Author Topic: OB & GYN  (Read 2554 times)

SnyderKristine

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OB & GYN
« on: April 02, 2014, 04:36:46 PM »
Hi All,

Need your help once again with the pricing. I have never done billing for OB&GYN before, but I have a prospective client that is interested in billing services. Here are some details I could gather:

She sees 12-14 patients in a day
Does 1-2 surgeries in a week
Will handle coding and claims submission herself

How much time would I have to spend on her account and how much can I charge her for that? FLAT FEE finally!

P.S.: She is already using a biller and doubt her capabilities, therefore she is looking for an alternative!

PMRNC

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Re: OB & GYN
« Reply #1 on: April 02, 2014, 05:08:09 PM »
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Will handle coding and claims submission herself

If she will be coding and submitting claims what exactly does she want you for?

Quote
How much time would I have to spend on her account and how much can I charge her for that? FLAT FEE finally!

Would need to know in more detail what you will be doing if she's doing her own claims.

Quote
P.S.: She is already using a biller and doubt her capabilities, therefore she is looking for an alternative!

Always a plus to sell what YOU can do better, just stay out of the contractual relationship between her and the other biller. DO find out what the other biller was doing, how well or not so well she was doing it, and offer alternatives.

Hard to say how much time without knowing exactly what she needs you to do.  HARD to do full practice management with the bulk (claims) being done by the provider, that's sort of the meat in the meat and potatoes. 
Linda Walker
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www.billerswebsite.com

SnyderKristine

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Re: OB & GYN
« Reply #2 on: April 02, 2014, 05:23:05 PM »
She basically wants me to handle insurance claims follow up, ageing and patients collections. Though I have offered her complete billing including claims submission.

kristin

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Re: OB & GYN
« Reply #3 on: April 02, 2014, 05:52:51 PM »
A lot would depend on her A/R, accuracy of patient demographic info, her coding skills, and how you would be applying payments. If her A/R is pretty current both from patients and insurances, patient demo info is accurate, her coding skills are good, and you can auto-post payments, it shouldn't take you a lot of time to work the account.

If her A/R is bad in either patients or insurance payments or both, patient demo info isn't updated/checked, her coding skills aren't the greatest, and you have to manually apply payments...you could spend a lot of time working her account.

I think you need to gather more information at this point, in order to price the flat fee, and know how much time you will need to work the account. And even if you give yourself what you think is a lot of time to work it, you will always need more time.  ;)




Michele

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Re: OB & GYN
« Reply #4 on: April 03, 2014, 09:20:55 AM »
I agree.  Is she expecting you to go back and clean up the old A/R?  Or are you just starting from one date of service?  If you are going back that makes a big difference.
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PMRNC

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Re: OB & GYN
« Reply #5 on: April 03, 2014, 12:11:32 PM »
Here's what I do when I have a potential client. Once I have a signed BA, I give them a list of reports I need. (depends on what they want done). So for example if I was going to only clean up A/R and do patient collections I would want a few DIFFERENT types of aging reports. I would want a patient aging (patient only balance and then another report of insurance aging and claims report of all claims submitted, pending, etc. If doing followup only I usually like to have that report BY carrier (detail claims summary).   Once I have all those reports I can then figure out time needed and go from there. I NEVER ever quote any pricing to any client w/out looking at what I'm getting into <g>.  Keep in mind that if you are not doing current claim submissions, you have more of an incentive to do a good job and get that service. Another reason you want to know what your looking at ahead of time is so that you can do your contract accordingly as well.

Good opportunity :)
Linda Walker
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One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Christy

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Re: OB & GYN
« Reply #6 on: April 04, 2014, 01:29:10 PM »
Why not just bill an hourly rate? It's a win/win situation- you get paid for all of the work that you do and the doctor only pays for the services that she needs.

I bill all of my clients hourly. They are all small, independent practices with fluctuating patient populations. I charge $25-$30 per hour and I find that it's often equivalent to 8% of practice revenue or $3-$4 per claim, which is pretty standard in our industry.

