Author Topic: New Business  (Read 1900 times)

Kimberly35

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New Business
« on: February 05, 2015, 09:29:36 AM »
Good morning all,

I am in the process of getting my first client. I had a meeting with and the expectation is that I will be submitting his claims, following up on AR and posting payments. He wants me to also resolve his outstanding AR which is about 35 pages long. His practice is really a mess but he wants to bring me in to help clean it up. I am wondering why my costs should be. I was thinking of charging an hourly rate initially to clean up his existing AR and going forward, charging a percentage based on what is collected. He has a small dental practice.

Any suggestions on how I should bill this client?

rdmoore2003

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Re: New Business
« Reply #1 on: February 05, 2015, 09:51:02 AM »
May I ask, how long has this provider been in private practice?   I am asking because the "35 page long AR" is causing my head to implode.
Regina

Kimberly35

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Re: New Business
« Reply #2 on: February 05, 2015, 10:06:20 AM »
Good question. I am not sure. He mentioned that he has been having problems with his office staff for a while and he wanted to outsource to eliminate his ongoing issues and put better controls in place.

PMRNC

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Re: New Business
« Reply #3 on: February 05, 2015, 11:09:09 AM »
35 pages is also making me queasy..

Couple questions:

what type of provider?
What state?
Heavy Medicare/Medicaid?

do you have a GENERAL idea of what the A/R looks like? For example, if I am speaking to a chiropractor (which I wouldn't.. LOL, but we'll use that as an example) and I see there is a lot of money out there, I want to look for such things as high A/R due to PI cases, auto/no-fault, WC..etc. With MOST practices you can find the common denominator of any problem. If I'm talking to a Pediatrician with a large A/R.. I look for things such as patient balances/collections, is he being too generous with discounts? If I'm talking to a mental health professional I look to see if they are completing OTR's, verifying benefits, etc.

Every practice/specialty is different but if your diligent before taking the client on you can identify the most common problems first.   No matter what you charge.. make sure it's spelled out clearly in your contract. I have not worked with a % of revenue in years and would never go back. I charge flat monthly fee with sliding scale to accommodate practice growth.. that means I get paid for everything I do. If you charge a % and yet you have a lot of WC or PI cases..you'll wait for your money. You also may have that provider that thinks they shouldn't pay you on what they collect in the office, or from a patient. It all has to be spelled out.   If I take on a client with backlog of A/R I actually give them two pricing structures by the "date of service" but with a begin date of when I start. This way I can work the A/R as I go and my time is compensated for at same time I'm making money off of the current claims.  Hope that makes sense.   You also have to consider fee-splitting laws in some states.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Kimberly35

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Re: New Business
« Reply #4 on: February 05, 2015, 11:34:22 AM »
Thanks Linda. It is a dental billing office in MD.

PMRNC

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Re: New Business
« Reply #5 on: February 05, 2015, 11:48:59 AM »
I don't have any experience with dental billing at all really.. HOWEVER I can tell you that you want a CLOSER look at that A/R. I don't know about other areas but in all places I've lived dental offices are the BEST at collecting patient portions UP FRONT.. they are like sharks with their money. LOL That's because dental insurance plans are EXPENSIVE and most people don't have dental or they have a very very limited annual dental benefit so dentists HAVE to be diligent in collecting at time of service and in creating clear and precise office financial policies. That's why you want a CLOSER look at that A/R.. 35 pages is a lot to blame on insurance.. <g>
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Kimberly35

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Re: New Business
« Reply #6 on: February 05, 2015, 11:49:55 AM »
You are correct and thank you very much for your feedback!!

rdmoore2003

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Re: New Business
« Reply #7 on: February 05, 2015, 01:57:00 PM »
I agree with Linda.  I do not have experience in the dental field.  However, look at his A/R to see what the common factor is.  You definitely want to look at his office policy/procedures.  Does his staff get benefits prior to seeing patient?  He may need an overhaul with his policy/procedures and office staff.  I say this only because if he is having issues with office staff, when and if you take over his A/R and his billing/filing now, make sure to DOCUMENT, DOCUMENT, DOCUMENT everything you do so as nothing comes back to "bite you".
Regina

Merry

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Re: New Business
« Reply #8 on: February 05, 2015, 04:31:39 PM »
I do have many years of dental experience and it is not like medical billing.
May I ask if you have any experience billing for dental? I would hate to see you get buried in something that you don't have knowledge about.
35 plus pages of AR really says nothing at this point without more information. If he participates with some insurance plans perhaps the balances are not accurate. You need to do so much research before you can even consider resubmitting the claims. Is he interested in paying you for doing the research? Sounds like a dentist that wants to be a dentist and not consider that he must first be a businessman.. nothing new to us who have been there for so long.