| This is a very difficult decision for any
| |
| | delinquent accounts enabling your office
|
| physician and partially boils down to
| |
| | manager to properly send the information
|
| this or her own personal ideology and
| |
| | to a collection agency of your choice. In
|
| comfort level.Hospital-based physicians
| |
| | my opinion billing services that own
|
| will almost always be better off
| |
| | collection agencies or establish close
|
| outsourcing because of the office related
| |
| | affiliate relationships with them are
|
| expenses that they would not otherwise
| |
| | unethical and should be avoided at all
|
| incur. As the owner of medical billing
| |
| | cost. Even though it is nearly impossible
|
| service you may think I'm naturally
| |
| | to find a collection agency that does not
|
| biased towards outsourcing. I can assure
| |
| | have relationships with medical billing
|
| you that this is not the case.Physicians
| |
| | services the point I'm trying to make is
|
| who are overly controlling, uncomfortable
| |
| | to be sure that your billing service is
|
| or mis-trusting toward billing services
| |
| | independent and you have the freedom to
|
| are nearly impossible to administer. I
| |
| | select a collection agency of your
|
| don't want anything to do with those
| |
| | choice. This relationship presents a
|
| types of physicians but I completely
| |
| | scenario whereby the billing service can
|
| respect and understand their point of
| |
| | simply go after the easy to collect
|
| view. Setting all ideology aside I would
| |
| | accounts and allow the more difficult but
|
| like to delve into the pros and cons of
| |
| | still collectible ones to slip into the
|
| this difficult and complicated decision.I
| |
| | hands of a collection agency who
|
| am a physician who is very interested in
| |
| | obviously charge a much higher percentage
|
| the business aspect of medicine and I do
| |
| | of collections. Again, it's easy to see
|
| not mind spending my valuable time
| |
| | how a billing service can facilitate or
|
| managing the medical billing aspect of my
| |
| | erode your sense of control. The most
|
| practice.Clearly, the best way to do your
| |
| | reputable collection agency I've dealt
|
| billing is to do it personally.
| |
| | with is a company called Collection
|
| Obviously, doing it yourself is probably
| |
| | Information Bureau (CIB). I've been doing
|
| not an option but if you're willing to
| |
| | business with them for years and they
|
| spend the time and have the interest I
| |
| | have never attempted to establish an
|
| would recommend that you do your own
| |
| | affiliate relationship with my company.
|
| billing. Keep in mind that most billing
| |
| | CIB can be reached at 1-800-231-3514,
|
| service owners and certainly our
| |
| | contact sandy Lopez.Different types of
|
| employees have limited medical
| |
| | billing servicesThere are three different
|
| backgrounds. Physicians who study CPT,
| |
| | types of billing services.* Fee per
|
| regularly attend billing seminars and
| |
| | claim* 50/50* Full serviceFee per claim
|
| keep up to date on industry changes are
| |
| | billing services charge a flat rate per
|
| the ultimate medical billing gurus in my
| |
| | claim. The fees generally range between
|
| view.I am a physician who has absolutely
| |
| | $1.25 to $5.00 per claim depending upon
|
| no time or interest in the medical
| |
| | the services provided.Advantages:·
|
| billing aspect of my practice. I am
| |
| | May be helpful to a brand-new practice
|
| completely reliant upon my office manager
| |
| | who is not fully implemented a computer
|
| and billing staff.Unfortunately, most
| |
| | system or is still trying to decide
|
| physicians are in this position. Even if
| |
| | whether to outsource.· Practices
|
| they were interested in keeping up with
| |
| | with old or outdated computer systems·
|
| all the changes and elements of medical
| |
| | Relatively inexpensive cost per
|
| billing the practical reality is that
| |
| | claim· Excellent for practices
|
| there is absolutely no time. Let's face
| |
| | who have a problem with only one
|
| it; time is your most valuable asset.
| |
| | particular payer group such as Medicare
|
| It's sort of like mowing your own lawn.
| |
| | or payers that require electronic claims
|
| You'd be way better off financially
| |
| | submission· Physicians planning
|
| seeing patients for three hours on
| |
| | to retire within one year·
|
| Saturday morning. I believe the
| |
| | Highly flexible· Low-volume
|
| following information will dramatically
| |
| | practices· less
|
| help with your decision to outsource your
| |
| | employeesDisadvantages:* Expensive for
|
| billing or continue to do it yourself and
| |
| | high-volume practices* Poor integrity of
|
| with future decisions in the
| |
| | accounts receivable* Lack of information
|
| ever-changing business aspect of
| |
| | systems* Lack of control50/5050/50
|
| medicine.The pros and cons of outsourcing
| |
| | billing services install computer
|
| your medical billing services.I would
| |
| | terminal/terminals in your office. The
|
| like to preface this article with a
| |
| | billing service performs part of the
|
| couple of obvious but important points.
