General Category > General Questions
Can you make a profit by charging 4%?
DMK:
--- Quote from: tallmanusa on November 14, 2012, 09:20:02 AM ---
And yes, they don't take anyone who does not have EHR, like most of these companies.
I am at a loss, if that is how the business is done, then where is the problem?
--- End quote ---
Because small practices and rural practices will NOT have to have EHR if there is financial hardship, but they will still need to bill for services. If you are only going to focus on large practices, hospitals and clinics, YOU may not care about outsourcing or the little guy, but most of the billers on this forum are servicing small businesses as well as good size clinics. The little guy will get fined for non-compliance just the same as the big guy, however, he'll get fined right out of business!
QueenAlicia:
WOW! My jaw dropped. Billing companies MUST comply with HIPAA. Don't comply you won't be in business long and you'll probably be in jail, lol. I think a revisit to the OIG third party portion may be in need here ;D
For example, if you are faxing over patient you know that you must black out some information? That is apart of HIPAA as well as verifying patient identity over the phone. You can't just give out patient information without identifying who the person is.
Outsourcing to India is another story and those HUGE companies will eventually fail because the patients will complain about their information being over there. In addition to that the laws here in the US do not apply over there and there have been several incidents were the offshore company has threatened to sell the providers patient info if they did not pay more money.
I would not trust ANY company that does business over there because it shows that they care about the dollar more than patient information security.
tallmanusa:
There are dozens of huge companies who do this business, actually well over 80% of the business is done by a handful of companies, they ALL outsource.
One company, which is public so their records are public information; Athena Health symbol ATHN, is valued at 2.2 Billion dollars; its CEO got paid $300 million dollars (including stocks) last year, he is not in jail , he is doing fine, living in a mansion of 50 million dollars. Again all of this is public information.
By the way they charge 6.5%.
DMK:
Athena is probably doing everything right, but I doubt that they all are. BTW are you working for Athena? Because it sure sounds like a sales pitch.
This forum is a great place for back and forth discussion about ALL the complexities of Medical Billing, not just a soap box for doing it ONE way.
As a nation, we are built on a lot of small businesses. True, there are large companies, making lots of money, but this forum is mostly about the little guy or the newbie or the person who wants the American dream of owning their own business.
There are laws in place (some good, some bad, some well intentioned but with bad consequences) that we ALL have to follow. The big guys can pay the fines and pass the costs on to their consumers, the little guy needs to do it RIGHT the first time and all the time.
If you don't understand this, you don't understand most of the people in this forum.
tallmanusa:
No, I don't work for Athena; what sales pitch, I compete with them.
I give their example because it is a public company, I don't have accurate information about private companies.
For the record I am building a company that someday would be a public company.
Laws are the same for little guys and mega companies. I don't believe that big companies get away with it because they are big. If anything big companies draw more attention and are subject to more scrutiny than little guys.
I pointed out how big companies are doing it, I don't make any value judgement, whether it is right or wrong, I state the way it is.
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