Author Topic: * Urgent Response * First Client  (Read 4305 times)

Merry

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Re: * Urgent Response * First Client
« Reply #15 on: April 26, 2014, 11:19:13 PM »
Terrific dialogue.  Thank you all. 

Merry

PMRNC

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Re: * Urgent Response * First Client
« Reply #16 on: April 27, 2014, 09:52:36 AM »
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4.  If Linda helps you establish a best-practices all-cash office with her advice, why do you even need a medical billing package?  We have clients who track their all-cash patients with Quickbooks or Excel spreadsheets.

Then what do they need you for? There are a few different "cash" practice models. Those practices still bill insurance, still do AOB.

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5.  Folks who have insurance know that a participating provider cannot charge them more than the "allowed amount" that their insurance carrier specifies.  But, from our experience, most folks who have insurance don't realize that a non-par provider is not constrained in any way by the "allowed amount" figure.  So - you either have to explain this to them before they see the doctor (this "work" should factor into the fee you charge), or they find out after the service is performed and they are asked to pay for it.  When the actual cost of service is explained before-hand, most prospective patients say "never mind", and seek out an in-network doctor.  When they learn about the actual cost of service after the service has been performed, many folks never return to that provider again, and in fact may not pay the provider any more than what their insurance "allowed amount" would be (in their estimation).  For our clients, who are using this as a tool to reduce the size of their practices, this is a useful thing to do.  For a doctor just starting out, who is trying to build a practice, this will probably result in no practice being built - as prospective patients seek out an in-network provider.  Unless the provider prices his services comparable to what the carriers' "allowed amount" is.  But if he is going to do that, why be cash only / non-par?

When dealing with NON participating carriers, there is no "allowed amount" it is called Usual & customary and patients who can go in or out of network (non HMO) usually have a higher copay/coinsurance to go out of network. Many NON par providers still bill insurance, collect the out of pocket and have an AOB to collect the rest. As long as they stick to their own office financial policies they can do quite well. Yes of course patients are told that billing their carrier is a courtesy and the patient knows their out of pocket is higher which is why it can be collected at time of service. Does this work for every one? Of course not. I think today with all that is going on and the failing ACA more physicians are getting OUT of par contracts and more patients are ok with paying a few extra bucks to a good provider..

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6.  For our clients who are cash only, many patients walk away because they can't figure out how to file a claim with their health insurance carrier.  They find a provider who is in network and who will file the insurance for them.  Some of our cash-only clients, who are not trying to reduce the size of their practices, have us bill on the patients' behalf, and simply include our fee in what they charge the patient.  The patients are much happier with this, and are much more inclined to pay the doctor up front - since they have hope that the carrier will actually get billed and that the carrier will pay them, the patient.

That's why I mentioned the different model's of cash pay.. the provider can stay NON contracted with all of them and still bill insurance companies while collecting the higher out of pocket costs.

Richard, your posts here may have been appreciated but they were awfully pompous, and assuming. You did make two assumptions here  1) that RCC has no experience and 2) that the provider doesn't know what he's doing. I don't think it's fair to ASSUME either.  Yes she could have gone to the kareo website, but what about all the other people asking about other softwares, they too could just go to the website at read right? 

It's funny how people can read the same words and come to completely different conclusions, I seen someone looking for more specific things than the average, "how do I do medical billing from home?" posts or the " How do I code this to get paid....?"  Yet this is the one we decide to point out to "teach" someone something?  Others may think talking AT someone is productive, I don't.

Pam, your welcome to keep emailing me. As I told you in my email, I see a good opportunity here for you!!
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RCC

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Re: * Urgent Response * First Client
« Reply #17 on: April 28, 2014, 11:06:01 AM »
@RichardP - Thanks again, but what I realized the classes that I took, just teach you how to fill out the billing form. So I was asking for experience from you guys. I really appreciate the information that you have given me and I will do my due diligence in getting information and researching it for myself. Not all billers do credentialing and I really didn't want to start doing that until I have the experience on doing billing first. The information that you all give is priceless and he doesn't have many patients has of yet. I have asked some medical billers in my area to let me work with them to learn the ropes because hands on it so much easier than just reading, but unfortunately some companies feel threatened when you state that you are starting your own company, then they think competitive. Because I wanted to bid on some jobs, that needed the experience of doing billing and they didn't want to partner. I will keep looking. You have opened up my eyes and my ears thank you so much. I am in NYC and not everyone like to help out each other, unfortunately. But once I become experience at this I will help someone else out, just like you guys do.

RichardP

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Re: * Urgent Response * First Client
« Reply #18 on: April 28, 2014, 12:38:15 PM »
Richard said:  We have clients who track their all-cash patients with Quickbooks or Excel spreadsheets.

Linda asked:  Then what do they need you for?

Richard answered:  For the clients who track their all-cash patients with Quickbooks or Excel, we don't bill on behalf of the patients.  So we don't process those transactions through our billing software.  So these clients truely don't need us, and don't utilize us, for these all-cash transactions.  But they also have patients who are not all-cash, and we do process those transactions.

Other clients, who are all-cash, have us bill the encounter as a courtesy for their patients.  Since we process those transactions through our billing software, the doctors don't track them with Quickbooks or Excel.

Linda said:  You did make two assumptions here  1) that RCC has no experience and 2) that the provider doesn't know what he's doing.

Maybe.  But if assumptions, the were informed assumptions.  RCC said this was her first client.  She also said New practice and all.  Strong probability that a new biller was talking about a doctor setting up in private practice for the first time.

Linda - I understand that guys talk differently than gals.  So I understand that "guy talk" can, and often does, come across differently to women than what was intended.  I would simply encourage folks to focus on the substance of what is said, and not get sidetracked by the form of the delivery.  And I point you to how I started my conversation here - it was going to be an instance of teaching to fish, rather than simply delivering the fish.  Why this person and not someone else?  Beats me.  The mood I was in and the fact that I had a minute to write?

I bet I have helped RCC (and other newbies who pass by here) think in a different way, and maybe more carefully, about what they are setting out to do.  That was my objective here.  Your objective is maybe something different.  I think that is good.  I think a variety of approaches to answering questions will trigger more thoughts in the learner's head than will be triggered if everybody simply repeats what everybody else says.

Merry

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Re: * Urgent Response * First Client
« Reply #19 on: April 28, 2014, 12:51:36 PM »
Richard.. I have a personal question about a practice in your area.  Would you look at your message that I sent please.  Don't want to clutter board with it. 

Merry