Payments > Insurance Payments
Insurance payments
maxamillion125:
I have a few questions. We're a new Medical Billing company and looking for ways to increase productivity and improve workflow. We started our business just over a year ago and we recently hit a MAJOR growth spurt. We were doing fine managing our 2 clients but thanks to some effective marketing, doctors referrals and some good luck we signed 4 NEW clients within a couple weeks. Needless to say we're kind of struggling right now with all the time it takes to transfer patient demographics and insurance, set up a workstation to remote log in, learn new EMR/PM systems and re-submit a years worth of claims for one of the new clients.
We charge a percent of the total amount the practice brings in or a minimum, whichever is greater. I know a lot of people say to stay away from charging a %, but it seems to work for us. Except in the initial month or two because the accounts require a lot of clean up, credentialing, and time to set everything up and learn the new EMR/PM system if the client doesn't want to use ours. Anyway, one of my main problems is posting Insurance/patient payments. We probably spend 3-4 hours a day posting payments. Do most of you use ERA and if so do you still receive a paper EOB and check? We would like to receive a paper EOB and check for our records but have the payment auto-post.
Thanks in advance!!!
PMRNC:
--- Quote ---We charge a percent of the total amount the practice brings in or a minimum, whichever is greater
--- End quote ---
I answered this in another thread..but YIKES on this method.. % or minimum??? I imagine it's a great marketing tool and assuming you are in state that does not prohibit percentage based billing. . but I have to ask.. are you being reimbursed for your time.. because that method surely wouldn't get me reimbursed for my time. J M H O
maxamillion125:
Percentage based billing is legal in MT. The minimum is really just to help us cover start up costs and PM software the first month or two before we start getting insurance/patient payments coming in. We are doing OK, charging 7%. What do you generally charge per claim? I can crunch some numbers and see if that method would be better for us in the future.
Thanks.
PMRNC:
--- Quote ---Percentage based billing is legal in MT. The minimum is really just to help us cover start up costs and PM software the first month or two before we start getting insurance/patient payments coming in. We are doing OK, charging 7%. What do you generally charge per claim? I can crunch some numbers and see if that method would be better for us in the future.
--- End quote ---
I don't do a per claim. My fee is based on a flat rate with sliding scale to accommodate growth of the practice. Basically means I'm getting paid for every single thing I do. I AM in a state that prohibits it..however BEFORE I changed over and came her to NY state. I ran reports and analysis and I'm getting paid 60% MORE than what I was with % based contract. My clients even are NOT seeing much of a difference either. Still a big time savings for them. Again,... this is JMHO. I do feel in the future we will all be prohibited from charging a percentage as it's too much of an incentive for fraud.
You have to analyze the AMOUNT of work done PER client as well as the time/cost per employee on that time worked per account. Those charging on a % of collections are indeed losing money, whether they want to admit it or not. THE only benefit is their ability to market "we don't get paid until you get paid" which is old and tired. A billing company charging a % of collections is NOT being reimbursed on time, experience or any other means.. but simply on the bottom collection line which doesn't begin to depict the time spend.
maxamillion125:
--- Quote from: PMRNC on October 23, 2013, 05:19:18 PM ---
--- Quote ---Percentage based billing is legal in MT. The minimum is really just to help us cover start up costs and PM software the first month or two before we start getting insurance/patient payments coming in. We are doing OK, charging 7%. What do you generally charge per claim? I can crunch some numbers and see if that method would be better for us in the future.
--- End quote ---
I don't do a per claim. My fee is based on a flat rate with sliding scale to accommodate growth of the practice. Basically means I'm getting paid for every single thing I do. I AM in a state that prohibits it..however BEFORE I changed over and came her to NY state. I ran reports and analysis and I'm getting paid 60% MORE than what I was with % based contract. My clients even are NOT seeing much of a difference either. Still a big time savings for them. Again,... this is JMHO. I do feel in the future we will all be prohibited from charging a percentage as it's too much of an incentive for fraud.
You have to analyze the AMOUNT of work done PER client as well as the time/cost per employee on that time worked per account. Those charging on a % of collections are indeed losing money, whether they want to admit it or not. THE only benefit is their ability to market "we don't get paid until you get paid" which is old and tired. A billing company charging a % of collections is NOT being reimbursed on time, experience or any other means.. but simply on the bottom collection line which doesn't begin to depict the time spend.
--- End quote ---
Wow 60% increase over % based contract, that's amazing. Is your sliding scale based on how many claims you submit or how many patients they see per month? Or is it just a cost analysis of how much time you think it will take per week/month?
We have a minimum charge per month for each provider. And its based on the what we expect it will cost us in employee wages, software, statements and other expenses + a 10% net profit. We haven't really tested this method yet because we just signed these new providers within the last couple weeks. But either way we won't be loosing money in the beginning and once payments start coming in then our 7% of the clients revenue should exceed the minimum rate.
I'm interested to hear about your flat rate, sliding scale fee.
Thanks
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