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Can a CPC open a billing company?

  1. #11
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    Medical Coding Books
    Quote Originally Posted by nelsong5 View Post
    Thanks again for the replies, extremedly helpful and ill be sure to speak with my partners this monday about the situation.

    NCgirl -The medisoft we have costs about $3000, yes it lets you intall that medisoft in various computers, lets you bill in all computers, you can enter patient info in all computers but the domain PC is the only one admitted to transmit to Medicare, unless they have upgraded because we purchased it in 2005. I do believe that the single user medisoft is $1000 dollars, i have not seen anyone else sell it at a cheaper price so id call their customer service if you want more info, hope this helps.

    Questions for ARCPC9491:

    Do they charge their sevices by a % that is billed? or is it a fixed income that they receive from the people they bill for?

    Good things and thank you for the replies, hope this helps not only myself but also the billing community.

    Thank you
    nelsong5,
    Sorry, I didn't check this post for a few days. To answer your question, the billing service will get a commission from the collections received from what you billed. (i.e. you wouldn't collect a % from incentive payments that insurances give, because they do not relate to a patient charge) For self pays, normally the client has the option to allow you to bill and take a % of the payment or this is non-commissionable and the client handles self pays on their own. The % that is billed is not a factor. Basically, you do not get paid, unless your clients get paid. This is an industry standard.

    I would never go with a "fixed income" - what happens if the practice expands and the charges and payments increase dramatically? you'll be locked in to your contract and you'll be getting underpaid for the services you are providing! You always want to set a % of collections as YOUR income.

    Also - about your software, Medisoft. Be aware that this software (atleast the version I have seen) limits reporting ability. Your clients will not only want standard reporting - but they will call you for off the wall things that most software doesn't have the ability to create. Reporting can be a burden on a billing company - so just make sure it can do LOTS of reporting i.e. by practice, by provider, by facility, by cpt, by charge, by referring md, make sure it can sort by day, month, year, just to name a few.

  2. #12
    Default think about this
    If I were to hire you to code and bill my services, I would ask you......Do you send claims electronically? What clearinghouse are you using for Federal, State and commercial payers? Are you going to be using direct deposit and electronic payment posting? What is you number of days for payment? What is your denial rate? Are you willing to come to my office to copy records if I don't have EMR? If you are charging me by the chart, does this mean one charge for the chart from time of coding to time of payment. Will you also be taking care of my creditentialing needs? NPI's? Denials? Appeals? Hearing level appeals? Collections? Mailing statements? Skip tracing?

  3. #13
    Default
    Quote Originally Posted by Icode4U View Post
    If I were to hire you to code and bill my services, I would ask you......Do you send claims electronically? What clearinghouse are you using for Federal, State and commercial payers? Are you going to be using direct deposit and electronic payment posting? What is you number of days for payment? What is your denial rate? Are you willing to come to my office to copy records if I don't have EMR? If you are charging me by the chart, does this mean one charge for the chart from time of coding to time of payment. Will you also be taking care of my creditentialing needs? NPI's? Denials? Appeals? Hearing level appeals? Collections? Mailing statements? Skip tracing?

    Oh the joys of Medical Billing ......... Let me add to that list

    If I was a client... I'd ask....

    How will I pay you? Do you directly bill me or will you take your commission out? (Normally commission is paid on a WEEKLY basis)

    How will I get my charges to you? Electronically or on paper?

    Will you create my super bill or charge slip?

    Do you have a courier that will come and gather my charges each day or do I mail them, or do I scan them?

    Will you create my fee schedule? Will you update it?

    If you're doing my credentialing, who should I participate and why?

    Will I have access to your software?

    Will I be able to check patient balances?

    Are you going to code for me? or will I have to?
    (My advice - always make the coding the responsibility of the provider/practice - to protect yourself - this needs to be in the service agreement. You may have certified coders on staff, but the responsibility is still of that of the provider/practice.)

    When will you report to me? Weekly, biweekly, monthly?
    (My advice - report WEEKLY - medical billing changes DAILY, actually by the minute!!!, if there is a problem, you don't want to wait a month to find out!! and they always call when they get the reports - so weekly is best!)

    Do you track RVU's?

    Will you audit my charges?

    Will you "train" me or "teach me" (or my staff) on E/M coding?

    Just in my experience.... don't get involved in "collections" send them to a 3rd party collection agency - write off the bad debt off the A/R and be done with it - it's a hassle thats why collections/attorneys need to get involved further. However, you should be able to "identify" what patients are ready to go to collections - standard I believe is 3 patient statements, attempt to make phone calls, send one demand letter, and if no response, they are identified for "bad debt" and ready to go to collections with the approval of the provider/practice.


    As I think of more questions, I'll add them

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