All of this adds up to 40+ hours a week for $1350.00 / mo
This doesn't seem right. At 400 claims per month for 7 clients that is only an average of < 60 claims per provider per month. That should not be taking 40 hours per week. We don't measure by number of claims but by income. One full time person should be able to produce $6000 - $9,000 depending on the type of providers and the set up of the biller (ability to autopost, etc). I would take a look at your systems to see if there is any place you can find a way to improve the amount of time it is taking. I would also take a look at what you are charging them. Maybe that is where the issue is. But in answer to your question, $1350 per month is not normal for 40+ hours per week.
I just wish I could afford to visit you folks in NY and see how you operate. I'll bet I'd learn a lot. Maybe someday
I have a different opinion, since I do charge a monthly fee it is based on how much I work. I couldn't measure how much I make by a provider's revenue as I'm in a state that prohibits fee-splitting so my fees cannot be even remotely related to the revenue of the practice. With that said, it's much easier to do a flat fee with sliding scale because then I can CHOOSE how much I want to make per hour and the provider NEVER sees that amount. For example, if I know a client is going to take 10-15 hours a week and I want $50 an hour, then their monthly flat fee will be approximately 500-750 a month. I also know how long it takes me to submit claims so the sliding fee would accommodate new patients by the amount of claims I can produce in the hour. This has worked great for me as I get paid for every single hour I work. I get paid for everything including making a phone call and I'm making exactly what I want to make and working the hours I want to work.
Costs of doing business are not passed on to the clients, or rather they shouldn't be. Things like training, coding books, accountants, lawyers, etc. The only "costs" to a client should be the costs associated specifically to the client such as claim forms, envelopes, printer ink, phone, fax, etc. You only want to add in the costs of those things the client utilizes, your "costs of doing business" are other items that the client would not need to pay for at all as a benefit to outsourcing.
* Should I charge extra for a client that sends me 200-300 old unpaid EOB's to call on and/or resubmit? If so, how much?
* What would you folks charge for direct mail billing of cash customers? I'm charging $11.75 for 3 months (3 invoices)
That's tough but you just have to estimate. Most eligibilty checks can be done online. We don't do a lot of eligibility checking but I would say it takes about 2-3 minutes to do an average online check. So I would guestimate that I could do 20-30 an hour. If you are doing multiple BC and you are logged into the BC website it takes less than 2-3 minutes, and some phone calls will take more, but it should even out. Also check with your clearinghouse. OA allows eligibility checks as well. Many PM systems have eligibility checking as part of the system. You may be able to streamline it.