Clean up old billing

[bethcanare]

I am a newbie and an inexperienced biller.  I just finished an online course and is currently working on marketing. I was just reading your book, "Secrets to Signing Up Your First Doctor" and I have a question about cleaning up old billing. How do you really do that?  Do you have to come in the doctor's office and read through all the EOBs?  Do you have to post all these claims on your own billing software again or just make phone calls to the insurance companies?  That is one thing I dread to do since I would not know how to handle that.

Thanks so much!

Beth

[Michele]

You don't have to do it by going into the provider's office or by reading thru all the eobs.  You could do it by working off of the provider's aging report, as long as the report gives you enough info.  Or you can have the provider have someone print off cms forms (just on blank paper, not on forms - to save $) for any outstanding claims. 

Sometimes we do work off of their eobs if they have a lot of denials, or if one particular insurance carrier is the problem.  You usually don't need to go thru them all, you can get a feel for what is going wrong and what needs to be done by looking at a couple of the denials.

But if they are losing a lot of money, they need someone to figure out why, and if that someone is you that is great.  In addition to that, if you can get the outstanding claims paid and increase their receivables that is even better.

Michele

[bethcanare]

Thank you, Michele.  Now that you explained it, I think this is something I can do.  I was also wondering how to charge client for this.  If I find a client who has problems with this old A/R, do I charge per hour or %?  I do not have a clue.

Thanks again.

Beth

[billspecial]

Some of the doctors I have signed will give you remote access to their computer for you to log into their server/software and work on the A/R on their system. I think it's better that way, most A/ reports don't have all the information you need if you have to resubmit any claims. Some doctors had a previous billing company and no access to their old billing and they only want you to be responsible for the current stuff. As a suggestion, If you are new at billing, start with a Family Practice doctor they are somewhat less complicated, and always research the information you don't know, don't guess at it. I know a doctor who signed with a billing company with a un-educated biller, by the time I got to him his office was running on CAP checks only and he was begging the bank for a loan to keep him from losing his office. So just a little advice ask questions and educate yourself. Good Luck!

[Michele]

How to charge them for this depends on a couple of things.  For example, if they are going to be using you now for all current billing and the old stuff is not too terrible then I would just charge them the same as I am for the current stuff, whatever percentage that is.  It is sometimes difficult to split it out.

But if it is a terrible mess, and/or I'm not doing the current billing then you have to charge more.  Clean up is more involved than current billing.  I usually charge a higher percentage than my normal fee if it is stuff that I am pretty sure can get collected.  I usually go about 1 1/2 x's my normal percentage.  If I'm not sure what it's going to be, then I will charge an hourly rate.

Michele

[CasinosStorm]

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