FAQ
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How much does it cost?
I charge a percentage of the amount recovered on each claim. If your practice files high value claims, I can discuss discounts that may affect your decision. I do not charge for copays, coinsurance, deductibles, or self-pays that are collected by your staff on the date of service. However, I keep track of these payments as part of your account maintenance.
Many billing services use the percentage model for their fees. It enforces the principle of “pay for performance“ and motivates the billing service to go after full reimbursement on all of your claims. I have been billing for 15 years and I know that the break-even point in this business is 5%. Take my advice, at 5% or less, be suspicious! They are taking shortcuts somewhere . . . probably on follow-up . . . that will cost you more in the long run.
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Why should I use a billing service?
There is a lot more to successful billing operations than filing claims and posting payments. I wish it were that simple. Two other revenue streams require equal attention: Follow-up on delinquent payments and recovery of patient balances. I would argue that 30% of your total revenue resides in these two areas. If not properly managed, that revenue will be at risk. A competitive billing service can discuss a number of strategies where your office and the service can work together to maximize your reimbursements.
Reports and analysis are an important service that a billing service can provide to help you make the best decisions. Written and oral communications skills are vital to communicating effectively with insurance carriers and documenting your problem accounts. Credentialing and registration skills are essential to navigating the complexities of provider enrollment in this highly automated industry.
If your billing service can’t help you with all of the above, you are NOT working with a full-service company.
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Can I access my account information?
Yes. If you have a computer and internet access, you can look at your account information whenever you wish. Sometimes there are licensing issues that can be solved for a nominal fee depending on your operating system. Please give me a call to discuss the specifics and I can give you an accurate estimate of the cost. I guarantee that it will be way less than the option of running an application at your site and will include many disaster recovery provisions to ensure secure operations.
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What software do you use?
We use Lytec Practice Management Software. However, we can also access your system remotely if you prefer. If your are using an EMR system, there are a number of techniques that we can use to service your account. Please call me for details.
We use the largest electronic claims clearinghouse in the U.S, to process your claims and our patient statements are professionally printed and mailed with a return envelope. Medicare, BCBS, and Medicaid claims are submitted directly to those systems. Our subscription to EncoderPro.Com is a major resource for researching payment policies, coding guidelines, and fee schedules. We can also scrub our complicated claims on this system prior to submission.
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Do I have to sign a contract?
You are not required to sign a Contract to begin billing services. Month to Month arrangements are available. A contract locks in your fees and services for 2 years and qualifies you for a preferred rate. Please call to discuss your options.
My contract with you is to furnish the best billing services at a fair price. If you are not getting that from me, you should find someone who can do it better.
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What do I need to know about a billing service?
You are trusting that billing service with your money. If they fail, it will cost you plenty. How long have you been in business? What specialties have you billed for? How about references? How much does it cost? What services are included in your fees? How many billers do you employ? I have this problem; how would you handle that? What performance results can I expect from you? What responsibilities remain with me? Do you have an office or operate from your home?
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Who can I speak to if I have a problem with my account?
Each account is assigned to an experienced biller who is held accountable for the overall performance of that account. I run reports every month to check on the status of your account and to discuss ways of getting it to perform better. If the account is particularly large, the biller assigned to that account will have assistants who help get the work completed in a timely manner.
Routine matters can be discussed with your account manager. As a fellow business owner, I am always available to you when you need me.
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What types of practices are best suited for billing services?
All practices can gain something from the experience, resources, and redundancy that a well-run billing service offers. Practices that see lots of patients or bill numerous procedures are the most likely candidates to outsource their billing. The volume of data alone and the cost to process it present the most convincing argument. When the total work . . . including everything (claims, payments, follow-up, appeals) . . . exceeds the capability of one full-time employee, it is time to start your search. There are fixed costs associated with every employee that you hire (workspace, computers, training, benefits). A well-run billing service can offer a cost competitive alternative to in-house billing. Find out if your practice can benefit. Give me a call.