Author Topic: Unexpectedly got my first client today  (Read 641 times)

squarepeg

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Unexpectedly got my first client today
« on: February 13, 2018, 07:19:54 PM »
I wanted to start my own medical billing business yeaaaars ago.  I bought the books from this site and everything.  After a few more years experience and frustration from working underneath people, I decided to advertise my services as an independent contractor.  I figured I would get my company name out there and network through part time freelance work. 

Long story short, I sent my resume and cover letter to someone looking for a part time biller.  I went in for an interview with him today.  I really didn't know the details of what he wanted me to do, but it just sounded like part time billing from home and going in the office a couple days a week.  Ends up he was impressed by my experience enough that he felt I could possibly do the entire revenue cycle.  Actually, after seeing how mixed up he was, I kind of suggested it.  Plus, the little voice in my head was yelling at me to take this on. 

But I am not prepared for this, not really.  I've done my time in medical billing and wanted to concentrate on consulting.  But here's the situation at hand:  He has 8 doctors (soon to be 10).  His docs are designated physicians for workers comp cases, therefore he is legally owed the money for his services.  His problem is that he doesn't have time to collect and see what's going on. 

He didn't know what a PM system was, EMR, or anything.  He couldn't exactly tell me how much his practice makes monthly (he kind of just threw out $50,000 at me).  He didn't really know what a clearinghouse was.  He has a clearinghouse now but it's RIDICULOUSLY INEFFICIENT.  With all this information, it was difficult to hide my shock.  But he wants to hire me on as a contractor.  I told him I would accept 10% of collections, claim submission and tracking would be a different fee, as will be monthly reporting.  I have a feeling I will be downloading Office Ally in place of whatever he has now.  He just needs someone with some sort of "know how" around insurance.

It all sounds like a slam dunk, but omg....

Are there any suggestions on how to price monthly reporting and calculating consult fees?  Monthly reporting is more accounting work than showing my work for the past month.  The fact that he really doesn't know how much he was bringing in monthly and that he doesn't know how to use excel is insane to me... and I can't work with that.  We'll see how that all pans out but I would appreciate any advice or similar experiences.  I have a habit of biting off more than I can chew, and I have a feeling that's what I may be getting myself into.   

Being that I wasn't prepared for something like this, I am a little gun shy of spending a ton of cash.  But if I wanted to take the data from their system (which seems like some makeshift customized program in outlook) how would I transfer that to a software like totalmd?  How does the transfer from PM systems usually happen?  I don't want to do this too quickly because I don't want to scare them off with a ton of new changes when I'm not even in the door yet  :-\
« Last Edit: February 13, 2018, 11:04:52 PM by squarepeg »

PMRNC

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Re: Unexpectedly got my first client today
« Reply #1 on: February 14, 2018, 05:31:33 AM »
Congrats!!!

You mention the practice is designated practice for WC.. with that in mind, yes there is probably a lot of  money out there, but if I were in your shoes, I'd not go a % of collections on this type of client with heavy WC..you'll wait and wait and wait for your money. A lot goes into WC and a good process has to be established, you want to find out what process they have. For example, are they sending letters requesting LOP's? How does WC claims work in your state, etc.

Next, as I've mentioned in many posts in the forum, you want to transfer data to your system? That's a question you can ask your software vendor, but it's still a conversion none-the-less and those are NEVER fun and can be costly. INSTEAD why not take him on as a trial, forget the the independent contractor situation and take him on as a client and remote into his system for a while and see how it goes before undertaking a conversion on top of trying to figure out the numbers. I'd also make sure you get a setup fee to accomodate the time it will take to gather the information you need. They don't sound too organized so I wouldn't hesitate to make this setup fee a little hefty but discount it (wink) if they sign your contract by XX/XX/XXXX

Make sure your contract covers everything the practice is responsible for providing you, that will also cut down on the time. If you are local, you can put in the contract that you will make the necessary trips to their office to gather what you need. Same for picking up billing/eob's, etc.

This is a great first client, If it were me I'd ditch the whole IC thing as it's a tax headache for both of you and work as a business owner so that you can establish your business right. :)  Just my 2 cents. :)
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

squarepeg

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Re: Unexpectedly got my first client today
« Reply #2 on: February 14, 2018, 11:35:51 AM »
Quote
This is a great first client, If it were me I'd ditch the whole IC thing as it's a tax headache for both of you and work as a business owner so that you can establish your business right. :)  Just my 2 cents. :)

This sounds like a dumb question, but what is the difference?  I'm meeting with my attorney tomorrow.  I know she said there are service agreements vs independent contractor agreements.  At first, just believing that I would be on my own I thought I would be under an IC agreement.  But seeing how things have transpired, it sounds like a service agreement (?)  My business is a DBA as it stands, not an LLC, with this being so unexpected.  But I look to make it an LLC as soon as possible.

