Billing > Billing
Pricing Strategy
Merry:
If you want to become a certified coder, AHIMA or AAPC. No matter what course you take, it is intense. Be prepared to learn anatomy and physiology and know that it will take you months.
I do not recommend AMBA.
I will tell you that you can become certified for Certified Healthcare Reimbursement Specialist and Certified HIPAA Information Specialist through the medicalbillingstudycourse.com,. It is online as we update it constantly. It is not on the website yet and you can contact me privately at merry@nebazone.com for more information if you would like. Prices are less but know this is for billing and not coding.
I have a different philosophy about the certifications as I have been writing them for over 15 years. I developed them so that you learn what you don't know. It is not a matter of just getting a passing grade and a certificate. My feeling that if a person is serious about this business, they need to know in what areas they are lacking so that they can educate themselves further. BTW, there are no study materials which are outdated so quickly. All the answers are on the Internet..open book. the only place where you can find up to date information today.
SnyderKristine:
--- Quote from: maxamillion125 on March 06, 2014, 06:33:57 PM ---We pick up deposits from the doctors office 2-3 times a week. We add up all the patient payments and paper Insurance checks, we also print out a payment report from all the payers we have set up EFT. We turn in our invoice every 2 weeks. It might be easier to track the sum of all payments in your PM software but we have to add up all the payments anyway before we post them.
--- End quote ---
I had this question in my ind from the very beginning, but I was not sure about how this works. What all can we include in the calculating our fees? Can we include all the payments coming to the providers office, no matter what is the source?
We will definitely include:
Payment from Insurance companies
Payment from patients that we called for collections
But can we include:
Co-pays or Deductibles that patient pays during the office visit
Capitation payments (becoz we don't have to follow up on them)
Please advice.. I don't want to sound unjust to the clients :)
Michele:
--- Quote from: SnyderKristine on March 19, 2014, 01:53:45 PM ---
I had this question in my ind from the very beginning, but I was not sure about how this works. What all can we include in the calculating our fees? Can we include all the payments coming to the providers office, no matter what is the source?
We will definitely include:
Payment from Insurance companies
Payment from patients that we called for collections
But can we include:
Co-pays or Deductibles that patient pays during the office visit
Capitation payments (becoz we don't have to follow up on them)
Please advice.. I don't want to sound unjust to the clients :)
--- End quote ---
If we are doing insurance only billing we do not include payment such as copays, and patient payments received in the office. But if we are doing full service billing we include all revenue received. We are responsible for tracking all revenue, and making sure it comes in. There is no way to separate revenue that one person collects, or another person, or whether it was in the office or mailed.
SnyderKristine:
I am planning to handling complete billing, which includes everything except coding. I will get a software, do demographics entry, insurance verification, reminders, claim submission, rejection handling, appeals and denial management, payment posting, Patient collections and statements.
Now can I include everything the doctors collects, except self pay patients. Just confirming, I don't want to be unfair. Thanks Michelle.
And one more thing, do we charge the same % for capitation payments?? because we don't have to follow up on them.
Merry:
If you touch the account you should get paid. Otherwise there would be two sets of books. Up to the provider if he/she wants to do that but the IRS will have a temper tantrum.
I am curious why you do not think you ha e ti do work for a capitated acct. When that monthly check cones in, you must check that every person had been included, track withholds etc.
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