Author Topic: Getting Payment from Physician's  (Read 2610 times)

galinafl26

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Getting Payment from Physician's
« on: November 29, 2012, 06:08:16 PM »
Hello Everyone! I just got a new account and it's my very first one. I wanted to know what report I should run to bill for my services? Do you guys run a monthly posting report? How do you make sure he's giving you all the eob's? Can someone help me with this process.
whats the best report to run at the end of the month?
Thanks

PMRNC

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Re: Getting Payment from Physician's
« Reply #1 on: November 29, 2012, 06:45:45 PM »
This depends on how you are billing your client and what's in your contract.  ASIDE from that your going to want to provide your client with many reports needed for him each month. Do you have a contract?
Linda Walker
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Michele

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Re: Getting Payment from Physician's
« Reply #2 on: November 30, 2012, 10:05:12 AM »
It will also depend on your PM system and what reports it provides.
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galinafl26

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Re: Getting Payment from Physician's
« Reply #3 on: December 03, 2012, 01:04:08 PM »
Yes. I have a contract. As per my contract, I get paid from monthly collections. I'm charging this doctor 7.5 %. Would I run posting report? What report is best ?? My pm system runs any report I need.

PMRNC

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Re: Getting Payment from Physician's
« Reply #4 on: December 03, 2012, 04:06:48 PM »
You are going to need to go into your reports and look for the report you need. You don't specify if your contract says 7.5% of ALL practice Collections, or 7.5% of what You collect, etc. There's a difference. I can't tell you what report to run, only you can do that based on how your entering your data.. more importantly how you are entering your payments into your database.  For example, if your contract says you get paid 7.5% of what your billing out, your payment codes would need to be broken out appropriately to distinguish the various types of payments in house vs. what's sent in from your billing.   ONLY good data going in, is going to be good data out. If you have not made those distinctions in your software than your going to have a very rough time figuring how to calculate your invoice.  When I did % based billing all of my payment codes were VERY specific..this way I could actually run a report based on whatever payment codes I used to show the payments I was bringing in. In my case I billed percentage of collections on ALL revenues received, so I could run my report using all of the pmt codes.
Linda Walker
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galinafl26

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Re: Getting Payment from Physician's
« Reply #5 on: December 04, 2012, 06:20:48 PM »
I am even more confused now than I was before asking a question on this forum. I collect money for what I collect. So did you run your report by posting dates? Lets say you started billing December 1,2012..so you would run a posting report from December 1st? Can you be a bit more specific please!

PMRNC

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Re: Getting Payment from Physician's
« Reply #6 on: December 04, 2012, 06:50:02 PM »
Quote
I am even more confused now than I was before asking a question on this forum. I collect money for what I collect. So did you run your report by posting dates? Lets say you started billing December 1,2012..so you would run a posting report from December 1st? Can you be a bit more specific please!

I'm not trying to be difficult but indeed it WILL matter what your contract says. Going by what you say, you are collecting your 7.5% on revenue YOU collect? If that's the case and hopefully when you posted payments you used a specific payment code to differentiate what YOU were collecting/posting. For example, if you were posting patient co-pay's collect at the time of service, you would have wanted to give it a code of it's own. Likewise if your client receives a payment from the patient via mail because of a bill you sent out that would be another payment code. Another one would be a payment code to differentiate each insurance payment.   If your contract states you will only collect 7.5% from YOUR collections, you can't run a report of line item posting because there will be payments made that you did not collect (time of service, out of pocket).   With that said your best bet is to run a report using the payment codes.   So for example if I were to bill a % of what only "I" collect, I would run my report on all payment codes assigned to those payments I posted as a result of my billing.

Like I said.. Good data in is good data out. If you did not setup your database with reporting in mind, your going to have a very difficult time of it.

IMHO.. I would never charge a provider ONLY what I'm collecting. When I billed a % (I don't anymore) my contract stated it was a percentage of FULL PRACTICE revenue, because it was MY time in posting ALL payments. 
Linda Walker
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galinafl26

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Re: Getting Payment from Physician's
« Reply #7 on: December 04, 2012, 08:14:55 PM »
my contract also states that I collect a percentage of full practice revenue however this particular doctor doesn't go crazy collection copayment or deductibles. Again, I can't get my question answered. Do I run an aging report based on whatever was posting to invoice my doctor?

Michele

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Re: Getting Payment from Physician's
« Reply #8 on: December 05, 2012, 09:05:09 AM »
The only way to know if he's giving you all of the eobs is to run an aging report and check all outstanding claims.  If they were paid, but you weren't notified, most likely he's not giving you all the eobs.

As for the report question, the reason your question isn't getting answered is because there is not a one word easy answer.  It truly depends on a lot of things, mostly how it's worded in your contract.  I'm going to assume it's not spelled out in the contract.  IF that is the case then it will just depend on how you set it up, and then you need to stick with that.  So if you start out doing by posting date and then continue that way, it should be fine.
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galinafl26

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Re: Getting Payment from Physician's
« Reply #9 on: December 05, 2012, 10:41:25 AM »
Michele,

Thank you so much for answering me. I actually understood you. I will stick to the monthly posting report for invoicing him.

Thanks,
Gayle!

PMRNC

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Re: Getting Payment from Physician's
« Reply #10 on: December 05, 2012, 11:58:29 AM »
It also depends on how you setup your database. Pulling ANY report from any PM system is not black/white.  If you are not organizing your database properly or according to what you want to report on, you won't get the report you want. That's why I said that IF you were basing your report on FULL practice revenue, an aging report would work, but a report ran on all payments would suffice for you to invoice your provider.   

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The only way to know if he's giving you all of the eobs is to run an aging report and check all outstanding claims.  If they were paid, but you weren't notified, most likely he's not giving you all the eobs.

Again, this is why it's important to have your database as organized and specific as possible. It will take the guess work out.  When I did a % of collections I was able to do a SIMPLE report based on my payment codes because I had setup that way.  I didn't want to have to match claims/EOB's, etc. Too time consuming.

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my contract also states that I collect a percentage of full practice revenue however this particular doctor doesn't go crazy collection copayment or deductibles

This is why I couldn't give you a more clear answer because you answered this in two different ways, the above is quite different than what you said previously:
Quote
I collect money for what I collect.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com