Starting a Medical Billing Business > Starting Your Own Medical Billing Business
Fees
PMRNC:
What I do is estimate the time I think necessary for each client on a monthly basis. I then determine my hourly rate (new billers will have this number lower, it should be based on experience, geographic location and education) then I deduct estimated costs and voila! my contract then has a clause that allows me to have a sliding scale so if the provider adds more work, that makes more work for me and I get paid more. It's quite simple but yes I hear you about the marketing stuff being drilled into your head. When I had my billing company setup a few years ago in PA I couldn't imagine charging anything BUT a %, but the more I researched, played the numbers..the more it worked. Then after you arrive at your monthly fee you get used to that way of thinking and you can justify it to the provider who questions it. For example here in NY it is illegal for a provider to enter into a fee-splitting arrangement, but there are a lot of billing companies who either don't know of it or just ignore it because "everyone else is doing it" When I have a potential client that is using one of these billing companies, I use it as a marketing tool I tell the provider that it's not illegal for me, but for them.. and that my best interest is their practice not just my wallet, that usually sells them or they research and see what I'm talking about, and then they have become educated.
I don't negotiate.. I used to, but I've been doing this too long to do that anymore. For the first few clients I can totally understand having a bargaining chip or negotiation, but I just don't anymore.
Pay_My_Claims:
--- Quote from: jcbilling on October 25, 2009, 02:11:18 AM ---Charlene -
I understand what you're saying about upcoding and falsifiying claims. Although I consider my services very professional and work hard to stay compliant, I realize there are billing services that are just trying to "get rich quick" and therefore give the rest of us a bad name. I guess I have a mental block because I have read so many marketing materials engraving in my head why % billing is beneficial to the provider.
Linda -
You make a good point about not getting paid on the claims that are not the fault of our billing. I have a client who has 3 offices that we bill for. The one office refuses to verify insurance benefits because the receptionist "doesn't have the time" and since the provider is out-of-network, we have so many claims going to the deductible and they don't collect the payment upfront. So the provider is losing money and so am I. I have talked to the provider multiple times about this and he shows no effort to change. It makes me so frustrated, because we spend time sending the claims knowing they won't get paid.
My next question is how do you determine what you charge a client on a flat rate plan? I know there are many factors, such as overhead costs, your time involved with the account, etc. Do you make a itemized fee schedule? Or do you just present a charge and negotiate...or do you not negotiate?
--- End quote ---
You would be getting paid if you charged a flat fee instead of %.
Pay_My_Claims:
--- Quote from: PMRNC on October 25, 2009, 02:37:16 AM ---What I do is estimate the time I think necessary for each client on a monthly basis. I then determine my hourly rate (new billers will have this number lower, it should be based on experience, geographic location and education) then I deduct estimated costs and voila! my contract then has a clause that allows me to have a sliding scale so if the provider adds more work, that makes more work for me and I get paid more. It's quite simple but yes I hear you about the marketing stuff being drilled into your head. When I had my billing company setup a few years ago in PA I couldn't imagine charging anything BUT a %, but the more I researched, played the numbers..the more it worked. Then after you arrive at your monthly fee you get used to that way of thinking and you can justify it to the provider who questions it. For example here in NY it is illegal for a provider to enter into a fee-splitting arrangement, but there are a lot of billing companies who either don't know of it or just ignore it because "everyone else is doing it" When I have a potential client that is using one of these billing companies, I use it as a marketing tool I tell the provider that it's not illegal for me, but for them.. and that my best interest is their practice not just my wallet, that usually sells them or they research and see what I'm talking about, and then they have become educated.
I don't negotiate.. I used to, but I've been doing this too long to do that anymore. For the first few clients I can totally understand having a bargaining chip or negotiation, but I just don't anymore.
--- End quote ---
I learned from it also Linda. My entire premise of doing medical billing from home is that every provider that I worked for, I KNEW I could do the job accurately and efficiently, and more time effective if it wasn't done in the setting I was in. More often Billers are Practice Managers, or they split their time doing front desk work. I know that if I could only do one provider in 8 hrs, it wouldn't be beneficial to work from home. If I could manage 4 providers in an 8 hr day, and at MINIMAL get paid the same as if I was working in an office (ex 2500 a month x 4 = 10k a month) The providers are happy, they are getting great service for the same or less than an in-house biller, and I get paid in a month what it takes others 4-6 months to make. I win, the provider wins. I really understand the reason behind the % billing, the motivation to do it, but lets be real. A BAD biller is a BAD biller. I don't like sales,and % billing is a sales position. I work each claim regardless of how I am paid because I enjoy my job, and I like to succeed. My knowledge will get me the $$ I deserve.
PMRNC:
--- Quote ---I don't like sales,and % billing is a sales position. I work each claim regardless of how I am paid because I enjoy my job, and I like to succeed. My knowledge will get me the $$ I deserve.
--- End quote ---
I COULDN'T HAVE SAID IT ANY BETTER!! ;D :D ;) ;D
jcbilling:
You all mention the slidng scale...how does that work? Do you review certain reports every quarter and determine if the fee goes up or down? based on reimbursements? how does that work?
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