General Category > General Questions
charging a %
Billergirlnyc:
I can't say I've never had a provider fight my pricing structure. Most I encounter are thankful for the information, but understand that what's on a state's statue and what's industry standard are 2 different things (in their minds). Those of us who don't use a percentage-based pricing system are often fighting an uphill battle. I mean ethics aside, set-fee's (at this time) isn't industry standard, and that's what I believe this particular doctor you were meeting with was referring too. I can't sit here and say I've never had a percentage-based contract, I have. I've moved away from them. I too like getting paid for all my services and my set-fee based pricing structure works perfectly for me and my clients, but in the past it was definitely a point of contention with certain clients. You will more than likely encounter more than just this doctor who pushes back and believes that industry standards supersede any state or federal statue. This is why I have stated and Linda have stated having an attorney is your best bet especially when structuring your contracts and the rules on the books for your state.
RichardP:
He's pushing for the language to be clearer ...
Edit: That quote was in Billergirlnyc's last paragraph before she edited it. It is not there now, but I'll leave this here anyway. /Edit
I like the language in the California Code. It makes things quite clear.
b) The payment or receipt of consideration - for services other than the referral of patients - which is based on a percentage of gross revenue or similar type of contractual arrangement shall not be unlawful if the consideration is commensurate with the value of the services furnished or with the fair rental value of any premises or equipment leased or provided by the recipient to the payer.
From here:
http://www.medicalbillinglive.com/members/index.php?topic=7131.msg21583#msg21583
You will more than likely encounter ... [those who believe] ... that industry standards supersede any state or federal statue.
And a biller may be from a state with a regulation on the book that is not being enforced, and the doctor's health care attorney has told him this. That is one of the several reasons why it is good for medical billers to have access to their own health care lawyer for opinions.
PMRNC:
--- Quote ---Those of us who don't use a percentage-based pricing system are often fighting an uphill battle.
--- End quote ---
No, actually not at all. I think the majority of the industry is just so stuck on the whole <yawn> marketing of "We don't get paid till you get paid" they have not sat down to look at it from an alternative payment method. I don't use fixed pricing. I have a monthly flat billing structure which takes into account time, expenses, hourly wage. NICE and simple. Just ask a doctor who else they split fees with, not their transcription, not their coder.. so why you? MY stand is this. I don't ever get into a negotiation about HOW I charge. You wouldn't call your mortgage company, your utility companies or even your babysitter to price haggle, so why would I? Generally I have only been ASKED "Why don't you charge a % of receipts?" That's a fair question and usually my answer is sufficient to them, it's never gone beyond me just telling them, I prefer to get paid for all work I put in, my guarantee of timely and quality service is what they are getting in exchange. If it is a NY client I will just simply tell them also about the fee-splitting law (YES, sorry Richard it is indeed enforced here) and I've always been received great by that .. especially if other billing companies have quoted them a % or they used a service that billed on a %. To them it says I CARE about their license.
--- Quote ---He's pushing for the language to be clearer ...
Edit: That quote was in Billergirlnyc's last paragraph before she edited it. It is not there now, but I'll leave this here anyway. /Edit
--- End quote ---
No fair.. if someone edits a post, there is a reason. so I don't feel addressing something that's not there in an edited post is called for. JMHO
Billergirlnyc:
--- Quote from: PMRNC on February 10, 2013, 10:05:07 PM ---
--- Quote ---Those of us who don't use a percentage-based pricing system are often fighting an uphill battle.
--- End quote ---
No, actually not at all. I think the majority of the industry is just so stuck on the whole <yawn> marketing of "We don't get paid till you get paid" they have not sat down to look at it from an alternative payment method. I don't use fixed pricing. I have a monthly flat billing structure which takes into account time, expenses, hourly wage. NICE and simple. Just ask a doctor who else they split fees with, not their transcription, not their coder.. so why you? MY stand is this. I don't ever get into a negotiation about HOW I charge. You wouldn't call your mortgage company, your utility companies or even your babysitter to price haggle, so why would I? Generally I have only been ASKED "Why don't you charge a % of receipts?" That's a fair question and usually my answer is sufficient to them, it's never gone beyond me just telling them, I prefer to get paid for all work I put in, my guarantee of timely and quality service is what they are getting in exchange. If it is a NY client I will just simply tell them also about the fee-splitting law (YES, sorry Richard it is indeed enforced here) and I've always been received great by that .. especially if other billing companies have quoted them a % or they used a service that billed on a %. To them it says I CARE about their license.
--- End quote ---
I agree about what the industry is stuck on, but it doesn't negate what I've experienced, which is how I was answering her question. Some doctors in NY just don't want to work with any other pricing structure. And my response to the original OP is so she doesn't think this is odd (the pushback I mean), because I don't think it is, well not based on my experience and what I hear from fellow billers in my area. Also acknowledging the issues I've run into helps her understand why she MAY have seen this doctor pushback on her knowledge and her terms. Of course you don't have to negotiate your pricing structure with anyone, but that's not what I'm discussing. I'm acknowledging that I've dealt with doctors like the one she has. It's clear this doctor knew about the rules but still refuses any other pricing terms than percentage. It's also clear that no matter how she framed her pricing structure or why this doctor wasn't interested, even if he was looking to change billing companies. I believe she was trying to figure-out why he was saying what he said, and I hope she has some insight into that now.
--- Quote ---He's pushing for the language to be clearer ...
Edit: That quote was in Billergirlnyc's last paragraph before she edited it. It is not there now, but I'll leave this here anyway. /Edit
--- End quote ---
--- Quote ---No fair.. if someone edits a post, there is a reason. so I don't feel addressing something that's not there in an edited post is called for. JMHO
--- End quote ---
Thanks, as I feel the exact same way.
RichardP:
No fair.. if someone edits a post, there is a reason.
OK. I get that. In this instance, I quoted what was there, wrote my comment, and posted it. Apparently, the edit was made after I copied the quote but before I posted my comment. It was only by chance that I later reread the post I copied from to find the re-write. Seems like this can happen any time folks are posting close in time to each other. Or not. Anyone can go delete from their post something that someone else has already quoted and commented on. If that someone else doesn't ever go read the edited posting they quoted from, they won't ever know the quoted material was deleted. I don't see a good way of preventing that potential problem.
Let me know if I should delete the quote in question and my response to it.
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