Starting a Medical Billing Business > Starting Your Own Medical Billing Business

Monthly minimum justified?

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williamportor:
Hello Everyone,

I could use some input here. I use a large clearinghouse (hewedi.com), they have a large payer list, have been very responsive to my needs, and I'm very happy with their service. This clearinghouse charges me $40.00/mo/client. All paper claims are free. The only problem is 2 of my smaller clients are mental health providors, and though they accept many different insurance plans, they frequently submit only 5-10 claims per month through me since they are semi retired, which means I'm losing about $10.00-$20.00/mo on each. These were my first two clients, they've been very easy to work with, and one even wrote a glowing letter about my excellect services. I don't want to lose these 2 ladies, but I'm having a hard time justifying losing money each month on them. With my 2 larger accounts I net about $1400.00/mo (and growing). My question is: Would I be justifyed in insisting a 15 claim minimum each month to cover my clearinghouse fees?

Michele:
Since the two smaller accounts are so small why not just print them to paper yourself?  You would have a little cost in printing, forms, envelopes and postage but it wouldn't be $80 per month.

HeidiK:
I agree with Michelle - or consider submitting the claims directly through to the carrier if they allow it.  For that small number of claims you wouldn't spend $80 worth of time entering them...

PMRNC:
A few years ago I changed my model of business. I don't contract directly with clearinghouses or software vendors. Makes my life SO much easier and I can concentrate on what I'm being paid to do.

With that said, I can see where I would agree with Michele and Heidi, but from a business point of view I would approach both and let them choose the model and at their cost. It sounds like your billing on a %? If so perhaps a change that way might help you as well. I don't charge a % so my revenue is not dependent upon provider reimbursement but rather the work that I do, the time it takes, etc. My clients pay for their own software licenses and subscriptions so they pay ONLy for my services and that makes them happy and me happy. I have a few small accts similar to the one your speaking of, and this is where it really benefits me. You should not lose money over a small acct. J M H O

Christy:
Office Ally is a free clearinghouse if governmental claims (Medicare, Medicaid, etc...) make up less than 50% of claims volume in any given month. If governmental claims are more than 50% in a month, the fee is $19.95.

You can use their PM software or upload claims from your own PM software.

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