General Category > General Questions
Can you make a profit by charging 4%?
tallmanusa:
Thanks for a very thoughtful response.
Just a question; your doctors seem to have a substantial practice, why not use a robust PM system like Advanced MD instead of Practice Mate.
And are you familiar with Mitochon, a free EHR and PM system?
You raise a very good question; with all this technology why would a doctor need us? I have to be able to answer this question, and in some detail.
The flip side of this technology is that billers are available at very low cost; I plan to pay 1% of the collections revenue cycle managment, and I have no shortage of them in United States; no need to go off shore.
The technology did not eliminate the job of billers, but it made their jobs scarcer to find.
PMRNC:
--- Quote ---The flip side of this technology is that billers are available at very low cost; I plan to pay 1% of the collections revenue cycle managment, and I have no shortage of them in United States; no need to go off shore.
The technology did not eliminate the job of billers, but it made their jobs scarcer to find.
--- End quote ---
I disagree, I do not think technology is pushing billers aside nor do I think they would be available at "low cost" First of all.. the position of "Medical Biller" is really outdated. If you are JUST a biller, you probably have been w/out a job for a while. WITH The exception of marketing I do not ever use the term Medical Biller to describe my self, I am a practice management administrator and consultant. I DO MUCH more than billing. And if we are going to talk about how technology has made them scarcer I would have to ask then why would a medical billing company need to hire billers than? ::) ;D
Only about 15% of what I do is medical billing actually. Almost everything else I do is not available with technology at all. Today's billing company has to be a full practice company and must offer a wide variety of services. Not to mention there are quite a few other things I can still add and might add in the future.
Nope.. I pretty solidly sold that my services will still be in demand even with all the technology. Though, I still do believe we won't see EHR as mandatory like they say.. I see so many delays coming.. it's inevitable.
RichardP:
It's been a busy week. Hope all who celebrated had a happy Thanksgiving.
tallmanusa, you asked "your doctors seem to have a substantial practice, why not use a robust PM system like Advanced MD instead of Practice Mate." Short answer: we get the job done with what we currently have, as described above. The billing software was paid for long ago, it does what I need it to do for complicated billing (things that more "robust" software does not do), and electronic billing through Office Ally is $20 per month only if Medicare is greater than 50% of the billing. I would gain nothing by switching to a different system.
Only one of my clients is using EMR, and is using Practice Fusion for that (it is pretty intuitive to use). We do the billing through my billing software as described above, which easily handles complicated billing. We have a customized fee slip that the doc uses to mark off what he did and sends that paper to us. The one client I have that was using the Practice Mate side of "Office Ally for billing, I have switched to my billing software and bill as described above. The paper fee slip leaves an audit trail for us to point to in case we are ever accused of billing for charges that the doctor didn't authorize. That protection is a valuable thing to have, and is difficult to come up with in a totally paperless practice (complicated subject not suitable for discussing here).
Other than the client using Practice Fusion, none of my clients intend to use an EMR. They will drop out of Medicare first if push comes to shove. My one client who uses an EMR says it has added about 1 1/2 hours to his work day just inputting all the data into the computer (others who use EMRs agree that his figure is consistent with the increased amount of time they must spend). He is seriously considering dropping the EMR. Seriously take some time and think this through. This doctor is one who earns more than one million dollars per year. Estimate what that translates into in terms of earnings per hour. It is now costing him 1 1/2 hours of earnings, every single day, just for the "priviledge" of using an EMR (plus whatever charges there are related to using the EMR). If he stopped using the EMR, he would re-gain that 1 1/2 hours of earnings every day. Multiply this reality by every doctor using an EMR and you can see some implications for long-term use of EMRs.
I did not ask "with all this technology why would a doctor need us?" I suggest you re-read both of my posts above to see what I actually said. Which was - technology cannot give a doctor what he actually needs in order to get paid - which is, someone who knows all that he can bill for, and what the highest level he can legally bill for and still get paid is. Remember my potential client with the 50-doctor doctors group? They have very bright and shiny and expensive technology - and they still leave about 30% of their money lying on the table. And they don't even know it (until we point it out to them). What caused you to think, from that example of the doctors leaving money on the table, that I asked "with all this technology, why would a doctor need us"? I said the exact opposite: it is not the technology that gets a doctor paid; rather, it is the knowledge in the head of the biller.
The technology may help figure out, on an aggregate level, which treatments lead to the best outcomes (data-mining aggregated EMR data). But you (and we) are not concerned with that. We are concerned with getting the doctor paid - by billing for all work done, at the highest rate that is legal. And, as the example given in my previous post shows, the technology does not help with that. Only the knowledge in the biller's head can help with that. (Read that last sentence over until you get it.) But this point is valid mostly for doctors who do complicated billing. Doctors who do really simple billing don't need a knowledgeable biller. But then, they don't need complicated technology either. Which of those types of practices (complicated or simple billing) are you going to sell your services to? Just remember that the robust IT solution is not going to help either one of those types of practices get paid. The complicated practice does need a biller who knows what they are doing. The simple practice doesn't. But the simple practice doesn't need complex technology either. So what is it that you are going to be selling if you think technology is more important in the billing process than wetware - when the technology does not actually get the doctor paid?
Note: Assume a single procedure code with three supporting diagnoses. I assume you know that your three supporting diagnosis codes must be appropriate to the procedure code in order for you to get paid. But did you also know that which diagnosis code is listed first can determine how much you get paid for the procedure? Put the right diagnosis code first and you will get paid the maximum. Put a different one of the three diagnosis codes first, and you will get paid less than the maximum - sometimes substantially so. If you didn't know this, you'd better hire someone who does know it.
Good luck with what you are thinking about doing. Keep us updated.
Finally - what Linda said.
Michele:
Garbage in - garbage out....no matter how good the system is. :)
tallmanusa:
Here is a link that speaks for itself. It is a thorough study.
http://www.cdc.gov/nchs/data/databriefs/db98.htm
Quote:
"Eighty-five percent of physicians who have adopted an EHR system reported being somewhat (47%) or very (38%) satisfied with their system."
It is anticipated that vast majority of practices have already adopted EHR or in the process of doing it; (55% in 2011). It would be completed before 2015 by all physicians practicing in USA; read the whole study. That is the reality.
There are five major medical billing companies in United States, most of those in business know who they are, they do about 80% of all business in medical billing. They ALL use cutting edge technology.
If I am going to be in business and I am going to challenge them, I have to do what they do, and be better and cheaper than them.
No rocket science, ABC of business.
Of course, if I did not want to challenge them, I could get by with my pencil and paper.
When I make a statement, I give a link to a study, data, or factual basis for the statement. I would hope others would do the same.
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