Author Topic: From one billing service to another (mine)  (Read 107 times)

Powerade_993

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From one billing service to another (mine)
« on: October 05, 2017, 08:22:03 PM »
First, thank you to each one of you who continue to provide support and answers for my questions. I have a provider who is on the fence about switching from their current billing service (private company who bills through her own billing software) to my billing service. The provider is requesting I use his EHR system moving forward and I'm comfortable with that. My question though would be how this information would transfer from her to me? She clearly has the billing history in her system and assuming I agree to A/R cleanup is this even possible? If so how does this process work? What about future payments that come through the clearinghouse she has step up? I'm confused on the logistics of this but want to be prepared and confident in my answer because I know this is going to come up soon.

Thank you again everyone!!

PMRNC

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Re: From one billing service to another (mine)
« Reply #1 on: October 06, 2017, 05:59:02 AM »
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I have a provider who is on the fence about switching from their current billing service (private company who bills through her own billing software)

To clarify when you say "through her own billing software" you mean the current billing company's software? That's how I'm taking it since the provider is a "he" in the later portion of your post.
The provider wants you to utilize the EHR to transfer to YOUR PM system? I'm not quite sure if you have a sofware you will utilize or the provider will have the PM System, generally the EHR won't be enough for you to setup to do billing and I would also say the EHR the provider has must be compatible with the software you use. As for payments coming through the clearinghouse via the other billing company, can't answer that because it depends on the contract they have with the provider. That's something you don't want to get into the middle of. If you take the account it's advisable that you have no contact or receive any data or work with the billing company at all as you will be interfering with their contract and that surely could get ugly. IF you plan to use your software what I would do is first find out if it's compatible with the providers EHR. But I would also strongly suggest the provider obtain the billing database and/or software if possible (again, depends on their contract) and you would set a date to which you would begin. The provider would need to sign up with whatever clearinghouse you will be using if you will be using your own PM system. Your contract would begin on that date. If the provider is not going to have access to the data of the other billing company they would be better to send you what you need along with all balance forwards, PI sheets/info, much of that you can get from the EHR but as for claim data, that's not going to come from the EHR.

I guess your question is hard to answer without knowing if you will be utilizing your own system/clearinghouse and if so will it be compatible with the providers EHR.

My advice about staying out of the current contractual relationship with the other billing company stands no matter what.. stay completely out of it and instead all information should come from the provider directly.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: From one billing service to another (mine)
« Reply #2 on: October 06, 2017, 07:04:28 AM »
My advice about staying out of the current contractual relationship with the other billing company stands no matter what.. stay completely out of it and instead all information should come from the provider directly.

Often we have providers who will ask us to "work with" the previous service to get any information we need.  Linda is right. Stay out of that relationship.  That's like the new wife asking the old wife for her husband's favorite recipes. 

We've had situations similar to what you are describing below.  We do have providers who have EHR but do not utilize the billing portion and we do the billing from our system.  That is how they want it done.  They have been using us for 20 years and they obtained the EHR a few years ago.  When they first started they didn't even have a computer.  We now have access to their EHR and we can obtain the billing information.  It isn't compatible with our system but we are able to print out the billing so that we have all information needed.  This save the provider's office time, and it's in a great format for us.  It's the same as if they gave us paper data, but it's all typed up. 

Their EHR system pushed them hard to use the billing portion and to let them handle the billing for a MUCH lower fee than we charge.  But our provider knew that the billing was handled overseas, and that they don't really "handle" the billing.  They basically submit the claims and then provide reports to the provider about which claims the provider's office needs to take care of.

When we have a provider who is leaving a previous outside billing service who does the billing from the BS's software we advise them that they should request a copy of the current AR (total AR not just over 30 days).   We also advise them to check over their contract to see what the termination terms are.  Usually the previous biller is responsible for working any AR that was billed by them but unfortunately there are all too many that don't.  Let's face it, if there wasn't an issue the provider wouldn't be switching.  It's not always the billing service's fault.  When we have an account leave us we clean up any outstanding claims submitted by us and provide a report of any claims that we were not able to clear up and why.  I have not seen that in any cases where we took over from another billing service. 

There are a lot of good billing services out there but there are an equal number of bad ones.  We have a local one that we know for fact they do not work aging reports, they do not send regular patient statements, and they do not handle denials.  We receive 2 - 3 calls a year from clients of them that inquire about our service.  We advise any potential client that if they use an outside service that utilizes their own software system they should at lease receive regular aging reports showing what money is out and how long.  The BS should be able to explain anything on that report. 
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PMRNC

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Re: From one billing service to another (mine)
« Reply #3 on: October 06, 2017, 08:33:56 AM »
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Linda is right. Stay out of that relationship.  That's like the new wife asking the old wife for her husband's favorite recipes. 

LMAO..I'm going to be thinking of this and laughing all day <g> I LOVE that analogy..  I could make it a bit racier but will stick with recipes. :)  :o ;D
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: From one billing service to another (mine)
« Reply #4 on: October 06, 2017, 10:22:13 AM »
OMG  I hadn't thought racier but now I have a mental picture I can't get rid of!   ;D
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