monthly fee. Mine is adjusted up by patient volume, for example one client is primary care physician so his volume usually increases.. when he reaches 10 new patients it goes up according to the hourly rate and gets added to the monthly fee.
It's great, I get paid MY hourly wage, they get a monthly fee and I'm compensated for ALL work I do. I should have done this all along :)
Linda Walker
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www.billerswebsite.com

Pay_My_Claims

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Re: PA & fee splitting?
« Reply #8 on: April 09, 2010, 03:27:56 PM »
BL Hoffman, I can't stand % billing. Too much work...I'm lazy...LOL
I consider several things in when I determine a fee. The amount of claims, the time it takes, what I want to make, incidentals and come up with a fee. You just have to really take into consideration everything when offering a fee. Also because we state that we are more cost effective than an in-house biller, many providers are looking for that savings. Percentage billing cost them more depending on the type of reimbursements they have. I quoted my first client (DME) 500 per month. Many think that is low, but her claim volume was low. I spent maybe an  2hours a month on her claims, therefore netting me $250.00 per hr. She may send me 5 claims, and they sent everything I needed. Her reimbursement for those claims were about 30K. my % rate was low, but do you think a provider would pay you 5% on 1o claims and that is $3,000??? We have to think about everything when we quote something to providers. I also look at the going rate for billers in my state. (10-16ph) so 1600-2,560 a month plus benefits is what they pay. I want my quote to be in that range, because they still save benefits and taxes on my services.

check out my website, my fee schedule is on it.

Michele

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Re: PA & fee splitting?
« Reply #9 on: April 11, 2010, 01:10:15 PM »
Most providers don't like their bill to fluctuate so you can use that to sell the flat fee. 

Michele
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Pay_My_Claims

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Re: PA & fee splitting?
« Reply #10 on: April 11, 2010, 03:47:51 PM »
Most providers don't like their bill to fluctuate so you can use that to sell the flat fee. 

Michele


True, also some providers are very much high $$ DME is one of them. My provider can see anywhere from 100,000 a week or more. Some of the medicaid checks alone are that much or more. When you consider we bill for custom rehab chairs that can be as high as $48,000 who wants to pay you 8% of that??? He will go broke.

blhoffman

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Re: PA & fee splitting?
« Reply #11 on: April 11, 2010, 08:39:14 PM »
All good points for me to remember and use. Thank you.