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

Contract questions....

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taxlady28781:
I'm working on getting all the information together for my contracts and have a few questions on how everyone is handling a couple topics in their contracts.  I have Alice and Michelle's book on writing a contract, (which is fabulous ladies!! Thanks!), but I am not sure how I want to handle a few things and want your opinions....

1. Termination.....how long are you providing follow ups on claims you have filed, if you do at all after your termination date...30/60 days?

2.  How have you addressed early termination of your contract if you have a one year contract?  Do you charge a penalty?  Require a 30 day notice with cause by either party and if so do you have specific instances lined out in your contract that would be appropriate cause for early termination?  For cases of fraud or suspected fraud, I was gonna do immediate termination.

I'm sure I will have more questions as I go along, but that is all for right now :)

Michele:
Thanks so much!  I'm glad you found the book helpful. 

1.  We usually do 60 days (90 on a larger account).  We clean up as much as we can in the 60 days, then provide them with a list of claims that were not cleared and why.

2.  Early termination without cause has a penalty.  30 day notice with cause.  Immediate termination if fraud.

Hope that helps!

Michele

PMRNC:



--- Quote ---1. Termination.....how long are you providing follow ups on claims you have filed, if you do at all after your termination date...30/60 days?
--- End quote ---

If you are charging based on a % this is where it can be sticky.. because you of course want to get paid for all the work you have done..at same time the provider could end up stiffing you so you want to be sure if you are charging % you state specifically that you will continue to follow up on all claims within the time frame you have worked.  One of many reasons I stopped billing on a % was so that I could just clean up in a given time frame and be done. I give 30 days in most of my contracts.

--- Quote ---
2.  How have you addressed early termination of your contract if you have a one year contract?  Do you charge a penalty?  Require a 30 day notice with cause by either party and if so do you have specific instances lined out in your contract that would be appropriate cause for early termination?  For cases of fraud or suspected fraud, I was gonna do immediate termination.
--- End quote ---

If a provider is unhappy with my work and wants out of their contract I do require 30 days notice, however I've never had to excercise any penalty but I have one in my contract that allows me to collect 50% of their flat fee for early termination w/out 30 days notice. 

YES YES to the termination due to fraud / abuse  but I have added one very important word to my contract...  "SUSPICION"  Any suspicion and/or knoweledge of fraud or abuse is subject to IMMEDIATE termination. In a nut shell, I don't touch another thing from that client the SECOND I suspect or know of fraud and/or abuse. The reason I added the word suspicion is because that's how the law reads on fraud and abuse, IF you knowingly suspect or have knowledge of..you are immediately libel and responsible for everything you do at that exact time. THAT one word means a lot because there will be physicians who might challenge that by saying "prove it".  By adding the word suspicion of.. it implies that you don't need to prove anything and that you are covering your own ass. You need ONLY state your suspicions and even that is a courtesy. I have had to terminate 2 clients.. one was suspect and the other I actually turned in under whistle-blowers.

I'm sure I will have more questions as I go along, but that is all for right now Smiley

QueenAlicia:
I like that turn suspicion. I will remenber to review my contract and add that.  I like all of the advice from seasoned billers, the help and advice is appreciated.

taxlady28781:
Thanks for the responses so far.  I appreciate all the insight you all give to us "newbies" in the business.  I'm so glad I found this forum, just wish I had found out about it and medicalbillingcourse.com before I dropped all that money into the course I took...it looks so much more like what I needed and a couple hundred dollars cheaper too....now I know and when I get ready to try to do coding I can ask here first for recommendations on courses for that, but that will have to wait a little while. 

Linda, I will be using a flat fee, probably a monthly.  And I definitely planned on using the "suspicion of fraud" in my contract. 

If anybody else has any other suggestions or advice please pass it on  ;D

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