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Wiki Decision to open my own billing service???

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gr8gal61

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Has anyone had the opportunity of success in providing billing services, at home to physicians? I have several years experience in several fields and have performed remote coding for over 4 years for a major trauma hospital and absolutely loved it. I am interested in a decent billing/coding program to use for all fields that doesn't require me to put my house on the auction block but more importantly is how to charge for this service? Hourly? Per Case? This is where I lack as I can market myself but the contract with a physician is what I have no idea on how to begin. Any and all help would be greatly appreciated. I am in Texas should this make a difference!
 
I have not had business in Texas yet but typical billing companies make a percentage of what they collect for the practice. So, if you collect $150K, you would get a small percentage of that monthly.

Hope that helps! Good luck!
 
I had a billing service back in the 90's. All I can say is it was very hard work and I did not have the capital to compete with the big companies offering the same. I did it for a couple of years, worked a whole lot of hours and didn't make much at it.
 
I own a Medical Billing Service/Practice Management Consulting service in West Texas. We opened 10 years ago last month and currently have 10 employees and service over 35 unique practices and over 100 providers.

Owning your own medical billing service is a lot of work and can be very tough. If you know what you are doing (complete revenue cycle management), then you can be very successful. With ICD-10 coming, I suspect there will be smaller private practices who will turn to outsourcing their billing if they are not able to successfully implement ICD-10 without significant interruption to their revenue stream.

I have used Medisoft for years in our billing service as I have worked with Medisoft since I began working in healthcare in 1996. We do medical billing for a variety of specialties and Medisoft works well for each of those. We are now Medisoft Value-Added Resellers and have found that it is a very good billing system with a low startup cost and low annual operating costs. There are many good billing systems out there, so make sure you do your research.

As far as charging for your services is concerned, the standard rate for physicians is a percentage of collections. Most of our clients are on a percentage of collections contract. Some of our providers (clients who perform high-dollar procedures and/or sell big ticket medical items) pay a per claim fee with a monthly minimum. For most primary care physicians/midlevel practitioners, the percentage of collections works the best.

Feel free to contact me if you have any questions. Starting a medical billing service is a big undertaking, but can be very rewarding if executed properly.
 
I currently do work from home. I have a start-up medical coding company, currently just one client.

As far as a contract is concerned, I currently have a contract with my client, and bill 6% of collected funds (note, this is NOT 6 percent of billed claims - this is 6 percent of payments in)

Example, if doctor bills $125 for a service, and the insurqance and patient total pasys $100 - he is billed 6% of $100, not 6 percent of $125.

The advantage you can offer to doctor this way is that

A - You are motivated to collect for him as much as possible, and to utilize correct coding procedures that eliminate denials, and claims being pended.

B - You are motivated to resolve what claims are denied/pended as quickly as possible.

C - You only get paid when HE/SHE gets paid.

Good luck!

It has worked for me. Now, my focus is on getting additional clients.

Incidentally, you might consider making it a part of your contract that the doctor pays the monthly fees on the software your billing vendor uses. This is currently the arrangement I have with my client.

There are any number of billing software vendors available, which charge a monthly rate.

You can private-message me if you wish for some extra information in this regard, as I'm not entirely sure AAPC would want specific companies/vendors mentioned on this Forum, as it might be construed as a recommendation from AAPC.
 
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