Starting a Medical Billing Business > Starting Your Own Medical Billing Business
starting a medical billing business
PMRNC:
How you charge should be spelled out completely in your contract. If you are going to charge a percentage of collections, just stating that is not enough, you would need to spell out that you willl either be charging a X% of total practice revenue (includes copay's and ALL incoming payments) or X% of insurance revenue..etc.
Typically the billing company should get a % of total practice revenue if they are doing full practice management.
My rule was. .. I touch it, I get paid.
--- Quote ---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).
--- End quote ---
You are going to find you will be VERY limited in the services you can provide clients. If you are going to use a sub-standard "print/send" claims only software, you will NOT be able to provide your clients with practice management, with claims only they really don't need a billing company since most of the work comes prior to and after the claim is submitted. If your intention is to cut costs starting out, you will find in the long run this will be a very big drawback. If you are looking to get into this business you need to have a full understanding of all services involved with full practice management. I'm afraid most of your claims only businesses are either gone or have figured out they need to do it all in order to stay competitive and in business.
DON'T Skimp on software..it's too important to your business and your clients business, and in the long run you will end up with a harder time trying to compete. Software conversions are NOT fun, and they are extremely costly. Take your time looking for the right PM Software and make sure it does all you need it to do. Going with a software that just prints/sends claims is really going to limit you where there is no need for your services.
Linda Walker
PMRNC
www.billerswebsite.com
PURPLELADY:
Thanks Linda.....
I do have a line in our agreement somewhat saying that we charge a % for any payments paid to dr as a result of our billing which includes insurances, capitation, self-pay, and co-pays (was not sure if I could include it).
Linda, maybe I'm misunderstanding what full practice management is. We are utilizing the full service of Office Ally and their software practice mate. I thought purchasing the "bill claim only" software would assist us. We will offer electronic/manual billing, follow-ups, resubmissions, pt billing, pre-collections on past due balances, provide drs with reports, telephone inquiries, etc. I thought this was enough for starters until we get our "feet on the ground". Our plan is not to always be home based. Should we be doing much more?? I guess I'm being aware of cost just in case things dont work out.
Linda, I greatly appreciate all your input!! Thanks again!!
Michele:
"I do have a line in our agreement somewhat saying that we charge a % for any payments paid to dr as a result of our billing which includes insurances, capitation, self-pay, and co-pays (was not sure if I could include it)." (from the last response to this post)
Be careful with that line. If you are providing a full service then you will be charging your % on the entire practice revenue, not just the amounts 'as a result of your billing.' Since you will be doing a full service you will need to track ALL patient payments including copays collected at the office by the office staff, which was not as a result of your billing. If you are tracking it, you need to be paid, and it would be difficult to separate what you collected vs what they collected. Like Linda said, if you touch it, get paid for it. If you track it, you need to be paid. With the line above you are saying you won't be paid for amounts collected in the office and that is a problem.
Also, regarding the software thing, Linda is correct (again!). It is too important to start out in a Yugo and then try to move up to a Cadillac. You don't want to limit yourself in your capabilities, especially in the beginning. You want to do an amazing job so that you get more clinics by referral. Saves on the need to market. There is a new technology available called SAAS which is allowing companies to offer a Great PM system at a VERY reasonable price. Many of the web based softwares are too expensive for billing services because they charge per doc/practice and they have a set up fee for every new provider. We have found one that charges per seat instead of per provider and the monthly fee for billing services is only $149 per month. They are comparable to the PM system by Ingenix, and AdvancedMD but at much lower cost. Most people don't think it's possible, but the SAAS allows them to offer the same features at a lower cost.
Whatever way you decide to go, just make sure you don't skimp on what you can do.
Michele
PURPLELADY:
I'm getting confused here guys.....
Are you suggesting I not go with Office Ally and their web-based practice management system (practice mate) for free? They also provide the reports needed for the docs. Again, I thought I could purchase the "print send" (145.00) to do my own claims opposed to paying office ally to do it. So, do I purchase a "full" billing software along with using office ally? Or do I just can the whole thing and start over? I'm bout to loose my mind!!! (smile) I guess I'm being too cost efficient considering there is very limited funds.
Michelle, I do see what you're saying about the line in my contract. I will review and correct my 2-page contract it since I'm doing just billing claims, follow-up, patient billing, and collections.
I tell you.....just when I thought I was getting close to starting!!! Where is the simplicity? (smile) I'm so glad I talk to you guys first. Thank You so much.
Alice Scott:
Alice here. ;)
I had to comment on this one as I have been researching software for the last six months. Michele and I became aware that the web based software had much more to offer than a server based one like the Lytec we have been using for the last 15 years. When I saw what the web based ones can do I really got excited. I see where it can cut down our data entry time by possibly as much as 50%. That is HUGE!!! I set up demos of all the web based programs I could but found them to be way too expensive for us to switch. It would have been five figures to get started. Then I found a new company using SaaS (which I had to look up on Wikipedia to understand). Saas is new and enables this company to offer the same advantages as the large web based companies for a monthly fee of $99 for a doctors office and $149 for a medical billing service. They don't have a set up fee and they don't charge extra for more than one doctor. For only $149 a month a medical billing service can have web based software. The software is in Beta version now, but I have tried it out and it is amazing. They will soon be accepting early adoptors and will have it fully available sometime in June. The company is called Xena and I think it's going to turn the world of web based software upside down. The last demo I did with one web based company had a minimum cost of $3000 per month plus a huge start up based on the number of doctors we bill for. I've checked and rechecked and Xena is $149 per month!!- no surprises.
I'm a little afraid of trusting our business to a limited free program which is trying to get you to upgrade to the paid version. I wanted all the benefits that the web based programs will offer. Xena offers the full practice management system with the clearing house, reports, and everything else you need plus some stuff you never thought of.
We had an opportunity to go to the HIMSS conference in Chicago this week and it was obvious that server based software is antique. Anyone starting this business needs to use a web based software and now there is an affordable one. Anyone still using a server based software needs to look at the advantages of a web based one. I wrote an article about some of the advantages for anyone interested. http://www.solutions-medical-billing.com/webbasedmedicalbillingsoftware.html You are welcome to call our office and ask Michele or me for more information. (1-800-490-4299 Eastern time)
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