Percentage Fee

[bt_elite]

I would like to know when charging a percentage for billing do you take a percentage of the insurance reimbursement and patient payment for the claim OR just the insurance payment. Please advise.

Thanks for helping me understand.

[Michele]

That depends on if you are doing complete revenue management or just insurance billing.  We have several providers who hire us to only handle the insurance portion of their practice and others hire us for full revenue management.  If we are doing a full revenue management then our fee includes patient payments.  It all comes down to what is specified in the contract. 

[PMRNC]

Make sure you are not in a state that prohibit's providers from fee-splitting arrangements. If not then I would agree with Michele, only I would add that you have to remember if you only take a % on insurance payments it basically means your doing a lot of free work and if the practice is handling billing of patient's and you the insurance payments, then you have two sets of accounting and that's a big risk if there is an audit. There should never be two sets of A/R.

[bt_elite]

Thank you for the replies. I am handling the entire healthcare revenue (insurance/patient) payments. Therefore I will take a percentage of both. I will also double check if GA is a state that prohibits fee splitting.

Thank you for your assistance.