Author Topic: Employees working at home  (Read 6568 times)

medco

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Re: Employees working at home
« Reply #15 on: October 17, 2012, 04:12:51 PM »
I don't have to spend $20,000 on computer software? I can just use theirs? If a doctor always used a clearinghouse does that mean the his computer isn't capable of doing his billing? Does he have to get it upgraded? Any help would be great.

midwifebiller

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Re: Employees working at home
« Reply #16 on: October 18, 2012, 01:25:51 PM »
Chiming in here. ALL of our contractors work at home. This has been a few billers, then grew to over 30 billers, AR specialists, benefits specialists, etc. Paying them per work (instead of per hour), solves the padded time card problem. Visiting their home office to check the set-up and compliance helps, too. Not everyone can work from home. We screen carefully when hiring and find out about kids at home, other family  members at home, schedules, basically as much as we legally can. If there is too much drama in her life, working at home will not work. We have had to let people go during their probation period when there was just too much drama or they couldn't stay on task. For the most part, I love having contractors with their own home offices. Instant Messaging, weekly team meetings and monthly face-to-face gatherings help hold things together and create an atmosphere of cooperation. I did have one biller come to my home office to work on the extra computer--and I didn't like it!  I guess I just like my space.
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

PMRNC

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Re: Employees working at home
« Reply #17 on: October 18, 2012, 04:08:08 PM »
Anyone with "access" must adhere to HIPAA regulations which do require login's to both the PM software AND that remote computer. So you can't just go sign on using doctors login. This is not just required for HIPAA but it's also a lifesaver for Audit trail. Suppose there is an audit, that person's login will be on the hook for any problems, and you can catch errors made by each person BEFORE it gets to a bad point.    For my clients I bill remotely for and logging into their system, I have not only a login for the PM software but I must first login with my OWN logmein credentials and then to their Windows, I have my own login as well.   All of that detail has to be outlined in your compliance plan.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

midwifebiller

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Re: Employees working at home
« Reply #18 on: October 18, 2012, 05:50:52 PM »
We use our own web-based billing program, not the midwife's, and each person has their own login. HealthPac has good audit reports which help keep track of when people log in, how much work they get done, etc.  It *would* be a nightmare if we could not keep track of each person!
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

Michele

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Re: Employees working at home
« Reply #19 on: October 19, 2012, 06:37:38 AM »
Wow you are the first positive case we've heard from.  Nice to hear it can be done.  :)
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PMRNC

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Re: Employees working at home
« Reply #20 on: October 19, 2012, 01:12:34 PM »
Quote
I don't have to spend $20,000 on computer software? I can just use theirs? If a doctor always used a clearinghouse does that mean the his computer isn't capable of doing his billing? Does he have to get it upgraded? Any help would be great.

If you are going to operate your own business, yes you will need a practice management system. Will you be able to access a clients computer / PM software? Yes if that's what they want, and yes if you plan to make sure you are in full compliance and you have a contract you are set, however for every one client you find that wants you to use their computer/software you will find 2 that want you to take it all.. so that means if you are going into business for yourself you will need to have a PM software system of your own. As a business owner you never charge your clients costs associated with "Doing business" such as attorney fees, insurance, coding books, continued education, memberships, software, etc etc. Any cost that is utilized by the business FOR the business is Never passed on to the client. IF you plan to work as an "employee" there are several things that must be done in accordance with IRS guidelines on both the clients end and your end. The client would need to provide ALL items needed, even the computer, software, etc in order to get any type of employee deduction allowed under IRS guidelines.   To give you an example, I had a client that left his practice and instead went into book publishing, he wanted me to work for him but he was in a different state, he went to his accountant who advised him that for an employee status he was better off finding someone inhouse because I would be using all of my own computer, supplies, etc and that wouldn't qualify him for any employee deductions.   

Point is that if your going to start a business you need to prepare to pay the start up costs as you would starting any business. If you decide you are looking to be an employee, well it's not advantageous for physicians to hire "employees'' to work from home, they get better deductions and lest out of pocket costs by hiring an outside billing agency/company.    I wrote this article from my website which should give you a good idea in weighing your options between starting a business and becoming a work at home employee.   http://www.billerswebsite.com/jobvsbiz.htm   I hope that helps.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

tallmanusa

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Re: Employees working at home
« Reply #21 on: November 12, 2012, 09:54:10 AM »
From what I can gather, there is a 80/20 rule in this business. (And in other businesses too). That 80% of the business is done by 20% of the companies. All of these medium to large companies outsource their work, some within USA, some off shore. Almost all pay for performance to persons who are sub contractors (not employees). Almost all use web based systems; for the most part web based system has no up front cost. Non web based systems are passe, like horses and bayonets.

The Superbill is also fading, the EHR is integrated, no Superbill is required. Good riddance.
Now how do these companies comply with HIPAA?

