Author Topic: charging a %  (Read 5605 times)

PMRNC

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Re: charging a %
« Reply #15 on: February 11, 2013, 08:44:05 AM »
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I agree about what the industry is stuck on, but it doesn't negate what I've experienced, which is how I was answering her question. Some doctors in NY just don't want to work with any other pricing structure. And my response to the original OP is so she doesn't think this is odd (the pushback I mean), because I don't think it is, well not based on my experience and what I hear from fellow billers in my area.

Of course I can't dispute what you have run into, but like I said, I think it's the way we are educating our providers that is the key. I think doctors like all other humans just simply think something they know is the way to go (hey that rhymes) and they like many others have  resistance to change.   Perhaps it is the WAY the other billing model is being presented. When I present my flat fee, and the sliding scale, and a provider gets to sleep on it, they quickly realize this is a better deal. I do NOT think providers are thinking the way those billers are marketing .."Yeah.. they don't get paid unless they get me my money". I don't think I could insult physicians intelligence that way, whether they are businessmen or not. They usually can't argue with the information I give them in common sense terms. What if their accountant charged them on a percentage? Yikes.. but hey on a good note, they won't get paid till he gets paid?    MANY times my flat fee comes very close to an average percentage just by happen anyway. And also once they realize if they are not satisfied they get an out.  THAT is my incentive.   

A while back I sent out a newsletter to both current clients and to my marketing database of various providers. In that newsletter I addressed the fee-splitting laws. I included a comment from my attorney, reference to 2 case precedences, and a direct quote from a lady from the NY State Education Department, office of the professions, directly related to the NYS and we cited a quick reference to a couple of case precedences. Incidentally ONE of the cases was a radiologist who contracted with his OWN son based on a percentage of collections to which he charged his father a percentage of collections.  Anyway, the article definitely spiked interest as I remember getting calls for MONTHS about it. The calls were all a bit different. Some wanted to know more and some even wanted proof even though I provided all legal citing s, references and even case precedences. My own attorney got a plug out of it and would you know he only got 2 calls to my MANY?  That told me a LOT about my market at the time. I did not do it to "grab clients" though that ended up happening anyway.  So it was worth the time I put into it. I've been researching this topic for YEARS and I learn more and more about it. Those who continue to do it because "everyone else is" could end up in another newsletter somewhere I guess.   I've decided to do another one of these on a different topic hoping for same results <g>

Bottom line, you may encounter some physicians resistant to change, take the time to educate them and give them something to back it up and show your concern for their well-being. MAYBE they won't hire you right there, but give them enough to remember you for the future. :)
Linda Walker
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Billergirlnyc

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Re: charging a %
« Reply #16 on: February 11, 2013, 03:21:30 PM »
I think essentially we're saying the same thing. I've said in tons of topics on this forum that educating a potential client is the best move anyone can ever make, but there will still be doctors who are resistant even when you educate them. I doubt anyone on here is in the business of trying to lose business. I'm more than sure that folks are doing their very best to perfect their pitch. Mines is damn good but it isn't foolproof especially on those who are hellbent on believing in the myth of "we don't get paid until you get paid" pitch.

To Richard P, it's not a big deal you don't have to remove your comments, but I edited my comments because I wanted to come back with a link to the article when I got one, as it's a very interesting court case -- one I'll be watching closely.
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PMRNC

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Re: charging a %
« Reply #17 on: February 11, 2013, 03:41:42 PM »
NY has the most interesting cases of all states I researched. Florida runs a close second. There are quite a few cases of just fee-splitting but the ones I have found to prove my point best are the ones where there were billing companies involved in the fee-splitting arrangement.

Quote
I think essentially we're saying the same thing. I've said in tons of topics on this forum that educating a potential client is the best move anyone can ever make, but there will still be doctors who are resistant even when you educate them. I doubt anyone on here is in the business of trying to lose business. I'm more than sure that folks are doing their very best to perfect their pitch. Mines is damn good but it isn't foolproof especially on those who are hellbent on believing in the myth of "we don't get paid until you get paid" pitch.