| |
| | billing process while your office
|
| If you have a system of controls, keep an
| |
| | performs the other. As you can probably
|
| open mind about the competence of your
| |
| | tell from my list of disadvantages this
|
| office manager, you've got an excellent
| |
| | is in my opinion the least desirable type
|
| computer system, proper information
| |
| | of billing service.Advantages:·
|
| systems and your office is doing a superb
| |
| | Less expensive than full-service billing
|
| job at collecting your money, then by all
| |
| | services· Avoid the purchase of
|
| means do not make any changes.
| |
| | practice management software·
|
| Conversely if you're planning to
| |
| | Creates a system of checks and balances·
|
| outsource your billing make sure you hire
| |
| | less employeesDisadvantages:*
|
| quality firm. I'll spend some time at
| |
| | High set up fees* Low accountability from
|
| the end of this article discussing this
| |
| | the billing service* Lack of control*
|
| further.Most leading experts agree that
| |
| | Communication Problems(all collection
|
| it costs about 4.5% of net collections to
| |
| | problems will be blamed upon your
|
| perform the billing function within a
| |
| | office)* Your staff will still probably
|
| physician's office. Incidentally, this
| |
| | wind up doing most of the work*
|
| is close to my actual cost as
| |
| | Completely reliant upon the Internet*
|
| well.Theoretically, a billing service
| |
| | Loss of data* HIPPA
|
| should be able collect more money than a
| |
| | issuesFull-serviceAdvantages:·
|
| physician's office because it is our core
| |
| | completely remove the billing process
|
| competency. The question is how much
| |
| | from your office· symbiotic
|
| more? This is why I focus on how to
| |
| | relationship· avoid expensive
|
| choose a billing service at the end of
| |
| | computer system· system of
|
| this article.The numbersA. Lets just do
| |
| | checks and balances· less
|
| the math in a theoretical model.We'll
| |
| | employeesDisadvantages:·
|
| base our numbers on a practice whose
| |
| | expensive· loss of control·
|
| total gross receivables are $100,000 per
| |
| | patient relations·
|
| month. Obviously, this is an overly
| |
| | collection agency relationshipsShould I
|
| simplistic model designed to quantify the
| |
| | outsource my billing checklist: If you
|
| aggregate cost and or opportunity cost of
| |
| | answer yes to most of the following
|
| the medical billing component
| |
| | questions then you should probably
|
| only.Current Aggregate Billing
| |
| | consider outsourcing?· Is your
|
| ExpensesIn-house expenseTotal gross
| |
| | overall collection rate declining?·
|
| revenue
| |
| | Is your accounts receivable too
|
| $100,000Current billing expense
| |
| | high?· Are you experiencing an
|
| $4,500(4.5%)
| |
| | increased number of denied claims?·
|
| ---------------Net
| |
| | Is your overall frustration level
|
| Revenue
| |
| | regarding your billing/business office
|
| $95,500Outsourced Billing ExpenseTotal
| |
| | very high?· Are you facing a
|
| gross revenue
| |
| | major capital investment in new hardware
|
| $100.000Current billing service exp.
| |
| | or software?· Are your computer
|
| $7,000(7.0% net collections)
| |
| | support fees to high?· Are you
|
| ---------------Net Revenue
| |
| | having a difficult time keeping or hiring
|
| $93,000Net
| |
| | experienced billing staff?· Are
|
| cost increase with outsourcing =
| |
| | you spending too much time on the
|
| $2,500.00As you can see in this," all
| |
| | business aspect of medicine?·
|
| things being equal" theoretical model
| |
| | Are you concerned that your staff or
|
| your practice would incur a $2,500
| |
| | office manager has knowledge of your
|
| decrease in net revenue with the
| |
| | income?· Are you completely
|
| implementation of a billing outsource
| |
| | reliant upon your office manager?·
|
| strategy. Keep in mind that this model
| |
| | Are you planning to expand your
|
| does not address other less tangible
| |
| | practice?· Do you believe that
|
| issues such as your reduced payroll,
| |
| | your practices cost structure is too
|
| computer expenses, ect. In reality the
| |
| | high?· Do you have several
|
| net cost could be substantially less than
| |
| | employees performing tasks that could be
|
| $2,500. Many physicians will perceive
| |
| | handled by a single more experienced
|
| this as a small price to pay while others
| |
| | manager?· Is your computer
|
| will consider it to be cost
| |
| | system obsolete?· Are hardware,
|
| prohibitive.5% theoretical increase in
| |
| | software, and information technology
|
| gross revenue with outsourced
| |
| | disrupting the operation of your
|
| billingTotal gross revenue
| |
| | practice?How do I select a billing
|
| $105,000 (5% increase)Billing service
| |
| | service?1. The service should fit or
|
| expense $7,350(7% net
| |
| | complement the size of your actual
|
| collections)
| |
| | practice. Try to get a basic idea of the
|
| ----------------Net revenue
| |
| | size of the firm. A solo practice will
|
| $97,650$95,500 -
| |
| | most likely have greater success with a
|
| $97,650 = $2,150.00 increase in net
| |
| | small to medium-sized billing firm.
