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How much to charge

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Steve Verno CMBS, CEMCS:
In Miami, the fee is more. usually around $12-$15 per claim.

A billing company i worked for couldnt bill Medicaid on a percentage bases based on FS 409 and the Medicaid manual, so we took our percentage and compared that to a per claim fee.  Came out the same in the end.   But, my fee is still a percentage. 

If I were in Iowa, like Michele said, the doctors would do handstands at $10 per claim. 

My last job paid $13 per hour.  The job before that was $50 per hour, but I was in a high cost area. Rent for a small 2 bedroom house was $2500 per month.  NO beach or water view unless you take the bathtub as water.

Pay_My_Claims:
Because of the differences in states regarding fee splitting Steve, I have actually changed my policy regarding billing providers. Instead of the percentages, I have moved to a flat-fee or a per claim charge. It also helps IMO when providers decide to terminate the contract. When I evaluate the client, I will have to look at the average monthly receivables, the number of claims submitted, and also whats is on the current AR. Factor in other variables to come up with a fee to charge. Let's say I have a Pediatrician and I charge them a flat fee of $2,000 per month to do their billing. If her average revenue is $20,000 a month, then I am making about 10%. If her revenue increases to about $30,000 per month I will be only making 6.5% commission, however I have increased her revenue, therefore after the 6 months we can review the fee. If her revenue was to be below the estimated 20,000 then I am making a higher percentage. Most people would not like this because they are concerned about the extra 200.00 they lost that month because they didn't do a percentage, but its really been an issue for me learning more and more about fee splitting. There are disadvantages no matter how you charge, but for me this suits me best

PMRNC:
 
--- Quote ---but its really been an issue for me learning more and more about fee splitting. There are disadvantages no matter how you charge, but for me this suits me best
--- End quote ---

In the long run we should all be moving away from percentage based billing. Yes it is change and with change comes questions and concerns. I'm in NY, what I have done is to actually make this a part of marketing/sales pitch. What doctor wants to know that the three other billing companies he wants to do business with are steering him into an illegal situation?
Not to mention the ones that are using another company already charging them a percentage, not only can I go in lower if I want the account and think it will be beneficial but I can sell them on the fact that they will be getting out from a possible legal mess or worse sanction.

Charlene.. make sure in your contract you leave wiggle room for growing practices. For example if you determined a group practice should pay $1000 a month, this should include verbiage to allow for growth of the practice as well as added work/services on your part. In other words you don't want them to grow their practice w/out you being compensated for your part in helping them grow, they might increase their patient load by more than 20% and in turn you want to adjust that monthly fee to fit their growth and yours.  I use a sliding scale, and because I am in NY I have to be careful the actual charges are not even "perceived" as being a percentage of any reimbursement.. so what I do is charge additional fees Per every 10 new patients.  This allows me to make more money, the practice grows, I grow and above all I'm compensated fairly for the additional work those additional patients bring.

Pay_My_Claims:
Thanks Linda, I am having that done as well. No way will I work and the business doubles in growth, volume and revenue and stay the same. This is why reports are so important for the provider as well as yourself.  I have my views on fee-splitting and I personally think certain things are "gray" areas, but the more I researched, the more Linda posted, the more I read.......I had to come to a conclusion that I need to readdress some things. What may not be clear to me, may be clear tomorrow. I don't want issues with Uncle Sam, so I know just as you can and have to bill differently in certain states because of the law...why not just implement it now. Its not the best or the worst, but what I feel will ease my mind and be beneficial to my company.

margemib:
Hi Linda,
How often do you make adjustments when you use a sliding scale?
margemib

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