I use Practice Mate PM which is free, or I use the client's software. My overhead is quite minimal- postage, ink, paper, fax....
« Last Edit: April 04, 2014, 01:37:52 PM by Christy »

Merry

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Re: OB & GYN
« Reply #7 on: April 04, 2014, 01:44:22 PM »
You should take into consideration that OB care is usually billed as a global fee when the newborn is delivered so if you bill a % of collections you would not get that far for a while.  Generally OB care is not billed for each visit  unless there are tests that are not included in the global fee.

PMRNC

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Re: OB & GYN
« Reply #8 on: April 07, 2014, 04:33:04 PM »
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Why not just bill an hourly rate? It's a win/win situation- you get paid for all of the work that you do and the doctor only pays for the services that she needs.

I bill all of my clients hourly. They are all small, independent practices with fluctuating patient populations. I charge $25-$30 per hour and I find that it's often equivalent to 8% of practice revenue or $3-$4 per claim, which is pretty standard in our industry.

I use Practice Mate PM which is free, or I use the client's software. My overhead is quite minimal- postage, ink, paper, fax....

This is not necessarily a bad idea/concept, however from a marketing standpoint it can be discouraging.. physicians see that $25-$30 per hour and may immediately dismiss interest in you as a company.. they maintain the quick thought of $10-$15 "in-house". Now of course we know $25-$30 an hour is still making out because of the other savings a practice will see, however you may not get the chance to explain that.. that's why my flat fee is BASED on an hourly rate but the hourly rate is not disclosed. For example, I might quote a price of $1300 a month that might be based on $30 an hour and I build costs into it.

Another reason I don't like to do "hourly" is because when a practice outsources, they should expect to receive services that are a "part of doing business". You can't build other costs into an hourly labor charge to appeal to a physician.

Costs associated with doing business include such things as books, attorney, educational items, seminars, classes/courses, etc.   If I charge an HOURLY labor rate, again the provider is going to assume that's high.. and right off the bat they are  put off. If you build a flat fee with sliding scale to account for practice growth you get your hourly rate you want and provider isn't put off by the numbers.
Linda Walker
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One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Christy

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Re: OB & GYN
« Reply #9 on: April 07, 2014, 06:25:25 PM »
 I have never had anyone question the hourly rate. I deal with very small offices, most of whom have varying amounts of patients/billing from month to month, so flat rate would never work for them. The providers' incomes fluctuate from month to month, and my fee ends up going up or down with along with their income.

In the case of the original poster, I don't see how she could calculate a flat rate with what's being requested.

I do see your point and agree about flat fee for larger practices. I have found a niche group in my area, acupuncturists, chiropractors and behavioral health- most of whom tried to do their own billing before hiring me. Any one practice can average between 4-12 hours per month depending in their patient flow in that month.

My hourly rate has my (very very minimal) costs built in.

Lawyers charge hourly rates, why can't we sometimes?
« Last Edit: April 08, 2014, 08:09:22 AM by Christy »

PMRNC

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Re: OB & GYN
« Reply #10 on: April 08, 2014, 09:21:08 AM »
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In the case of the original poster, I don't see how she could calculate a flat rate with what's being requested.

The flat fee is really based on an hourly rate plus costs, the only difference is that the practice doesn't see the hourly rate. For example I have a VERY small psychologist who's flat fee is $690 He sees the flat fee as one rate no matter his income. The flat fee is a slidng scale to accommodate new patients, he doesn't see that I'm charging $30 an hour.

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Lawyers charge hourly rates, why can't we sometimes?

I don't want you to misunderstand.. I LOVE the hourly rate.. the only difference between my way and your way is the client really doesn't know my hourly rate and the fee only adjusts up when the practice grows, which in your case would go up because you would be spending more time right? I'm in NY so I can't even have my fee LOOK like a %, in fact I wouldn't even look to figure that out.. LOL
Linda Walker
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One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com