I agree. Though it is hard to educate when some have already made up their minds.. because "Everyone is doing it"  ::) ??? :-\
Linda Walker
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RichardP

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Re: charging a %
« Reply #18 on: February 11, 2013, 04:12:35 PM »
Billergirlnyc said: ... you don't have to remove your comments ...

OK.

Billergirlnyc

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Re: charging a %
« Reply #19 on: February 11, 2013, 04:21:45 PM »
NY has the most interesting cases of all states I researched. Florida runs a close second. There are quite a few cases of just fee-splitting but the ones I have found to prove my point best are the ones where there were billing companies involved in the fee-splitting arrangement.

Yep. The case I was mentioning was in a trade newsletter for Physicians that one of my clients sent over to me. A NY doctor is suing the Dept of Ed over the wording in their statue about fee splitting. He's actually fighting that medical billers/coders shouldn't be a part of it. I thought it was interesting because here was a doctor who wasn't under any kind of investigation who was challenging the statue. He's hoping that it will be changed like the it was in Illinois ----> http://www.mcdonaldhopkins.com/news.aspx?id=dhm8QN3p4E-cNV1SJUT8KA. He wants special provisions made for medical billing companies and coding companies. That's the gist of the article. As soon as I find a link where anyone can read it, I'll post it.

Quote
I think essentially we're saying the same thing. I've said in tons of topics on this forum that educating a potential client is the best move anyone can ever make, but there will still be doctors who are resistant even when you educate them. I doubt anyone on here is in the business of trying to lose business. I'm more than sure that folks are doing their very best to perfect their pitch. Mines is damn good but it isn't foolproof especially on those who are hellbent on believing in the myth of "we don't get paid until you get paid" pitch.

Quote
I agree. Though it is hard to educate when some have already made up their minds.. because "Everyone is doing it"  ::) ??? :-\

LOL, so true. So very true!  ;D
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~Dalia, CPC, CPC-H, RHIT.

PMRNC

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Re: charging a %
« Reply #20 on: February 11, 2013, 04:55:28 PM »
I think I have info on the case your referring to.. I'll see what I have but meantime here's some more interesting reading:

The NY Bar Asso has had several requests for the verbiage change. This one in particular is a response to them from the NY Medical Society which I think really drives home clarification because this issue has been before the courts before.  With Illinois the law was more grey so they had more wiggle room to change. I don't think you will see NY change.. but what do I know.

 http://www.nysba.org/AM/Template.cfm?Section=Health_Law_Laws_Regs_and_Opinions&Template=/CM/ContentDisplay.cfm&ContentID=28915

Pg. 3:    By it's terms, section 6530(19) appears to prohibit arrangements which compensate a management service organization or billing company on the basis of a percentage of the income or receipts of a physician's practice. In addition, physicians and billing companies should be aware that courts have generally concluded that compensation arrangements between physicians and lay persons based upon a percentage of the income or receipts of a medical practice are void and unenforceable. See, e.g., Hartman v. Bell, 137 A. D.2d 585 (2d Dept. 1988); United Calendar manufacturing v. Huang, 94 A.D. 2d 176 (2d. Dept. 1983); Toffler v. Pokorny, 157 Misc. 2d 703 (Sup. Ct. Nassau Co. 1993).
Linda Walker
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PMRNC

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Re: charging a %
« Reply #21 on: February 11, 2013, 05:23:41 PM »
I have this one in my giant folder too though I cannot locate a source:  This is a Practice Management/billing company IN Florida (also state that prohibits physicians from fee-splitting contractual relationships, though that is NOT relevant, just a coincidence) who was suing a NY chiropractor for payment.. but OOPSIE... he's in NY so contract was null void.

On April 2, 1991, the Florida Circuit Court for Pinellas County granted a request for summary judgment made by a New York chiropractor who is being sued by PMA in Florida. The court ordered that:

    "The practice starter agreement is null and void under New York law (Education Law S6509-A, McKinney's Consolidated Laws of New York, Annotated) because it constitutes illegal fee splitting."


