Re: Paying a billing service

[Pay_My_Claims]

Only for the 2 weeks I did it. I was still back and forth because full and part-time help were not really qualified. I use my experience to speak directly to physicians about staffing issues. Why they are overstaffed and have an outstanding AR. You are staffing the wrong areas!!!

[Danni R.]

Same here Danni. Do you know one of the problems with in house medical billers??? They don't just concentrate on the billing/AR/Collections. They are often sitting up front with the Admin Asst. They are utilized for overflow calls, check outs, scheduling etc. I once interviewed at a chiro's office and he did set them up to work in an old storage closet!! They gave you a desk, phone and PC and others came in and out to get dead files. The gen prac/ped I work for I had to tell them its difficult to try to work at the front desk doing billing. If the receptionist is busy, and you don't assist the client, it shows poor customer service. I convinced her to hire a part-time receptionist and put me in the back. She worked from around 10-3 or 12-5. Great p/t hrs for a retiree

You nailed it, Charlene. One of the biggest gripes among all medical assistants, especially up front in the admin area, is long hours (the first ones there, opening to closing the office), tons of responsibilities, pressure, stress, and lousy pay.

Ironically, it is not unusual that the inhouse medical billing staff is utilized right in the front desk area, especially in the large group practices, when it gets busy. You can easily 4-5 people hustling and bustling, working hard. Some may be on-the-job trained medical office receptionists, some may be certified medical assistants, some may be medical records clerks, some may be medical billers - all asked to help run the front office areas for the doctors. I've seen it. And it can get quite busy, and overwhelming. Your solution was an excellent one. I bet it made a HUGE difference.

[Steve Verno]

maybe he wants to pay her his fee for services rendered. 

Lets wait to see what crops up.

[Pay_My_Claims]

Same here Danni. Do you know one of the problems with in house medical billers??? They don't just concentrate on the billing/AR/Collections. They are often sitting up front with the Admin Asst. They are utilized for overflow calls, check outs, scheduling etc. I once interviewed at a chiro's office and he did set them up to work in an old storage closet!! They gave you a desk, phone and PC and others came in and out to get dead files. The gen prac/ped I work for I had to tell them its difficult to try to work at the front desk doing billing. If the receptionist is busy, and you don't assist the client, it shows poor customer service. I convinced her to hire a part-time receptionist and put me in the back. She worked from around 10-3 or 12-5. Great p/t hrs for a retiree

[Danni R.]

I performed both duties. I was the PM/Biller. Physicians are cutting edges everywhere because of low reimbursement. Do you remember when front desk was just a check-in/out position? Smile, Greet, take a copay, copy the card. Now I find them getting auth's verifying insurance, posting payments, entering charges etc. The pediatrician I interviewed with (office manager) is the husband. He NEVER did any billing before. He said he was doing ok but they are getting busy and he got behind. He said he has 12k in old claims that he didn't know how to fix. He didn't know how to read the EOB. He would do what he could do and wait for payment. He didn't know about a clearing house. They have a web based software/emr system he doesn't know how to use. They have had it 10 months and are now going to change over. He was very easy to convince to outsource since he was truly at his wits end.

Right, that was our job: the administrative medical assistant at the front desk. I remember those days.

[Pay_My_Claims]

I really don't understand why most doctor offices are apprehensive about control because most of the office managers does know squat about bill and really do not adequately and consisely monitor the inhouse billing cycle due to all the day-to-day interoffice distrations.  Most are concerns with, "what can you do for me that the current inhouse biller or outsourcing agent is not currently doing..."  Which it boils right down to money, and spend less of it.   

Yet, I agree with the fees aspect of things...  They really want more for less!

Densie35

   

I performed both duties. I was the PM/Biller. Physicians are cutting edges everywhere because of low reimbursement. Do you remember when front desk was just a check-in/out position? Smile, Greet, take a copay, copy the card. Now I find them getting auth's verifying insurance, posting payments, entering charges etc. The pediatrician I interviewed with (office manager) is the husband. He NEVER did any billing before. He said he was doing ok but they are getting busy and he got behind. He said he has 12k in old claims that he didn't know how to fix. He didn't know how to read the EOB. He would do what he could do and wait for payment. He didn't know about a clearing house. They have a web based software/emr system he doesn't know how to use. They have had it 10 months and are now going to change over. He was very easy to convince to outsource since he was truly at his wits end.

