Charges to Clients

[vicki1]

What is the average billing rate for billers? I am charging my clients 7% of what gets paid. One of them is asking for a decrease stating my rates are too high. What do you all charge? 

[Danni R.]

What is the average billing rate for billers? I am charging my clients 7% of what gets paid. One of them is asking for a decrease stating my rates are too high. What do you all charge? 

Without going into exact figures or percentages, here is my stance... the other option for them is to go elsewhere and get cheaper! Next time this client tells you your rate is too high... have your blurb, and horror stories ready, and scare the willies out of them about "cheap services".

Don't be smart... just have a real conversation that serves as an eye-opener... Tell them stories of business failure, and the cost to fix things, and catch up. Somewhere in there, throw in the phrase "Of course, if you want cheap, you can get cheap; and there is always India!". Also, mention that it they should decide to come back later to fix the mess, your rates will be likely higher, especially since the 7 per cent they are enjoying now is a special rate that was established especially for them as an appreciated customer. Once you painted the picture, I am sure they will be happily staying.

I've used this technique myself in web design. It works. Never ever heard as much as a peep of a complaint ever again, even though over the years my rates still increased a little. My biggest advantage and selling point (hook) is my reliability, accuracy, credibility, productivity, and availability within 1-2 hours, and on weekends, if needed, to help or answer questions. Sadly, I too had to literally convince a couple clients, that my rates are a BARGAIN... and right on target.

I NEVER go back on my rates! They were carefully determined for each individual client before a proposal was forwarded and discussed again before the contract was signed. Agreed, is agreed...  Sometimes, however, if I feel the customer is sincere, and valuable to me, I am willing to sit down and examine the breadth of the current services to determine if we can pin point certain parts of the service that they no longer need; or can take over themselves, and thus, rather than reducing my rates, make every effort to meet their new budget. 

However, if I sense it's simply a case of "buyer's remorse" ... a rate reduction for the services agreed to is not up for discussion. Once agreed, I deliver, and expect to get paid. However, I am speaking of web design rates and contracts, rather than billing services. Nevertheless, I am fairly sure, the situation is similar.

[Pay_My_Claims]

My rates vary per client.

[Lynne]

I do a full practice analysis before giving a rate and have never had a ONE size fits all rate. Even my setup will vary per provider.
Also you want to be sure you are not in a state where fee splitting arrangements for providers is prohibited if you are billing a percentage rate.

[Steve Verno]

to me 7% is a bargain

to add my own statement

you get what you pay for 

he sees my fee, he'll have a heart attack.

Mine are high because I get the real dirty work from cheap doctors who tried to save a buck but got someone who couldnt find their fanny if they had an electron microscope and a map. When showed pictures they didnt know the difference between sh*t and shineola.  MY work usually takes me about 2-3 years to clean up.   

On time a doctor refused to pay me saying I stole money from him.  I got him a $50,000 check on claims denied 5 times. I quit and hired a lawyer that the doctor had to pay for based on my contract.  he called a couple of days later saying he had my check.  I picked it up and never went back.  It bounced and he had to pay me in cash plus the bank fees.  He still had about $1,000,000 in unpaid claims and receivables.   IN the middle of the project, he decided to change the claims payment address.  I think he tried to hide money.  But calls revealed the checks and the fact that they were cashed.  That caused another call to my lawyer and letters to the OIG under the Qui Tam Act. He has called a few times asking me to come back.   Last I heard, no biller or coder would take him on as a client.  Ive stepped in lots of shineola in my many years.

[Danni R.]

to me 7% is a bargain

to add my own statement

you get what you pay for 

he sees my fee, he'll have a heart attack.

Mine are high because I get the real dirty work from cheap doctors who tried to save a buck but got someone who couldnt find their fanny if they had an electron microscope and a map. When showed pictures they didnt know the difference between sh*t and shineola.  MY work usually takes me about 2-3 years to clean up.   

Ditto, Steve! Exactly my stance. If the rate was fair and fine when discussed, it should have been fine when agreed to, and the goods delivered.

A lot of work and time goes into determining a fair rate – many personal questions need to be answered and a significant amount of research within the industry, and specific to the client needs to be done before hand.

