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What To Charge Client For Research, Verifying Benefits and Submitting Claims?

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jyoung65:
This client has patients that has not met their deductible, but the claim still need to be submitted to the insurance companies. I have to verify benefits, research and submit claims. They will not pay out because patient has not met deductibles. What should I charge per claim for this type of service it is time consuming? Thanks for your suggestions!

PMRNC:

--- Quote ---This client has patients that has not met their deductible, but the claim still need to be submitted to the insurance companies. I have to verify benefits, research and submit claims. They will not pay out because patient has not met deductibles. What should I charge per claim for this type of service it is time consuming? Thanks for your suggestions!
--- End quote ---

What does your contract state? Your contract should specify what constitutes a "claim" and should clearly define services. If it's Full practice management than the fee is all inclusive to what you are charging.

This is one of reasons I charge monthly flat fees based on my time so that I get paid for all services fairly.

jyoung65:
This is a client that I work on her aged and denied claims. I do not do full practice management for her.  Thanks :)

PMRNC:

--- Quote ---This is a client that I work on her aged and denied claims. I do not do full practice management for her.  Thanks :)

--- End quote ---

It would still depend on what is in your contract. If your not contracted to work on current claims or provide FPM, but aging only you would still want a contract to protect you and define the services. This way when you have situations like this come up there are no questions.

DMK:
This is really an important issue folks!  More and more patients will have high deductibles so there won't be claim payment from the insurance company, but there will still be the same amount of work!

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