Payments > Insurance Payments
Insurance payments
PMRNC:
--- Quote --- In one of our converstations on this issue, Linda stated her fee, as a percent of the stable revenue of her clients. That percent was quite high, and I doubt any doctor would hire her if she told the doctor up front that percentage as her "fee" to do the doctor's billing.
--- End quote ---
I don't think I did state my fee. and there are NO percentage figures at all in the way I do my fee. It's not at all based on revenue as in NY state you can't even perceive a percentage of revenue. Maybe I had given an example comparing. The fee per month is based on MY hourly rate PLUS expenses. A thorough analysis was done before switching over to this method. ___ hours a month x $__ hourly rate, add expenses. When switching over I knew how long, from doing a thorough analysis of time per client, how long it took me to perform each task, so if I was able to process 5 new patients an hour then 5 patients X $__ hourly rate would be added for every 5 new patients (this number and time could vary with experience, specialty, etc) I admit to do this type of billing you need to have a good handle on your time and efficiency. I don't have employees to pay and hardly any overhead at all except for standard charges such as supplies, claim forms, envelopes and the normal costs of doing business. All clients were given new contracts with the flat fee estimate so there were no surprises.
--- Quote --- I doubt any doctor would hire her if she told the doctor up front that percentage as her "fee" to do the doctor's billing.
--- End quote ---
Awfully assumptive of you don't you think? Again, I do NOT just do billing. I maintain my clients par contracts, office and financial policies, policies / procedures, etc., I.E. PRACTICE MANAGEMENT. I don't' think I've done billing only since I started my business.
--- Quote --- if you charge a flat fee, and the doctor's business stays fairly constant over time, that flat fee divided by revenue collected actually is a percentage of revenue collected
--- End quote ---
MAYBE.. but generally it doesn't work out that way or you have multiple % rates. LEGALLY SPEAKING my attorney told me the method cannot be BASED or PERCEIVED to be on a %.
--- Quote ---* I don't see how billing a 7% fee for all monies collected won't cover your costs and leave something for profit. I'm sure there are exceptions - but the fewer patients the client sees, the less of your time you spend on that billing, so your own expenses go down as the income collected from that client goes down. The reverse is also true: as the number of patients your client sees increases, the time you spend on his billing increases, your costs increase, but so does your income
--- End quote ---
.
I can't see how any one can make that assumption not knowing more about the company, (employees, time spent, office space, overhead, etc) Every company is different, I have seen billing companies with a few employees charge 7% and LOSE money. Chop up that piece of the pie and pay rent, overhead and expenses and absolutely you eat money and your not being compensated on your time.
MY overhead is LOW.. I do not pay any software fees, clearinghouse fees etc. I'm able to work on any PM system the client has in place, I can set them up with a PM system if they need one. That's one of reasons my clients are happy. I am completely flexible because my profits are based on my time and I can get what I'm worth at the same time as paying minimal overhead.
Whenever this comes up, it seems people just give an argument based on what is best for the provider w/out thought to their OWN business. IN ALL of my clients if you add cost of employee's into their costs my fees are still an incentive to them. When was the last time you called up your accountant or tax guy, mortgage company, phone company and haggled with them over their prices?? LOL YOU don't.. why would OUR business be any different.
I'm not saying not to charge %, I'm saying that it's YOUR business and the old tried and true "We don't get paid until you get paid" MAY not cut it anymore for YOU.. always works for them, but not you. I've NEVER met a provider once I explained my fees and how it works argue with common sense. I deserve to be compensated for my experience, work and commitment. It's NO different from any other business. If I opened a pizza shop, I wouldn't pay my employees a %, if I hired a delivery driver to deliver pizza, I'm not going to pay him a % of what I bring in, I'm going to pay him for his time and expenses (gas, mileage).
--- Quote ---One of the other things to consider about percentage billing is the fact that physician's fees are constantly being lowered. Since the physicians are taking a 2% cut in their Medicare pay, so will you!
--- End quote ---
EXACTLY
I also DO not just do billing. I maintain my clients par contracts, office and financial policies, policies / procedures, etc. If I charged a % of revenue I'd do all that work for free.
--- Quote ---One of the major issues I see from switching from percentage based billing to a flat fee is when our yearly contracts expire our clients will know exactly how much they've been paying us monthly compared to how much they're taking in. If we've been averaging around $2500 a month for a client and his practice is fairly consistent how do we convince him that we're now going to charge him $3500 flat rate fee for the exact same job we've been doing?
