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Billing Service Invoice

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Michele:
We take several things into consideration. 


* Number of patients seen per week/month
* is provider in network
* what is average reimbursement per visit
* is provider's front end good (do they collect accurate information from patient, do they collect copays at time of service, etc)
* does provider get auths when needed
Once we have all of this information we determine approximately how many hours per month the account will take.  Just remember when accounting for your hours it is not like a hired employee's hourly rate.  You have business expenses to consider.  Taxes, cost of doing business, etc.  All of that must be taken into consideration.  So $20 per hour is not nearly enough when calculating your monthly fee.  A $15 an hour employee costs an employer at least $23 with payroll taxes and that doesn't even begin to count the other expenses.  The cost of having that employee in the building, sick time, vacation time, benefits, training, printing costs, software costs clearinghouse fees.  The list goes on.

You also need to consider what the provider is bringing in to make sure your fees are cost effective for them as well.  For example, if you calculate that an account will take you 10 hours per month (don't forget to allow for working the aging report, appealing claims, etc) and you figure $50 per hour then you may consider charging $500 per month.  But if the provider is only bringing in $4000 per month, your fee will not be cost effective.  Equally if the provider is bringing in $1000 per month, you may not be calculating your time right.  If you are in a fee splitting state you don't want to calculate your flat fee based on their income.  But it is good to just use their income to verify your calculations.  That doesn't mean if you have an account that you think will take you 10 hours, but they are only bringing in $3000 that you charge less.  It's just a tool to use to try to catch any miscalculations.  Some accounts are more work than they are worth and that's good to figure out before you get stuck in a contract.

Hope that helps!

Kerry:
Thank you so much Michele for your feedback.  It helps a lot!  Let's me know if I am on track or need to reconsider some areas.

PMRNC:
My monthly flat fee is based on time but I do mine a bit differently and my clients never actually see my hourly fee. The fee I come up with is based on evaluating all of the services, any backlog/AR and any eligibility/benefit services needed. I don't use their revenue at all. I'm in NY so physicians can't enter into any agreement where services are paid with respect to revenue at all. In addition to that state law my time and work don't change based on the practice revenue. I also provde 2 full hours of consulting a month which lets me go into their office and help get them organanized or fix any front/back end problems that would make my fees exhorbant because of the office inefficiencies. I use the monthly practice reports and I counsel them on things they can be doing more efficiently. My hourly rate then includes any costs per client. I don't have any software, tech support or clearinghouse fees so I'm able to compete and base my charges mainly on my time without incidentals. Not to mention there is so much less to do at the end of the month AND less to explain to the client.

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