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Chiro Specialty Profitable?

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dfranklin:
I am fairly new to medical billing (8 months) and I have been billing for a Chiro for about 6-7 months.  I charge a percentage (from reading other posts I am inline within the 6-8%).  I just can not seem to make much money with them.  I file between 30 -50 claims per month and receive insurance payments around $3,000/month.  So do the math at say 7% I am only receiving $210.  My software (web based) about $100/mo.  Not much left for me for the work.

They handle their patient billing because they have a lot of cash patients and have special agreements/plans individually with them.  In fact, when an insurance patient has a copay or deductible or patient responsibility they make special arrangements with them for that money as well.  So I don't see any payment on the patient responsibility.  Even if I did I don't think it is all the much still.  So essentially I am just submitting claims and posting EOBs on my end and following up to make sure insurance A/R is good.

I would like to take on more chiros but I just don't know how to do it where it is profitable for me.  Even if I did it on a per claim at $5.00/claim that is only $150-$250 based on their # of claims (still not good).

Would love some help and ideas.

Thanks!

Alice Scott:
HI,
We too bill for quite a few chiros and they can be a "pain" - no pun intended.  Chiropractors vary greatly in how many patients they see,  how they bill, and how much income they generate.  Some wish to work with self pay patients and don't want to deal with insurance.  The 30 - 50 claims a month can't take you very long to take care of.  You just need to multiply that times a few more chiropractors.  You will run into chiropractors who can generate you much more than $200 a month.  We have one single chiropractor who we bill well over $1000 every month.  We handle all his patient billing as well as the insurance billing and he runs a very efficient office.  He bills modalities and sells foot levelers.  Many of our single chiropractic offices average $300 - $400 per month income for us.  $200 is a low.

With your web based software - are you paying per provider?  This can be expensive.  We are now using a web based software with no up front costs that doesn't charge per provider.  They charge only per computer seat.  So if you use only one computer at a time the cost is $149 per month.  That's it.  You need to be aware of your costs as well as the income you generate.

Alice

PMRNC:
My advice is that you need to step back and look at your contract. I see a few problems which COULD exist.
You say the practice is managing all patient payments?  Right there is (could be) a problem, are you tracking them? If not that means there are two sets of books for the practice... BIG NO NO!
If you are tracking them, does your contract state your % is based on the full practice revenue or is it specific in saying insurance payments only?
Right there that issue is causing you a "loss".  If the practice is NOT managing these payments together you might want to tell them it's a bad idea to have two sets of books. And if your contract is stating your collection rate is based on total practice revenue, they are in breech.

After you look at these issues and if everything is on the up/up and your just taking a loss it might be a good idea to turn the client loose. 

Also $100 a month for software.. I agree with Alice, if this is per provider, it's expensive but it's also a cost you could pass on to them, if it's not per provider than it's a loss or just the cost of doing business.

thatcuteblonde:
You might want to find a chiropractic office that has physical therapy as well or at least modalities. 30 to 50 claims per month is extremely minimal. If you're thinking about expanding and doing this long term, you might want to consider purchasing a software program. You can get a program like Medisoft for a very reasonable rate, especially if you purchase it from E-bay or Craigslist.

PMRNC:
I don't recommend ever purchasing a PM software off of Ebay and Craigslist, way too many bootlegs out there not to mention there are licensing fees to companies such as Medisoft. You never BUY the software, just the right/license to use it. It's true there are some vendors using Ebay but you have to really do your homework to be sure they are reputable and the copy will be licensed to you. I've seen a lot of people get stiffed buying off Ebay and Craigslist is even worse.

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