|
| revenue.As you can see from this model
| |
| | Obviously, a solo family practitioner
|
| with a 5% increase in collections your
| |
| | would probably not be very well served by
|
| net revenue will increase $2,150.00 with
| |
| | a publicly traded firm.2. Avoid long-term
|
| the added expense of the billing service.
| |
| | binding contracts. You should be free to
|
| Keep in mind that a 5% increase in gross
| |
| | terminate your agreement any time within
|
| collections is actually quite
| |
| | 30 days written notice. The agreement
|
| conservative and should easily be
| |
| | should clearly specify what each side
|
| obtainable by quality billing
| |
| | will do for the other. Make sure the
|
| service.IntangiblesB. A billing service
| |
| | agreement assures that upon termination
|
| should be able to provide you with a
| |
| | you'll receive a highly detailed account
|
| substantial reduction in your day-to-day
| |
| | receivable report [listed by individual
|
| aggravations such as practice management
| |
| | patient] .3. Ask for references and call
|
| software issues, fewer employees, hassle
| |
| | the other providers!4. Inquire
|
| of hiring competent employees, less
| |
| | investigate the actual owner of the
|
| health insurance, less training,
| |
| | company. Ask to speak with the owner
|
| ECT..ect. Conversely you will however
| |
| | directly.5. Avoid firms who offer too
|
| lose some control over your practice. If
| |
| | many different types of service. Medical
|
| the billing service does not collect more
| |
| | billing is a very highly specialized
|
| money your expenses will increase. It's
| |
| | field. Companies who offer, collection
|
| up to you to determine whether or not the
| |
| | agency services, payroll, financial
|
| increased expense is offset by decreased
| |
| | consulting, tax consulting, malpractice
|
| aggravation.securityC. A billing service
| |
| | insurance, marketing services etc. etc.
|
| should be able to increase your security
| |
| | are not in my view focused enough on what
|
| levels by creating a system of checks and
| |
| | they're there to do. Collect your
|
| balances. As a former police officer I
| |
| | money!6. Ask other physicians. Keep open
|
| can assure you that crime statistics
| |
| | mind about this one because physicians
|
| indicate most embezzlement/fraud/theft
| |
| | who are happy with their billing company
|
| occurs from within. During an
| |
| | do not necessarily want them to grow and
|
| investigation a store manager for Sears
| |
| | generally like to keep a low profile on
|
| and Roebuck Co. once told me," our
| |
| | this issue.7. Is the billing service for
|
| customers take it out piecemeal but our
| |
| | sale? Try to ascertain whether or not
|
| employees take it out in wheel barrels"
| |
| | the firm has recently been sold. In your
|
| This logic also applies to a doctor's
| |
| | contract/agreement you should request to
|
| office. A billing service can provide an
| |
| | be notified within 30 days of the pending
|
| extra layer of protection because there
| |
| | sale. In my experience billing services
|
| is a system of independent checks and
| |
| | are constantly being bought and sold.
|
| balances. Typically billing services are
| |
| | Sometimes the acquisition is a positive
|
| fairly large businesses with strict
| |
| | thing but quite often the merger
|
| internal controls. My organization
| |
| | acquisition can be very detrimental. You
|
| Medi-Bill Inc. Operates internally
| |
| | should at least be notified and given
|
| similar to a banking institution with the
| |
| | ample time to make a proper decision on
|
| way we handle funds. It is highly
| |
| | whether you'll stay with the new firm or
|
| unlikely that the ownership of a
| |
| | select another.8. Where will your checks
|
| reputable medical billing firm would risk
| |
| | and correspondence be mailed? This
|
| the consequences of committing fraud
| |
| | delicate and important issue need not be
|
| against a client.Conversely, the issue
| |
| | as complicated as it appears. Many
|
| once again boils down to control. Many
| |
| | physicians for obvious reasons are
|
| physicians are understandably quite
| |
| | reluctant to allow checks and
|
| unsettled at having their checks and
| |
| | correspondence to be forwarded directly
|
| correspondence mailed directly to the
| |
| | to their billing service. Some
|
| billing service. Further compounding this
| |
| | reputable, high-quality billing services
|
| dilemma is," what will happen to the
| |
| | will not even provide services to clients
|
| checks and correspondence after the
| |
| | who insist upon having the checks and
|
| billing service agreement is
| |
| | correspondence mailed to them directly.