[Danni R.]

My answer might be slightly different..
I don't Negotiate with fees I charge.  However I might be inclined to entertain a different method of "how" I charge. I do not have a "set" fee schedule. I go into the practice and provide them with a full cost analysis and I even break down their savings to show them what they are saving, what they are gaining if they sign my contract.

ON THE OTHER HAND... If I am new and trying to get my foot in the door certainly it would behoove me to be somewhat flexible with this line of thinking. I don't find "fee for service" odd at all. In fact the provider just wants to pay for what they are getting. I had a client that just wanted to pay a fee for submitting claims, verifying benefits. He didn't want full practice mgmt, he didn't want anything beyond those two services. I figured out what I wanted to make, how long those tasks would take and came up with a "fee for service".. Later on down the road he must have learned to trust me or just became more aware of the savings and we went to a full practice mgmt based contract.

Actually, this is exactly how I proceed. My story was the exception, and somewhat condensed. However, after many many days of back and forth, I did ask that question, and it was exactly what got my foot into the door that day, and earned me a long standing, highly appreciated client. Best response I ever gave (in that case!) after being pushed to the brink...

[Steve Verno]

Linda,

On a side note, I wish to thank you for teaching me about fee splitting.  A billing company contacted me and asked about percentage billing in Florida.  I sent them the link to the Florida Statute.  So, again, thanks much for your info and help.

[Danni R.]

ROFLMAO!!!

I agree with you Danni about you setting your own fees, and yes providers will try to negotiate which is fine for me. There are always circumstances that can warrant an increase or decrease in your fees. I think the trend is to try to get more bang for your buck. The increase in billing services, especially home based is allowing physicians to haggle more over what they want to pay for. Before I started I sent out surveys to a lot of the practices in my area to determine what their needs were and apprehensions to medical billing services. I can only speak for here, but 2 big concerns was cost&monitoring  One provider stated if he could find a billing service who's fees would be equitable to the cost of an in house biller, he would consider it. He just doesn't want to pay more simply because he makes more. The ones he contacted charged by the percentage recovered and once he survey'd that he stated he would be paying for 3 medical billers if he did that.

I really don't understand why most doctor offices are apprehensive about control because most of the office managers does know squat about bill and really do not adequately and consisely monitor the inhouse billing cycle due to all the day-to-day interoffice distrations.  Most are concerns with, "what can you do for me that the current inhouse biller or outsourcing agent is not currently doing..."  Which it boils right down to money, and spend less of it.  Yet, I agree with the fees aspect of things...  They really want more for less!
Densie35

AND SO DO I!!!! Win - Win. He, he.
And why not? Don't we all?
                

[Pay_My_Claims]

ROFLMAO!!!

I agree with you Danni about you setting your own fees, and yes providers will try to negotiate which is fine for me. There are always circumstances that can warrant an increase or decrease in your fees. I think the trend is to try to get more bang for your buck. The increase in billing services, especially home based is allowing physicians to haggle more over what they want to pay for. Before I started I sent out surveys to a lot of the practices in my area to determine what their needs were and apprehensions to medical billing services. I can only speak for here, but 2 big concerns was cost&monitoring  One provider stated if he could find a billing service who's fees would be equitable to the cost of an in house biller, he would consider it. He just doesn't want to pay more simply because he makes more. The ones he contacted charged by the percentage recovered and once he survey'd that he stated he would be paying for 3 medical billers if he did that.

[Danni R.]

On the latter, of course, freelancers and consultants state their own fee, of course, clients often try to negotiate, that's normal. However,  as a professional I have accepted it as part of the game. Sometimes I despise the heckling over my fees for (expert) services. My fees are already priced well, and always reasonable.

A couple years ago, when a client in serious need really got on my nerves with his arguments. He truly tried to squeeze blood out of a turnip, so to speak. Eventually I asked: "When was the last time you argued with your doctor, or lawyer about their fees when your feet were cut off and dangling by a thread? You came to me for professional advice, and that's what I am willing to give."

I have to add, this client never regretted his decision.