Starting a Medical Billing Business > Starting Your Own Medical Billing Business

starting a medical billing business

<< < (11/21) > >>

PMRNC:
I had some clients who were just so disorganized that I would have them fax deposit slips so I can match them up to the payments for the week, I had one provider who insisted on doing his banking daily so with him we actually got on track faster by matching up daily.
I know there are billing companies with lock boxes setup who collect/gather the checks and make deposits, I had a hard time selling that to a physician, plus as you grow it becomes too time consuming IMO. Doctors AND billing company both are both bound by state/federal record retention laws anyway so it just seems a bit safer to get them on a weekly schedule to fax over daysheets/superbills, etc. Busier offices might want to do it twice a week. Your contract should have this included in the provider responsibility area of the contract.
As for mistakes... if the office made ANY mistake on the superbill or daysheet, I would fax it back along with a quick form for them to complete and sign and send back. I did that to Cover my butt, doing this on the phone would be too risky, even if I documented it, it's still not proof enough they made the correction or change.

Your BAA is your Business Associates Agreement which is required by HIPAA, you will want to discuss this with your attorney and make sure you research and are very clear on HIPAA regulations. The HITECH Act is going to be an extension of HIPAA next year that will bring forth the SAME liability to Business Associates as it does to Covered Entities. MOST third party billing companies are considered BA's and providers are Covered Entities, however there are some billing companies that are Covered Entities, it all depends on your setup/services. Years ago when HIPAA went into effect and I was billing, I chose to cover myself as a Covered Entity, I guess I saw this coming down the pike.

For errors & omissions you might want to research by your state. Some companies refer to E&O as ; Business liability, business malpractice and Quai Tam insurance. Coverage varies from 1 Million and up. For a 3 Million dollar policy in Upstate NY (I'm not billing, just consulting right now) I pay $866 for the year which I've heard is pretty good. In NJ and PA it was much higher, premiums will vary by state and by the services you will provide. Those coding and actually doing contract negotiations, fee schedule negotiations, etc will pay higher premiums because their liability is greater. The average policy premium for a small to mid size medical billing company providing full practice management can range from $600-$2000 a year, again it depends on your location, liability, services, and amount of coverage you choose. A good start in researching this is to call your home-owners and see if they sell that type of insurance. Just be sure you specify it's "Liability" insurance, don't get confused between that and regular business/office insurance which covers your equipment, and work area.. etc.

Linda Walker
PMRNC
www.billerswebsite.com

PURPLELADY:
Thanks Linda. 

     I  thought that since this is starting out as a home-based business that our LLC and homeowners insurance would be enough.  Thanks so much for the info.  I will look into it asap.

     I'm planning on purchasing the Ingenix code it fast (2008) 1-9 software for 49.95 single user and the icd-9, hcfa and cpt books.  Am I wasting my money? What reference material do I really need? If I need any. I did stipulate in my contract that diagnosis and procedure codes should be on all charge slips.

PMRNC:
You can shop for coding books, I like Ingenix, but there are also others, if you are comfortable with it stay with it, I also do keep the books handy and updated yearly. I like the binders so that I can order updates and just insert them rather than a bookshelf full of coding books. I recommend always having at LEAST the previous year and the current year because many billers can get their feet in the door by offering to clean up A/R which involves older claims. having 3 years (2 previous years and current) is Ideal.

As for your setup, the LLC is to protect your personal assets.. it's not the same as "liability" in your day-to-day work. Many billers think that just because they don't code they don't need Errors & Omissions but that's not true at all. There are many other liabilities out there, the false claims act for example doesn't just say if you submit a fraudulant claim you are libel, how it reads is that anyone who is sending claims "SHOULD" know. To give you an example, I had a client a few years back that was required by law to supervise his biofeedback techs, that meant when biofeedback was done, he had to be IN his office and available. As a billing company I knew that rule, however I was not AT the office, therefore the claims I sent where he WAS NOT in his office and I did NOT know.. were considered "errors" .. Once I found out (he went on a trip to Europe and superbills were being faxed to me by his biofeedback tech) Then it became MY liability because then I knew what was going on. I had to legally report it, stop sending claims and dismiss the client. Medicare actually paid me a whistle blowers fee (2 years later. LOL) and he was sanctioned. IF I had continued to send claims KNOWING they were fraudulent I would have been held JUST as libel as he. Going to court ONE time on federal or state charges will close your doors for business very quickly. Another example is if you are billing charges you know the provider is coding incorrectly and he/she refuses or doesn't change or document, you are again, just as responsible legally.
To go further, if you look at lawsuits involving billing schemes you will find many Office managers and in-house billers going down right along with the doctor.

I am not trying to scare you but I believe when you enter this business, there is more to know than just the fluff of how nice it is to work from home.

If you don't currently have clients, you don't have to purchase your insurance until you do. To be honest I didn't purchase my E/O until I had 2 or 3 clients and generated income. Some associations will offer discounts on E/O, but be careful of them and make sure the discount is worth the membership fee. One association out there charges an arm and a leg and many sign up just to get a $100 discount on E/O but they pay over $500 to become a member. ???

PURPLELADY:
THANKS PMRNC!!!  YOU ARE ALLLLRIGHT!!!!

PURPLELADY:
Question.....

Can I safely assume when charging a percentage per claim that I include the copay that is paid up front at the dr office?  Also, when billing the dr monthly, am I adding all moneies collected for the month and then do the percentage of that or  am I billing a percentage for each claim. By the way, in my previous posts I stated that I was going to purchase ezclaim software for 570.00. Well, they have a software that just prints claims. I will be using that and office ally for starters(office ally charges a fee for putting claims to paper).

Navigation

[0] Message Index

[#] Next page

[*] Previous page