|
| terminated?"(Again, we will discuss
| |
| | I'd like to spend a few moments on this
|
| alternatives to this at the end of the
| |
| | important issue and explain the
|
| article)TechnologyD. State-of-the-art
| |
| | ramifications of exactly where your
|
| practice management software is an
| |
| | checks and correspondence will be mailed.
|
| extremely expensive investment. If you've
| |
| | Maintaining the integrity of your
|
| already invested in a high quality
| |
| | accounts receivable is crucial! If your
|
| computer system I do not believe
| |
| | office routinely fails to properly mail
|
| outsourcing your billing would make much
| |
| | copies of checks and correspondence to
|
| sense financially unless your computer
| |
| | your billing company your practice could
|
| vendor is charging outrageous support
| |
| | be in grave danger of losing control of
|
| fees. If you're considering purchasing a
| |
| | the accounts receivable. If your account
|
| computer system or a medical record
| |
| | receivable is to maintain any semblance
|
| management system my favorite vendor who
| |
| | of financial integrity it is crucial that
|
| we've been working with for over 15 years
| |
| | billing service employees do not spend
|
| is Office Management Solutions (OMS)
| |
| | valuable time and effort following up on
|
| based in Tampa Florida. The owner's name
| |
| | claims that have already paid and not
|
| is John Peake and he is by far the most
| |
| | properly forwarded to them.
|
| honest and reputable computer vendor I
| |
| | Understandably, your service may even
|
| have ever worked with. OMS can be reached
| |
| | look upon this as an intentional effort
|
| at 813-963-5582 or you need to update
| |
| | to reduce their commissions. Again, bank
|
| your system, purchase a new system or
| |
| | lock boxes provide a sound alternative to
|
| your support fees are getting out of hand
| |
| | this dilemma. Some practices solve this
|
| this may be an opportune time to consider
| |
| | problem by directing all checks and
|
| outsourcing your medical billing
| |
| | correspondence to a P.O. Box keeping
|
| services.Financial securityF. Many
| |
| | EOB's separate from other corporate mail.
|
| physicians, for obvious reasons do not
| |
| | The checks and correspondence are mailed
|
| want their office managers/staffers to
| |
| | to the billing service," unopened"
|
| have any in-depth knowledge of how much
| |
| | biweekly. This is an excellent
|
| money the practice is making. A
| |
| | compromise and creates a system of
|
| reputable and properly run billing
| |
| | control. There are many other possible
|
| service can create this level of
| |
| | options but the important point to
|
| financial security. The best case
| |
| | remember is that ONE entity must be
|
| scenario is for your staffers to only see
| |
| | completely responsible for the validity
|
| your expenses and have only a limited
| |
| | and integrity of your EOB's.9. Make sure
|
| understanding of the revenue being
| |
| | all checks and correspondence are issued
|
| generated. This can also be accomplished
| |
| | under your tax identification number and
|
| internally by making and recording your
| |
| | made payable to you! Make sure your
|
| own deposits. If you're going to do your
| |
| | contract/agreement specifies that the
|
| own billing I must emphasize the
| |
| | billing service will not countersign or
|
| importance of financial security. You
| |
| | attempt to countersign your checks and
|
| must create a system of financial
| |
| | correspondence.David J. Duncan
|
| security. If you don't have the time to
| |
| | President and CEO
|
| personally open your mail and make the
| |
| | Duncan is a graduate of Florida
|
| deposits you are definitely a candidate
| |
| | Atlantic University with a B.A in Finance
|
| for outsourcing. Many banks offer a
| |
| | and is the original founder of Medi-Bill
|
| "lockbox" where you can direct your
| |
| | Inc. He also has an extensive law
|
| checks and correspondence. Bank lockbox
| |
| | enforcement background and is a former
|
| services are generally quite pricey. They
| |
| | police officer with the City of Fort
|
| usually charge about .25 per copy. You
| |
| | Lauderdale. Mr. Duncan's reputation for
|
| may also opt to take out your own P.O.
| |
| | honesty and integrity is well known
|
| Box located adjacent to your billing
| |
| | throughout the medical community. During
|
| company. This way you still maintain
| |
| | his career, Mr. Duncan has provided
|
| control of your checks and
| |
| | billing, financial and practice
|
| correspondence.Collection agenciesG. Many
| |
| | management services to physicians and
|
| billing services own or have affiliate
| |
| | medical practices in a variety of
|
| relationships with collection agencies.
| |
| | specialties throughout the country. He
|
| You'll most definitely want to avoid this
| |
| | has extensive experience with,
|
| situation. Make sure your billing
| |
| | managed-care, hospital contract
|
| service provides you with a monthly
| |
| | negotiations, data integration and
|
| report containing proper information on
| |
| | practice management.
|
