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Percentage Billing

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kwardbilling:
Hi Everyone:  I was wondering if anyone can direct me to a place where it is documented that you can't percentage bill for your billing services in the state of MA?  I don't percentage bill, but I have lost business to several billers locally that do.  I am happy with the way I bill,(flat rate) but was wondering if anyone knows where I can find this documented.  Do you think it's appropriate to send an email to the clients have lost to other billers and tell them I hope they are happy with their choice in a billing service, but if for some reason they aren't I hope they consider calling me.  I was also going to mention that I wouldn't be able to accommodate their hope for me to percentage bill as it's against the law in the state of MA......does anyone have an opinion on this tactic?

thanks, as usual, for any advice
Karen

PMRNC:
many years wiser, when this question comes up I always Have to ask.. WHY would you want to bill % anyway?  Get paid for the time you put in, businesses in all walks of life do business and make money for all their time spent, lawyers, accountants, etc..

BUT if you have to know..

The states that have anti-kickback statutes separately identifiable from federal rules are California, Florida, Georgia, Massachusetts, NJ, North Carolina, and Texas Where it gets sticky is that some of states I mentioned have some gray area.. others are very straight forward in the fact that it is considered an "illegal fee splitting arrangement" to receive a percentage of revenue.. PERIOD. Then you have the ones that have their OWN law that pretty much is VERY clear (aside from Anti-kickback) that a physician cannot enter into a fee-splitting arrangement as such.  Those states are Florida, North Carolina, & NY, Illinois was one of them but it was overturned...however that is on re-appeal as we speak..awaiting a decision.   

NOW.. I know I did not answer your question....


--- Quote ---I was wondering if anyone can direct me to a place where it is documented that you can't percentage bill for your billing services in the state of MA?
--- End quote ---

The answer is No there is no such documentation that says a billing company cannot charge a percentage of collections. Why?  because it's not illegal for the billing company, but for the provider to "enter an arrangement that would constitute a fee-splitting arrangement" Mass is one of those states where there is a very gray area..my best advice would be to NOT do it. My motto:  "Better safe than sorry".  But if you want a better answer, I have to refer you to seek legal advice and even a second opinion for this.  But as I asked before.. Why would you want to?  Most answer this by saying "the provider wants it"  to which my response to them is to ask them if their lawyer charges them on a percentage, his accountant? I think not. Once you explain to any potential client that you are in business for financial gain as well as to be compensated FAIRLY on the time you spend working. If a provider's response is "But everyone is doing it"  Well I give them the old "Well if everyone was jumping off a bridge I sure wouldn't" If they are worried about your work, remind them that your reputation is online as well as future referrals, common sense :)


And if that doesn't work, here's the deal breaker:  " Violations of fee-splitting laws may subject a physician to disciplinary action by a state's licensing board, in addition to other sanctions." Usually that does it :)

Someone can come along and find you documentation that you could interpret to mean it can be done, others will provide the same information and interpret it to mean the opposite. I would better trust my gut first and then my attorney. And again, remember it's the doctor who would get into legal trouble.. YOU however could find yourself with money owed to you by the provider and your contract in those states with those fees, is NULL & VOID.. Yes it's no good, don't go to court, don't pass go and use your get out of jail free .. in other words your S.O.L  And I have seen billing companies suffer such a loss.  NOT worth it.

JMO :)   

Alice Scott:
Linda,
Thank you for clarifying this confusing topic.  Your knowledge is very valuable.
Alice

kwardbilling:
Hi Linda:  As I had said in my post I DON'T HAVE ANY INTENTION OF BILLING PERCENTAGE.  I guess my biggest question was, "is it appropriate to respond to the two clients who recently hired another billing agency, just because they percentage bill" by sending them an email telling them why I bill the way I do, which is flat rate.....!  In your response, I'm thinking it's probably most appropriate to tell them the reason I flat rate bill is number one it's much easier to keep track of and both my clients and myself know, can anticipate what the monthly expense will be, but mostly because it's not legal for a provider to pay a biller percentage...

I guess my biggest reason for this post is because I've noticed recently have have lost two clients (very close to signing with me), but went with someone else because of the way they bill.

Thank you for your response though.  I was anticipating that if I emailed the clinician they may ask where they can find that information......I'm sure they don't realize it.

PMRNC:

--- Quote ---Hi Linda:  As I had said in my post I DON'T HAVE ANY INTENTION OF BILLING PERCENTAGE.  I guess my biggest question was, "is it appropriate to respond to the two clients who recently hired another billing agency, just because they percentage bill" by sending them an email telling them why I bill the way I do, which is flat rate.....!  In your response, I'm thinking it's probably most appropriate to tell them the reason I flat rate bill is number one it's much easier to keep track of and both my clients and myself know, can anticipate what the monthly expense will be, but mostly because it's not legal for a provider to pay a biller percentage..
--- End quote ---
.

I would definitely tell them that these billing companies do not have their best interests, unlike yourself :)  Out here in NY have taken a few clients like that :) 

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