Author Topic: Subcontractor  (Read 7060 times)

jyoung65

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Subcontractor
« on: February 16, 2011, 05:06:43 PM »
I will be needing subcontractors soon, I have no clue on how to pay them for their services. Would I pay a percentage or flat rate?

I have been searching the web, for a sample of a medical billing subcontractor agreement. Had no success can anyone direct me to a website, to review a sample of a  Medical Biller subcontractor agreement?

Thanks;)


Michele

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Re: Subcontractor
« Reply #1 on: February 16, 2011, 05:49:59 PM »
Do you mean to do billing for you?  But not to pay them an hourly rate but to pay them some sort of flat fee or % based on work?

Michele
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jyoung65

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Re: Subcontractor
« Reply #2 on: February 16, 2011, 06:39:53 PM »
Yes, I need to know how to pay a Medical Biller subcontractor.

PMRNC

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Re: Subcontractor
« Reply #3 on: February 16, 2011, 06:43:23 PM »
i would think you can reimburse them however you want really. I would NOT use sample contracts.. I would have them drawn up and include a good non-compete of some sort as a deterrent. Non-competes don't always hold up, but a good attorney can get it as good as you need it for your state.
Linda Walker
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midwifebiller

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Re: Subcontractor
« Reply #4 on: February 16, 2011, 07:32:44 PM »
I only hire independent contractors (not employees) and it has worked very well for me.  A few things to remember:

As a contractor, they must send you an invoice. Some contractors will already have their fees (per hour, per job, or otherwise), some will not and you will need to negotiate a fee.

Also, as a contractor, they must be allowed to work for other companies.  They may choose to only work for you, but if you were ever audited, this is one of the things they look for.  A non-compete clause is a red flag for a tax auditor and not enforceable in many states.

Your Agreement should clearly state 1) what their responsibilities are; 2) what your responsibilities are; 3) the fact that they are an independent contractor and therefore responsible for their own taxes, business licenses and equipment; 4) payment rates and time schedules; 5) contract terms, including grounds for termination.  An accountant can help you with the differences between an employee and a contractor (also good info on irs.gov) and, as stated above, an attorney can help with the legal-ese of a solid contract.

We had one contractor who we had to let go, then she came back demanding unemployment benefits.  Our Agreement clearly stated she was not an employee, but a contractor and it saved our backside. 
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

PMRNC

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Re: Subcontractor
« Reply #5 on: February 16, 2011, 07:49:13 PM »
Quote
Also, as a contractor, they must be allowed to work for other companies.  They may choose to only work for you, but if you were ever audited, this is one of the things they look for.  A non-compete clause is a red flag for a tax auditor and not enforceable in many states.

Ugh I didn't even think of that.. EXCELLENT points.   So do you think it's better than employee's? Seems to me in this line of business the contractor could easily worm their way into your clients?  Maybe it's better expense wise?  What's the appeal over an employee?  I'm just curious. I couldn't get anyone to work for me for double my own salary.. LOL I'm too difficult so I keep things at a level I'm comfortable with and refer the rest out to my awesome networking buddies!
Linda Walker
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medauthor

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Re: Subcontractor
« Reply #6 on: February 16, 2011, 11:13:47 PM »
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

Markland Medical Billing

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Re: Subcontractor
« Reply #7 on: February 17, 2011, 12:53:08 AM »
Hello.
Does anyone know if an independent contractor can work in your office without confusing independent contractor relationship?

Also, anyone know of any free medical billing course online or has access to study guides for the certification test?


"Pray without ceasing and in all things, give thanks."

PMRNC

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Re: Subcontractor
« Reply #8 on: February 17, 2011, 07:55:55 AM »
Quote
Does anyone know if an independent contractor can work in your office without confusing independent contractor relationship?

I will defer that to someone who uses independent contractors. My guess is no they shouldn't be working at your office and I'm sure there are IRS guidelines on what would actually constitute an independent contractor ?

Also, anyone know of any free medical billing course online or has access to study guides for the certification test?

