Author Topic: Optometry Billing  (Read 875 times)

galinafl26

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Optometry Billing
« on: March 14, 2014, 01:04:56 PM »
Hello Everyone!

I am about to take on a new Optometry account. He's a provider in Florida who will be doing medical billing. All I will be doing for him is billing insurance companies for medical diagnosis. I am aware that I am not allowed to charge a percentage billing in the state of Florida, however, I have no clue how much to charge him for a flat rate service. He told me that 30% of his patient's have medical diagnosis and those are the patients that he would like to submit to insurance companies.
I would really appreciate all your help!

Thanks!
Gayle

Michele

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Re: Optometry Billing
« Reply #1 on: March 17, 2014, 05:19:54 PM »
You need to have more information in order to come up with a flat fee.  How many patients does he see in a week/month?  What is his average charge?  Does he do testing or just exams?  Will you be doing patient billing?  Once you find all of that out you can determine a flat fee.  There are a couple of different methods.  Some people calculate how much time it should take to do that amount of work, some people calculate an amount that the doctor should collect based on their work and multiply by a % to determine the flat fee.  Example:

Dr sees 50 patients per week.  Average charges per patient are $200 (he performs testing and exams).

    50 pts
x  52 wks per yr
x$200 charges per patient
= $520,000

Then say the dr only collects about 70% of amounts billed (due to contractual adjustments, etc)

$520,000
x 70%
$364,000
x   6% (average billing service charge)
$21840.00
/ 12  months in a year
$1820   Flat fee for billing

Or

Dr sees 50 patients a week.  Estimated time to do account is 10 hours per week.  (Allow for data entry, aging, appeals, pt billing, etc.)

$40  (hourly fee - keep in mind this is not a fee that someone would be paid to work hourly, but you have to take into consideration all of your other expenses, insurance, office space, software, updates, clearinghouse fees, printing expenses, etc.)

$40
x 43.33  (hours - 10 hours per wk x 52 wks per yr / 12 months to get the average per month of hours)
_________
=$1733  Flat fee

All of the above figures were pulled from midair!

Hope that helps!
Michele
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