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

Fees

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gderilus:
I live in Florida and I think there's a fee splitting law, But I was wondering if I can still charge a percentage even if there's a fee splitting law. I know sometimes it would be better to charge a percentage than a flat fee depend on the provider.

Also when charging a flat fee, do you charge like a specific amount each month or do you charge a fee per claim submitted.

PMRNC:
Florida is indeed a fee-splitting law state:

The basis for the final order appears in F.S. 458.331(1), which sets forth a list of acts or
 omissions for which the board may take disciplinary action against a physician's license.
The list includes 458.331(1)(i), which prohibits "paying or receiving any commission,
bonus, kickback, or rebate, or engaging in any split-fee arrangement in any form
whatsoever with a physician, organization, agency, or person, either directly or
indirectly, for patients referred to providers of health care goods and services . .

Michele:
You can either set it up to charge a flat monthly fee or a per claim fee, whichever one works out better for the situation.

Michele

Steve Verno CMBS, CEMCS:
IM also in Florida

Two companiea I worked for charged a percentage and they still do.  If you know anything about Florida, I doubt anyone will do anything if they find out you are charging a percentage.

The only thing you cant charge a percentage on is Florida Medicaid.  That is clearly spelled out in the Florida Medicaid Provider Manual.  We took our percentage and determined the per claim fee that is equal to the percentage and that is what we charged.

Good luck

PMRNC:
I Don't agree Steve, it's not a matter of the state doing anything as it's not illegal for the billing company however if you are in a state that prohibits fee-splitting and you are charging a %, your contract is basically not worth the paper it's typed on, not to mention it's a risk to the provider because it's their ass on the line. I'm in NY and I know that if a potential client tells me they are using a service that's charging them a % I use it as a marketing tool and before the end of the conversation they are thanking me because I was thinking of them. It's just irresponsible to do something you have been shown to be wrong just because everyone else is doing it.

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