No, not free and if you were to find one I would really have to question it's success.
Also there is NO ONE NATIONAL CERTIFICATION FOR MEDICAL BILLING, there are various certifications put out by various associations, but do your research before you put out the money. Many will lead you to believe you will be "NATIONALLY" Certified, well IMHO that's only because they can say that if they sell the course "NATIONALLY"  ??? Putting that aside, the BEST course I have seen and mostly because it is geared towards those who want to start their own business is www.medicalbillingcourse.com  you actually have access to software later on in the chapters and will get to submit practice claims as well. It's VERY well written and we have NUMEROUS members who have gone through this course, they are very hands on and support is wonderful.  I always tell people, their certification you receive is ONLY as good as the education you receive with it, without that, they are just a few nameless letters next to your name that mean nothing.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

jyoung65

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Re: Subcontractor
« Reply #9 on: February 17, 2011, 09:21:24 AM »
Thank you for all your answers, very enlightening. I did not know that IC give you a price for their services. I thought it was the other way around, you tell them what you pay them for their services. I really would like to hire local IC, only because I would like to meet with them face to face to interview them and have meetings.

Before I hire a IC what are some things, that is a requirement? Is it E&O insurance, business license and to be bonded? So it is the responsibility of the IC, to have their service agreement and I just need to sign it?

« Last Edit: February 17, 2011, 09:39:15 AM by jyoung65 »

PMRNC

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Re: Subcontractor
« Reply #10 on: February 17, 2011, 09:55:32 AM »
I had a false interpretation of what an IC was too.  It does make sense to me that the IC would set their fees, and yes I am also guessing there would be a contract as well as a HIPAA /HITECH BAA's. In terms of E&O.. again I am guessing here based on what I am learning as well about IC's it that they should be carrying THEIR own E/O. Also since they are IC's just like with Subcontractors you would need to inform your client and add a clause in your own contract with the client to disclose this fact. They in turn would also need your HIPAA BAA to include that information.  I can't really say about the "Bonding" except to say that unless they will be handling the monies directly or acting as a collection service you wouldn't need them to be bonded.   

With all that above, that was why I was wondering if it really is that advantageous to do this vs. hiring an employee?
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: Subcontractor
« Reply #11 on: February 17, 2011, 11:19:24 AM »
We hire employees, not sub contractors, but we have them sign a non compete clause.  We learned the hard way - and I mean hard!  Anyway could have been worse.  But when we asked our employees to sign it (the existing ones when we decided to implement it) only one gave us a hard time.  (Another gave a little of a struggle)  The one said "I would never do that!" but wouldn't sign the form.  Like Linda said, many times they aren't enforceable.  But her not wanted to sign spoke VOLUMES to us.  She is no longer employed here.   :)   When she left we looked at the other employee and said "do you want yours back?"  She declined.  There's that hind sight again!

Michele
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medauthor

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Re: Subcontractor
« Reply #12 on: February 17, 2011, 07:30:53 PM »
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

midwifebiller

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Re: Subcontractor
« Reply #13 on: February 20, 2011, 12:06:51 AM »
Markland--Yes, a contractor can work in your office. My brother is an independent contractor who worked at Boeing for years. Microsoft also hires independent contractors who work in their offices (yes, I'm from Washington).  As long as the rules are followed, it works.

Linda--I got very tired of the "time-clock mentality" of some of the workers in my previous business partnership.  They felt as long as they were on the clock, they could reorganize their filing cabinet, re-label their folders, clean their desks for three hours, sit on hold for 45 minutes, etc., etc.  When I left the partnership,  I decided to do things a little differently.   So far, everyone is happy to be on the billing end, with that layer of management (me) between them and the providers (we've got some real firecrackers for clients). They appreciate the tax write-offs and having the freedoms a contractor-status brings them. I have found contractors who are certified billers/coders and are self-employed bring more of a sense of pride in their work.  I certainly am not doing nearly the baby-sitting that I was before!  I do ask for a detailed time card with every invoice.  This lets me see which providers are taking up the most time and where problems might be.  For example, we had one midwife who would call her biller and take two hours of her time with claims questions.  She would do this every week or so.  I saw the pattern on the time card, and we nipped that in the bud.  (We all work from our home offices.)  Having contractors also makes payroll a lot easier.  :-)

JYoung65--I do have my own "fee schedule" of what I'm willing to pay a contractor, based on her experience and training.  If the contractor does not have her own price, I will make an offer.  I also work with interns, but that's a whole different topic.
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

Markland Medical Billing

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Re: Subcontractor
« Reply #14 on: February 21, 2011, 10:07:36 PM »
Thanks! You guys ROCK!
"Pray without ceasing and in all things, give thanks."