--- End quote ---
This is hard to answer w/out specifics on how you work, employees, overhead and more importantly the practice revenues. BUT.... bottom line is why wouldn't fees increase? A lot of things happen in a year, cost of living, etc. I'ts NO different from any other business or an employee getting a raise. Jumping $1000 a month is rather high if you were not doing a sliding scale to accommodate the growth of the practice all year long then yes, this could be feasible.. Again, not here to argue with anyone, what you charge and how you charge is your business, I'm only saying that in ANY business your there to make money, there are not many service driven businesses like us charging a % .. are we just too focused on the provider's thoughts only? Sounds one sided to me.
RichardP:
--- Quote from: PMRNC on October 25, 2013, 12:05:33 PM ---I don't think I did state my fee. and there are NO percentage figures at all in the way I do my fee.
--- End quote ---
Yes Linda, you did not state your fee (flat fee). And I did not intend to give the impression that you use any percentage figures at all in the way you do your fee.
I was making a mathematical point now, as I did in our previous conversations. That point is this: when anyone divides their flat fee for the period by the client's income for the period - you get a percentage. If the client's income stays relatively stable over time, and one's flat fee stays stable over time, that percentage will stay stable over time. In a previous conversation, you did this calculation and stated the percentage you came up with.
When you do this type of calculation, it becomes easier to see that, no matter what one calls it, one actually does get paid a percentage when doing billing, flat fee or no. Again, this is a mathematical point, not a legislative one.
DMK:
One point I would like to make is that if one of your clients was largely a Worker's Comp. practice, you'll starve before you get paid and you'll put in 10 times the amount of work to get paid on just ONE claim. So a % base isn't good for many practices. It will depend largely on how easy or difficult it is to get claims paid.
What if your doctor is lazy and doesn't complete documentation, so you can't even file the claim until all the ducks are in a row, what's your time worth to keep following up to send a CLEAN claim?
I've been reading these threads for a long time and I'm fascinated at how strongly people hold onto the % based service. We, as professionals, should be paid for the time we spend. PI, and Work Comp takes more work. If we were all just doing data input and just collecting the easy money there wouldn't be this discussion. I get told daily how much the doctor appreciates that I track down the old claims and find out what's holding up payment. That's not just data entry, that's my know how, and it's worth something.
The analogy that Linda keeps giving about what you pay your accountant (and how it's not negotiable) is great. I'm paying for his expertise, I'm paying him to know the laws and for his advice on doing things correctly. And his payment includes when he screws up and has to talk to the IRS! When we screw up we're on the hook too!
PMRNC:
--- Quote ---I've been reading these threads for a long time and I'm fascinated at how strongly people hold onto the % based service. We, as professionals, should be paid for the time we spend. PI, and Work Comp takes more work. If we were all just doing data input and just collecting the easy money there wouldn't be this discussion. I get told daily how much the doctor appreciates that I track down the old claims and find out what's holding up payment. That's not just data entry, that's my know how, and it's worth something.
--- End quote ---
The WC was actually ONE of the reasons I had had enough of billing %.. I had a client heavy workers comp because he specialized in sexual harassment, some of those cases went on for years and even given LOP's which promised HIM money, I was still working for that payday in the future. Ridiculous. Actually when I introduced flat fee he was the first to say he completely understood. I don't get why chiro billers even THINK of a percentage!
I think because this is such a tough market people think that telling doctors they won't get paid until they get paid is their incentive.. and for a long time it was, it would at least get a raised eyebrow in a tough market. It would be very difficult for a new billing or PM company to start off with flat fee. I think If I was starting out I'd do it with ONE year contract and then you have a year of data analysis to move to the flat fee or any other pricing. Since NY State is SO cut and dry about fee splitting, I know many billing companies here, who charge differently, some on a per claim, per service, some on flat fee per patient, some on hourly rate, etc. There are so many ways to do it.
--- Quote ---I was making a mathematical point now, as I did in our previous conversations. That point is this: when anyone divides their flat fee for the period by the client's income for the period - you get a percentage. If the client's income stays relatively stable over time, and one's flat fee stays stable over time, that percentage will stay stable over time. In a previous conversation, you did this calculation and stated the percentage you came up with
--- End quote ---
That's a Lot of If's.. The flat fee should change with growth of the practice, stable income? Not sure I'd say the providers I deal with are stable, my mental health clients have WC cases that drag on for years, I have one that does court testimony, another who does prison visits. All those circumstances require a lot of work (separate contracts for them with state, some with attorney's, etc) Same would go for a chiropractor for example, I think they would raise an eyebrow at the idea of "stable". The flat fee accommodates the WORK I do and the GROWTH of the practice. SOME months it will seem like I'm getting a lot but then when they collect those older settled WC claims, their checks from the prisons and state every so many months it all evens out.
Navigation
[0] Message Index
[*] Previous page
Go to full version