Billing > Billing

Charging a Fee - Need assistance asap!

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RCC:
I am a new biller and I am working on a price to charge a office that bills 3000 claims a month, but that said 65% of the claims are capitation, I will be charging per claim because I am in NYC and we cannot charge % they charge between $225 & $325 per visit. Do I just calculate by the number of claims per month? thanks for your help

PMRNC:
65% capitation?? really?

Why don't you do a full analysis of their current billing and entertain a flat fee rate based on a competitive hourly rate to start? If you have other clients this is pretty easy to do as you know how long it takes you per account, provider, etc. I'm in NY too and I do it that way and would never go back to % billing even if we could in NY.

RCC:
Thanks Linda, thats what they said, thats a lot right.

PMRNC:
I'm not sure I'd buy 65% capitation .. even in NYC.. BUT in all fairness most office managers on the fly really don't have a good accounting of what's going on. I'd be shocked if it was even 35% capitation.. they are disheartening from the market and have been for years.  I've also learned that some offices do refer to capitation as participating/managed care.. so they could just be confusing it.

Merry:
Is this a primary care practice? You do want to be sure that you are tracking the monthly checks and withholds if the practice  is contracted with  capitated plans.

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