Also, over the years I have learned that here is a "psychology" to your rates, and how you conduct business.  It is a fine art to determine a new client's needs, as well as meeting everyone’s comfort level. It is smart business to always leave some negotiating room – but then stick to the agreement. To me, reducing your rate simply because a client has "buyer's remorse" is a sign of weakness. You are giving in. From then on, chances are you will never meet your own goals with that client, and it will never truly be win-win ever again.

Make your proposal, and let the client at that point make the decision. Of course, if the client requests a fast turn-around, it is inevitable that you can only do it at a higher rate.

[Lynne]

Also, over the years I have learned that here is a "psychology" to your rates, and how you conduct business.

VERY WELL SAID!!!  Truer words have never been spoken!
There is definately a psychology there!  I could actually judge whether a provider was going to be a headache or not JUST by the way he responded to my setup fee or rates.. just an ounce of hesitation would cause my alarm to ring. I have also completely walked away (literally) from doctors who come back with "well I just talked to a company that said they charge 4%" (if you are in NJ you get this one!)
I would respond quite frankly "Then I suggest you call them and take the 4%, have a nice day"

[Steve Verno]

as they said in the movie "Airplane"

Chump dont want de help, chump dont get de help

[Tharlan]

Really, what you charge is based upon the type of provider, geographic location and the average "ticket" (average charge).

For instance, generally speaking, if you are billing for an anesthesiologist whose average charge is $700, your percentage will be lower than billing for a chiropractor whose average charge might be $70. 

[Danni R.]

Really, what you charge is based upon the type of provider, geographic location and the average "ticket" (average charge).

For instance, generally speaking, if you are billing for an anesthesiologist whose average charge is $700, your percentage will be lower than billing for a chiropractor whose average charge might be $70. 

Tammy, you are right... Adding your points, this is what my list looks like. Although, this is how I determine my fees in web design, I believe it holds true for any other consultant, or freelancer.

These are the things I take into consideration:

 - type of provider (you are right, Tammy!)
 - urgency and complexity of the project
 - my experience and qualifications
 - long-term, or short-term contract
 - going rate in your location
 - my own financial goals and thresholds
 - my own workload and deadlines
 - client comfort zone, eg. flat rate per project, hourly rate, or percentage
 - and the average "ticket" (average charge) (as suggested by Tammy).

On the other hand, my shooting rate may be higher than the going rate because I have a greater overhead, or I may be in a more expensive region than they do. I also may have more, or fewer billing days per year than others.

[Lynne]

"Money talks, bullshit walks".

I love it

A good client will appreciate the fact that you don't slap a price tag on a service. Sometimes I cringe when I see some medical billing company's website where they list a price for each service... or the one advertising 4% in big bold letters.. (ahem..cough, sneeze..hiccup)

To me that's the equivlant of "GET YOUR HOT DOG...HOT DOGS HERE!"

[Steve Verno]

Years ago, I dealt with one of those kinds of hot dog vendors.  It was nickle and dime the doctor for everything.  They were fired when they wanted to start charging for every patient phone call. 

The doctor sued them successfully when he showed the court how much he lost when using them.  He hired me to so a CSI act on them. That meant months of going over reports, medical records, eobs and everything else.  They were what i call a code it bill it and forget it company. 

I''ll take two with chili,and onions and a nice cold Zirndorferor Killians Irish Red if you dont carry Zirndorfer. 

[Danni R.]

When a prospect contacts you (via email) and asks:

"What are your rates?" or, "What do you charge for that?"

The best way to convert that prospect into a client is NOT by sending a rate sheet right back.

But rather, call to find out exactly what they need!

Because when you are promoting services and someone asks for a price list right off the bat, you just don't know enough to give it yet.
 

[Tharlan]

That is true Danni.  You must get personal in order to give a good quote.  Fact finding is important in the process of providing an "Outline of Recommendations"..   which should turn into a "Proposal" which then turns into a "Contract".

[EBS]

Well you have read everything the experts have to say. I charge my clients based on two factors: how many patients they see in a month and how much monthly collection on average they have. Because most often the work required to f/up on claims is based on number of claims filed...if a practice sees 100 patients and brings in $100/claim average would be charged a higher percent of collection than a practice that sees the same amount (100) patients and brings in $500/claim (because of procedures etc.) My current rate for a typical single physician specialist office is 5%.