But regardless, isn't the tax burden still the same.  I'm still subject to the SE tax and responsible for federal.  How does that affect the client? 

williamportor

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Re: Unexpectedly got my first client today
« Reply #3 on: February 22, 2018, 12:32:16 PM »
I wanted to start my own medical billing business yeaaaars ago.  I bought the books from this site and everything.  After a few more years experience and frustration from working underneath people, I decided to advertise my services as an independent contractor.  I figured I would get my company name out there and network through part time freelance work. 

Long story short, I sent my resume and cover letter to someone looking for a part time biller.  I went in for an interview with him today.  I really didn't know the details of what he wanted me to do, but it just sounded like part time billing from home and going in the office a couple days a week.  Ends up he was impressed by my experience enough that he felt I could possibly do the entire revenue cycle.  Actually, after seeing how mixed up he was, I kind of suggested it.  Plus, the little voice in my head was yelling at me to take this on. 

But I am not prepared for this, not really.  I've done my time in medical billing and wanted to concentrate on consulting.  But here's the situation at hand:  He has 8 doctors (soon to be 10).  His docs are designated physicians for workers comp cases, therefore he is legally owed the money for his services.  His problem is that he doesn't have time to collect and see what's going on. 

He didn't know what a PM system was, EMR, or anything.  He couldn't exactly tell me how much his practice makes monthly (he kind of just threw out $50,000 at me).  He didn't really know what a clearinghouse was.  He has a clearinghouse now but it's RIDICULOUSLY INEFFICIENT.  With all this information, it was difficult to hide my shock.  But he wants to hire me on as a contractor.  I told him I would accept 10% of collections, claim submission and tracking would be a different fee, as will be monthly reporting.  I have a feeling I will be downloading Office Ally in place of whatever he has now.  He just needs someone with some sort of "know how" around insurance.

It all sounds like a slam dunk, but omg....

Are there any suggestions on how to price monthly reporting and calculating consult fees?  Monthly reporting is more accounting work than showing my work for the past month.  The fact that he really doesn't know how much he was bringing in monthly and that he doesn't know how to use excel is insane to me... and I can't work with that.  We'll see how that all pans out but I would appreciate any advice or similar experiences.  I have a habit of biting off more than I can chew, and I have a feeling that's what I may be getting myself into.   

Being that I wasn't prepared for something like this, I am a little gun shy of spending a ton of cash.  But if I wanted to take the data from their system (which seems like some makeshift customized program in outlook) how would I transfer that to a software like totalmd?  How does the transfer from PM systems usually happen?  I don't want to do this too quickly because I don't want to scare them off with a ton of new changes when I'm not even in the door yet  :-\


PMRNC gave some good advise on fees. This sounds like a really messy but potentially lucrative opportunity for you. I would add that it might make your job easier if you could obtain permission to work in their office for awhile, where you have access to all their records, until such a time as you have the data entry finished, and you've been able to gather the information you need to do your job in an organized manner. From your description of their situation, I'm wondering how this could have happened in the first place, working with the front office staff to keep things organized and efficient is something that may be your next big challenge. You might wish to address this in your service agreement before you and the provider agree to move forward. Someone with your experience knows that working with front office staff that simply doesn't care or insists in working in a disorganized manner will make your job impossible no matter how good you are as a biller. 
« Last Edit: February 22, 2018, 12:49:24 PM by williamportor »

PMRNC

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Re: Unexpectedly got my first client today
« Reply #4 on: February 22, 2018, 03:28:47 PM »
Quote
I would add that it might make your job easier if you could obtain permission to work in their office for awhile, where you have access to all their records, until such a time as you have the data entry finished, and you've been able to gather the information you need to do your job in an organized manner.

EXCELLENT suggestion, I have actually done this to a point for all my clients since I changed business models a few years ago. I used to use my own software but over the years with companies going out of business, or the software being inadequate I decided I didn't want to be a slave to the practice management software vendor anymore. With that in mind the client didn't have to suffer the losses of time in reimbursement and there was NO messy conversion on my part either. What i did was spend 2 weeks in their office to get a feel for how their process was. I reviewed all policies, procedures, software, reports, etc..and then would get them setup in-house so that when I took over from my home office it would be smooth and easy.

Great Suggestion William!!
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com