Starting a Medical Billing Business > Starting Your Own Medical Billing Business
Pricing my biling service
atwmedbilling:
from my research Arizona is one of the state that doesn't let to split bill so I put together a flate fee I wanted to know what your thoughts was
0-1500 in A/R 1000 monthly
1500 - 2000 in A/R 1500
and so on would it what better if it was amount of claims ?
Do you include appeals denials payment posting in that monthly fee ?
Michele:
I think your numbers must be off a little. You said you would charge $1000 for up to $1500 in monthly A/R? That's 66% of the max.
Anyway, our flat fee includes everything that the client will need. Some of our clients only want claim submission. Others we do full service. So we base our flat fee to include all services that we will be performing.
atwmedbilling:
What is a good way to use a flat fee ?
Michele:
This is from a previous post by Linda:
"There have recently been a few threads on this. How I do it is based on hourly rate, what I want to make per hour. My formula goes like this:
For this example I will use an hourly rate of $25 p/hour.
I determine the amount of time I will need per week per client (estimated). This is easy if you have been billing for the provider and it's always a good idea to calculate how much time you spend on each client no matter how you are charging. For this example we will say this provider will take or takes 12 hours per week.
I then add up my expenses PER client (this should NOT include any fees for the cost of doing business such as computer, attorney, books, education, etc) only costs such as clearinghouse, postage, phone, claim forms, software per client fees, envelopes, ink, paper, etc.. should be included in these costs. For the sake of this example we will use an estimated cost of $500
I then take my hourly rate of $25 and multiply it by 12 hours per week=$300 per week X 4 weeks= $1200 per month
I then add my estimated costs for each month $1200 + $500 = $1700 monthly flat fee total.
To create the sliding scale I then break down (again estimating) how many patients/claims I can comfortably do per hour. For this example I will use 8 patients. That will equal $25 (hourly) per every 9 patients added. That will allow you to continually get paid for your time and allow for growth of the practice. Remember to increase you "costs" and I do this once every 6 months as per my contract.
Nice and simple, and biggest factor is I get paid for all my work. :)"
We also use another formula as well:
Take the estimated or average receivables for that client per month. Multiply that amount by the average percentage for your area (6%, 7%) and compare it to the number you got from the previous formula. It's a great way to double check and make sure you are in line.
PMRNC:
--- Quote ---We also use another formula as well:
Take the estimated or average receivables for that client per month. Multiply that amount by the average percentage for your area (6%, 7%) and compare it to the number you got from the previous formula. It's a great way to double check and make sure you are in line.
--- End quote ---
You want to be careful with that formula, for example NY State is VERY clear that physicians cannot only enter into a fee-splitting arrangement, the arrangement cannot even be BASED on a formula to split fees.
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