Starting a Medical Billing Business > Starting Your Own Medical Billing Business

Analyze this

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williamportor:
Just looking for opinions here, but what can a freelance biller working full time for smaller clients i.e. Chiropractors, LMT, ND's's etc. expect to make / month? The reason I'm asking is I'm doing:

* 350-400 claims per month split up among 7 clients
* Phone follow up and resubmission of 10-15% of claims that didn't pay (for various reasons)
* Mail invoicing of 60 invoices + phone follow up/ mo. for a ND
* Setting up 2 clients for me to submit claims through office ally + receive electronic remittances
* Phone follow up of a small mountain of old unpaid EOB's for a newer client left over from former office staff that didn't know how to bill correctly


All of this adds up to 40+ hours a week for $1350.00 / mo

 4 of these clients were added in the last 6 months. Between all this and a few other mini disasters I'm doing a lot of "side work" unrelated to actual claims submission which amounts to a lot of work hours for little pay. I'm sure as I get a few of these billing messes cleaned up, and the setup work for office ally and Medicare is complete this will be less labor intensive, but right now I could make a lot more $$ per hour selling nails at Home Depot. The good news is since I stopped trying to bill for MD's my client base has stabilized and I'm not losing clients. The bad news is I'm working long hours for not much income. So....Am I undercharging my clients? Is this normal for a biller with 4 recently added clients in the last 6 months? any input would be appreciated.   ???   

Michele:
This doesn't seem right.  At 400 claims per month for 7 clients that is only an average of < 60 claims per provider per month.  That should not be taking 40 hours per week.  We don't measure by number of claims but by income.  One full time person should be able to produce $6000 - $9,000 depending on the type of providers and the set up of the biller (ability to autopost, etc). 

I would take a look at your systems to see if there is any place you can find a way to improve the amount of time it is taking.  I would also take a look at what you are charging them.  Maybe that is where the issue is.  But in answer to your question, $1350 per month is not normal for 40+ hours per week.

williamportor:
$6000 - $9000 / month you say?? Wow, looks like I'm inefficient and undercharging. OK, I'm almost certain I'm undercharging, but 6 out of 7 of these clients fax in the billing info, since they have no billing software, and about 25% are new clients, so lot's of data entry. I try to charge a flat monthly fee, but it averages about $3.00 / claim. I guess this is a good place to start. Once I have the old claims caught up, and can see the light of day, I'll look to bumping up the fees.

* Should I charge extra for a client that sends me 200-300 old unpaid EOB's to call on and/or resubmit? If so, how much?

* What would you folks charge for direct mail billing of cash customers? I'm charging $11.75 for 3 months (3 invoices)



 

PMRNC:
I have a different opinion, since I do charge a monthly fee it is based on how much I work. I couldn't measure how much I make by a provider's revenue as I'm in a state that prohibits fee-splitting so my fees cannot be even remotely related to the revenue of the practice. With that said, it's much easier to do a flat fee with sliding scale because then I can CHOOSE how much I want to make per hour and the provider NEVER sees that amount. For example, if I know a client is going to take 10-15 hours a week and I want $50 an hour, then their monthly flat fee will be approximately 500-750 a month. I also know how long it takes me to submit claims so the sliding fee would accommodate new patients by the amount of claims I can produce in the hour.

This has worked great for me as I get paid for every single hour I work. I get paid for everything including making a phone call and I'm making exactly what I want to make and working the hours I want to work. :) 

Your income is very low for that claims volume and that many clients so I would take a look at not only What you are charging but maybe HOW you are charging. If you WANT to be reimbursed for all the time you spend you have to set your fees accordingly. Remember you do NOT have to disclose that hourly rate to your clients. Remember also to add in the expenses for software, clearinghouse, etc. Since I utilize all my clients PM systems, I'm nearly pure profit with very little overhead and costs aside from normal operating costs.


--- Quote ---All of this adds up to 40+ hours a week for $1350.00 / mo
--- End quote ---
  That adds up to just $33 an hour COMBINED for all clients. Imagine the income if you used that $33 an hour as a base for flat fee for EACH client :)

williamportor:

--- Quote from: Michele on September 19, 2017, 09:41:17 AM ---This doesn't seem right.  At 400 claims per month for 7 clients that is only an average of < 60 claims per provider per month.  That should not be taking 40 hours per week.  We don't measure by number of claims but by income.  One full time person should be able to produce $6000 - $9,000 depending on the type of providers and the set up of the biller (ability to autopost, etc). 

I would take a look at your systems to see if there is any place you can find a way to improve the amount of time it is taking.  I would also take a look at what you are charging them.  Maybe that is where the issue is.  But in answer to your question, $1350 per month is not normal for 40+ hours per week.

--- End quote ---

I just wish I could afford to visit you folks in NY and see how you operate. I'll bet I'd learn a lot. Maybe someday  :-\

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