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Kimberly35:
Good morning all,

I am in the process of getting my first client. I had a meeting with and the expectation is that I will be submitting his claims, following up on AR and posting payments. He wants me to also resolve his outstanding AR which is about 35 pages long. His practice is really a mess but he wants to bring me in to help clean it up. I am wondering why my costs should be. I was thinking of charging an hourly rate initially to clean up his existing AR and going forward, charging a percentage based on what is collected. He has a small dental practice.

Any suggestions on how I should bill this client?

rdmoore2003:
May I ask, how long has this provider been in private practice?   I am asking because the "35 page long AR" is causing my head to implode.

Kimberly35:
Good question. I am not sure. He mentioned that he has been having problems with his office staff for a while and he wanted to outsource to eliminate his ongoing issues and put better controls in place.

PMRNC:
35 pages is also making me queasy..

Couple questions:

what type of provider?
What state?
Heavy Medicare/Medicaid?

do you have a GENERAL idea of what the A/R looks like? For example, if I am speaking to a chiropractor (which I wouldn't.. LOL, but we'll use that as an example) and I see there is a lot of money out there, I want to look for such things as high A/R due to PI cases, auto/no-fault, WC..etc. With MOST practices you can find the common denominator of any problem. If I'm talking to a Pediatrician with a large A/R.. I look for things such as patient balances/collections, is he being too generous with discounts? If I'm talking to a mental health professional I look to see if they are completing OTR's, verifying benefits, etc.

Every practice/specialty is different but if your diligent before taking the client on you can identify the most common problems first.   No matter what you charge.. make sure it's spelled out clearly in your contract. I have not worked with a % of revenue in years and would never go back. I charge flat monthly fee with sliding scale to accommodate practice growth.. that means I get paid for everything I do. If you charge a % and yet you have a lot of WC or PI cases..you'll wait for your money. You also may have that provider that thinks they shouldn't pay you on what they collect in the office, or from a patient. It all has to be spelled out.   If I take on a client with backlog of A/R I actually give them two pricing structures by the "date of service" but with a begin date of when I start. This way I can work the A/R as I go and my time is compensated for at same time I'm making money off of the current claims.  Hope that makes sense.   You also have to consider fee-splitting laws in some states.

Kimberly35:
Thanks Linda. It is a dental billing office in MD.

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