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How much to charge
PMRNC:
I'd have to see the case to decide, but my guess is that he won because there was no contract, it was considered null/void. I'm in the process of continuing my research but it looks like we have a few more states out there that have had the law on the books just resurfacing. Fee-splitting doesn't have to be a negative, it can be a marketing positive. I don't hesitate to tell a provider here in NY about the provision and I give him the statute. Yes I have to clarify that the billing company isn't doing anything wrong, it's him/her that is. It's his/her ass on the line. Providers can be sanctioned, and so far they have been in a few states and I suspect we are going to see MORE of this.
Michele:
Wow! $10 per claim, what type of provider was it? Surgery I hope. I don't understand the services out there that rake these providers over the coals like that. If you are getting $10 per claim, you certainly should be doing more than just initial submission!
We went into an office once and in a very short time determined the office manager (also responsible for the billing) not only did NO follow up (there goes 35% off the top!) but also didn't bill any inpatient hospital visits (3 docs all went to hospital daily) or nursing home visits (1 did 4 NH's). The 35% was because there PM system was in rough shape, bad insurance info, bad patient info, etc.
Very long story short, she still works there -- we don't. What is the matter with these doctors! I went back to visit and he was crying the blues to me about how he was losing $40000 a month since I stopped working for him and I started laughing. He said "don't laugh at me". I said "I can't help it, you could stop it right now but you chose not to." That was 18 months ago, he's still losing $40000 a month!
Michele
Steve Verno CMBS, CEMCS:
He was a pediatrician and that seemed to be the going rate in Orlando as other providers I met also paid the same to their coder and biller. There are companies out there that i call "code it, bill it and forget it companies" They pride themselves on how many clients they have. They just code it, bill it, and dont follow up, hence the forget it. I dont mind as they keep me busy. They are fired and I am called in to clean up the mess.
PMRNC:
I was going to respond but wanted to wait for Steve to clarify as If I do the math.. $10 per claim really isn't high at all for many types of practices, I think we resort back to that old info on the web of $3-$5 per claim <g> This might be why a per claim fee when you can't do % might not be optimal. A flat fee/sliding scale might work better appearance wise. If I took one of my clients monthly fee and did the math it comes out to about $9 per claim.. (shhhh)
Michele:
We are in a pretty rural area and I know the locals would fall over if I told them $10 a claim, but you are right Linda, when you figure a way to bill them that comes out more like a percentage, they don't realize they are paying close to that.
Michele
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