Is a flat rate per claim and a monthly service fee inappropriate?

[gonzalezllg]

Good Afternoon Everyone,

Just started a new billing service and I'm trying to refine my pricing structure. I'm looking for some feedback on a pricing scale that would include a monthly service fee that would cover add on services, plus a per claim flat rate fee.

My specialty is with Mental Health practices that have their own scheduling and billing software. I'm thinking of offering levels of service that would include admin work, then layer in the per claim fee. For example:

Level i, $50 Monthly, $8 per claim
-services included a, b, & c

Level ii, $75 monthly, $8 per claim
-services include x, y & z

Would the market place find this to be inappropriate and expect to only see a per claim fee? I am a power user to a couple E.H.R. Platforms used in private practice. So my services can lower their level of admin detail. Just wondering if the potential clients would be averse to this type of scale. Thoughts?

Thanks for reading.

LG

[PMRNC]

I have never actually created prices or plans ala-carte like that. I do a very thorough practice analysis and then I charge a flat fee with sliding scale which is based on my time and not by claim. This way I'm paid for all the time I put in. When you do per claim you will find that unless you are VERY super clear on what YOU determine is a claim, providers take advantage or they find ways to contain cost (hold dates of service, etc.) This also really undercuts your services, there could be WC claims, PI, or very lengthy appeals and you'll basically work for free.

In my fees I include any costs related to the client such as postage, etc. I do NOT maintain PM software or clearinghouse costs. The provider does. Helps me keep costs competitive.

[Michele]

I have seen several different pricing structures but I have not seen one like yours.  That doesn't mean it won't work for you, just that I haven't seen it.  I think MH providers may not like the per claim fee along with an admin fee but that's based on the providers I am familiar with and I'm in a rural area where a PhD is only getting $67 per visit in some cases so $8 plus an admin fee may be high.  However in NYC that may not seem high.  I'd be curious to see what type of response you get.