To find out who these companies are do a search on Google for " medical billing companies "; the top five companies do most of the business. Their websites describe that they offer web based integrated EHR.
The point is that this business has changed so much that it has not much in common with yesteryear technology. Some people still believe that you have to pay up front for software.
Even a small operator with few doctors has to compete with the major companies; if you have no cloud based system, no EHR, and no sub contractors to offer, I am not sure how far you would get.
« Last Edit: November 12, 2012, 10:11:11 AM by tallmanusa »

PMRNC

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Re: Employees working at home
« Reply #22 on: November 13, 2012, 02:21:29 PM »
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for the most part web based system has no up front cost. Non web based systems are passe, like horses and bayonets.

No way.. I disagree completely.. the #1 most widely sold PM system has been Medisoft for YEARS and it's still the most widely used.  Of all my clients total past/present only 3 had web based/ASP based systems.   

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The Superbill is also fading, the EHR is integrated, no Superbill is required. Good riddance.
Now how do these companies comply with HIPAA?

Ask them how EHR is working out in NY/NJ with the after affects of Hurricane Sandy..  It is my prediction this is going to be postponed, NOT for just that reason but for reasons having to do with Cyber Terrorism. It's already happened in small chunks and the middle east is only getting more tech savy on us. Plus you will have patients who exercise their right to "opt out".   Paper is not going away. I have many clients who don't want to lose some of the paper systems in place, they don't trust EHR's. MANY providers are even waiting until absolutely necessary.. most of their fears are based on the exact situation they are facing in the hospitals after the hurricane in NY/NJ, EHR was completely DOWN the entire hospital's came to a very scary stop. Also the government's track record with implementation of these types of things always includes a few years in postponements, they still have NOT ironed out the kinks in security.     As for compliance, again. The software companies make their solutions compliant, it's up to each provider to IMPLEMENT HIPAA security.   

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To find out who these companies are do a search on Google for " medical billing companies "; the top five companies do most of the business. Their websites describe that they offer web based integrated EHR.

No disrespect as i know your new, but I think you are putting way too much thought into EHR and forgoing all of the other "more" important aspects of having a billing/practice management company.   I've already contracted with a few companies to network with and give referral's (affiliate) because I don't plan to get involved in the EHR stuff at all. I'll let them handle that part :)

Quote
The point is that this business has changed so much that it has not much in common with yesteryear technology. Some people still believe that you have to pay up front for software.
Even a small operator with few doctors has to compete with the major companies; if you have no cloud based system, no EHR, and no sub contractors to offer, I am not sure how far you would get.

Again, I have to disagree, even with those solutions the MAJORITY of practices still do not fully trust internet. It's not the technology, it's the security that is the issue. I have talked to many clients with hangups on this issue and rather than try to talk them into something they are NOT ready for, I work with them, they retain the right to the same control, that's actually the number one marketing drawback in our industry, doctors are hesitant because they don't want to lose control. Why should I force technology when I can be an extension and ease them slowly.  I've seen too many billing companies lose potential clients because the client wanted to retain some control or use their software, etc.   
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

DMK

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Re: Employees working at home
« Reply #23 on: November 14, 2012, 10:52:00 AM »
Linda, you're my hero!

PMRNC

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Re: Employees working at home
« Reply #24 on: November 14, 2012, 11:02:12 AM »
I aint giving up my source documents that Cover my ass.. HELL NO! :)
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

DMK

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Re: Employees working at home
« Reply #25 on: November 14, 2012, 12:34:44 PM »
And Sandy was a bit of a litmus test for EHR wasn't it?  Can you imagine if you were in the hospital at the time, on a complicated set of medications and "poof" no one could find any information on you?  Scary.

PMRNC

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Re: Employees working at home
« Reply #26 on: November 14, 2012, 03:34:52 PM »
Very scary indeed. They are still in a PICKLE over this.. the power going out was one thing.. having your entire infrastructure go down when you rely only on that.. YOU got problems. I'll take any and all bets from those that think we will see MANDATORY EHR :) :) :)  You will lose :)
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

QueenAlicia

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Re: Employees working at home
« Reply #27 on: November 15, 2012, 03:20:33 PM »
A small company with no subcontractors can get pretty far. I AM a small company with 1 subcontractor that will be providing services for the new department that I am offering.  It can be done and I have seen growth over this year so I  disagree.  Many members from this own site have reached out to me for advice because they have seen me start from NOTHING!  Do not under estimate the small company's because they don't remain small forever.

I think that some people should be in this business as a business not as a biller but the actual owner for awhile so that they can be able to give valid observations.  Many practices are now just jumping on board for EHR, many haven't attested yet. 

The web based system that I am leaning towards getting to invest for clients that don't have their own or don't care what system I use has a down payment and is an industry leader.

tallmanusa

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Re: Employees working at home
« Reply #28 on: November 15, 2012, 04:58:58 PM »
What web based system is that?

QueenAlicia

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Re: Employees working at home
« Reply #29 on: November 15, 2012, 09:39:12 PM »
NueMD.  Also if you want to get specialty specific Bright tree, Office mate and a few others require a down payment.

Those that don't require a huge payment every month such as $499 a month per provider.  The only one that can compete with everything at a lower price is Kareo.  You can research others such as Total MD, Advanced MD, Omni MD, Care Cloud.

Like I said I started from nothing, spent money investing in things that I wish I didn't, so taking the time to invest in software has been a long process for me.

From the website to pricing it has been a long process for me but my business has grown and prospered.