While the Florida court has found the PMA contract void for all New York chiropractors, PMA has argued that it still should be paid for the value of the services it provided to its client (quantum meruit). In order for PMA to receive any payment on its contracts with New York chiropractors, PMA will have to prove in court the actual value of its services.

PMA has appealed the summary judgment. The appellate court probably won't hear the case before November 1991.

According to Jean Simons, Esq., a Florida attorney who represents over 120 PMA clients as well as the New York chiropractor who won the summary judgment:

"New York has strict fee-splitting statutes which have been well supported by the New York courts. The Florida court has recognized the right of New York to regulate medical practices within that state by granting this summary judgment declaring the PMA percentage contract invalid for a chiropractor who practices in New York."
Linda Walker
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PMRNC

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Re: charging a %
« Reply #22 on: February 11, 2013, 05:26:22 PM »
Not beating a dead horse just trying to help. THIS is the lead article I give potential clients.  GREAT marketing article:

http://articles.submityourarticle.com/how-illegal-fee-sharing-may-cost-you-your-new-york-medical-license-51893
Linda Walker
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Billergirlnyc

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Re: charging a %
« Reply #23 on: February 11, 2013, 05:52:10 PM »
I don't think you're beating a dead horse, but the truth is since this effects this doctor's license he's allowed to fight the language or waste his money doing it. It won't change how I do business, but I will definitely be watching to see what happens. Maybe they'll do the opposite of what he's asking and specifically state third-party medical billing companies. Who knows.
Don't worry. Be happy.
~Dalia, CPC, CPC-H, RHIT.

PMRNC

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Re: charging a %
« Reply #24 on: February 11, 2013, 06:30:01 PM »
Quote
I don't think you're beating a dead horse, but the truth is since this effects this doctor's license he's allowed to fight the language or waste his money doing it. It won't change how I do business, but I will definitely be watching to see what happens. Maybe they'll do the opposite of what he's asking and specifically state third-party medical billing companies. Who knows.

I agree. I'm actually glad to be away from % based billing. The clients I have had that switched over with me have not ONCE complained. Their invoices are pretty comparative. I get paid for all my time as I deserve to be. I would never go back to a %. I think eventually the entire industry will be subject to similar laws that will in general prohibit fee-splitting PERIOD.  I kind of hope so because it better serves us to be held in a higher standard. Make sense? 
Linda Walker
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Billergirlnyc

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Re: charging a %
« Reply #25 on: February 12, 2013, 11:33:23 AM »
Quote
I don't think you're beating a dead horse, but the truth is since this effects this doctor's license he's allowed to fight the language or waste his money doing it. It won't change how I do business, but I will definitely be watching to see what happens. Maybe they'll do the opposite of what he's asking and specifically state third-party medical billing companies. Who knows.

I agree. I'm actually glad to be away from % based billing. The clients I have had that switched over with me have not ONCE complained. Their invoices are pretty comparative. I get paid for all my time as I deserve to be. I would never go back to a %. I think eventually the entire industry will be subject to similar laws that will in general prohibit fee-splitting PERIOD.  I kind of hope so because it better serves us to be held in a higher standard. Make sense?

Agreed and I think so too.
« Last Edit: February 12, 2013, 11:39:21 AM by Billergirlnyc »
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QueenAlicia

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Re: charging a %
« Reply #26 on: February 12, 2013, 04:54:33 PM »
My clients are on a flat fee.  The ones who want to be on a % have a minimum attached to it.  I don't feel it is an up hill battle. Either you want my services or you don't.  I know the value of what I my services are.

DMK

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Re: charging a %
« Reply #27 on: February 13, 2013, 10:42:29 AM »
Bravo!  Any doctor who wants to railroad you isn't someone you want to work for because there will be more trouble down the road.  Evidently there are some billers <wink wink> who just bill what they're given and will take any and all contracts.