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Billing Companies

  • 1.  Billing Companies

    Posted 03-20-2018 10:33
    Hi everyone,
    Our EMR has practice management but we are getting tired of doing the billing ourselves  and calling the insurances for explanations. We are complemplating out sourcing our billing. Many that we ask that a biller in house but we don't want to do that because that will be another staff member and we are trying to keep overhead low.
    Is it worth out sourcing billing ?? What is the average fee ? or should we just stick to doing it ourselves?
    Hope all is doing well!

    Orange Doc
    Orange Doc Family Medicine,PLLC
    Clermont FL

  • 2.  RE: Billing Companies

    Posted 03-21-2018 05:14

    I get the sense that most practices, as they get going, find the 'back office' insurance issues to be a burden and eventually outsource them.  The good news is that if you have a billing system that someone can access remotely (cloudbased or you have something like 'log me in')they can access remotely for a few hours per week and they do not need to be local.  I think the fees vary...but overall turn out to be well spent.



  • 3.  RE: Billing Companies

    Posted 03-21-2018 07:39
    My experience has been that nobody cares as much about your billing as you.  As primary care docs, we generate a higher volume of lower value encounters. Billing company I used and others that quoted me charge a percentage of billing, usually 6-8%. They would do procedure based sub specialty billing for 6% (fewer claims, high value per claim, much easier for them). But for primary care, 8%. They can get 70 percent of money with really not too much work-the "easy" money. The other 30% only comes in with tedious (read: expensive) work-the "hard" money. If they want to make more than their percent of your "easy" collections, it's more cost effective for them to take on another practice, and collect THEIR "easy" stuff than to scrap for YOUR "hard" money. 

    To be clear, they always PROMISE to scrap for every dollar...but some of our scrapping is for pocket change. And inevitably, there are "problems" with one or more insurers that negatively impact collection efforts. In the end, you have very little recourse against them if you only get the easy money. They can just add another practice or two and make more easy money. But you just gave up 30% of your bottom line, plus the 6-8% you paid them on what you did collect. 

    Working AR is an art and a science. With the right combination of office policies, staff and strategy, it can be done with some reasonable efficiency (though its harder and harder each year). But the lesson is, your BEST internal effort will nearly always beat their result. It's just too important to your bottom line to neglect. I'd say if you have a reasonable result at this time, try to buff it for efficiency and keep studying ways to maximize up front collections. If your office is doing poorly, and it's just not your thing, shop around. But realise most of the success in collections is found in the work done on the day the patient is seen, by you and your office staff. Insurance verification, upfront collection of copays and balances, desktop deposit, coding, documentation, charge input and proper claim submission is most of the puzzle. Focus efforts there, and they'll always be a better result. 

    Good luck!
    Michael R. McLeod, MD, FAAFP
    Somewhere in South Texas. 
    Sent from ProtonMail Mobile

  • 4.  RE: Billing Companies

    Posted 03-21-2018 07:54

    Most people here will tell you to do your own billing    I have never done my own and as I watch, over the years, the ones who  do their own billing are unhappier(is that a word?)  Get a good biller Rates are 6 to  8% of collections Interview them get recommendations  spot check them Make sure they get an  bill out for every encounter you sned( have a system) Why anyone who can make 150.00/hr would do what a 30/hr person can do  better is beyond me  I do not   snowplow the office lot I do not   change the lightbulbs or fix the door For pete sake  outsource it.You will be happier.

         Jean Antonucci MD
         115 Mt Blue Circle
         Farmington ME 04938
    ph 207 778 3313   fax 207 778 3544

  • 5.  RE: Billing Companies

    Posted 03-21-2018 08:19
    I agree with Jean, billing is a pain and it's a good idea to find someone else to do it.  However, finding someone good can be difficult.  I've tried twice and failed, so I continue to do my own billing.  My wife follows up on the denials and sends out bills to patients.

    The first time I tried paying a local person per hour.  She was a retired hospital biller.  Unfortunately between health and family problems very little actually got done.  The second time I went with a firm that was going to take 6%.  They did zero work on denials; they were happy to take the 6% of the easy ones- the ones that got approved first time.  The denials take time to fix so the return for them was much lower.  My accounts receivable grew quite large because of that effort.  In both cases the biller made a lot of promises but failed to deliver.

    I would love to know if anyone has found someone to work on the denials and patient billing only.  I use Trizetto; getting the charges out and the remits entered is relatively easy.  Does anyone have a biller they can recommend who might want more work?

    Michael Barron
    Barron Family Medicine
    University City MO

  • 6.  RE: Billing Companies

    Posted 03-21-2018 11:41
    This is a frequent topic over the years, and we all have different situations.  A doctor new to billing and credentialing, etc, would need to spend significant time in the beginning and have patience.   This forum has been very helpful over the years as well as the calls we used to have when we would discuss coding and reimbursement.  (We are hoping to get that restarted.)

    I have always done billing in house, but must admit my biller has been with me for many years.   Also, since I have an "established practice" there is not a lot of patient turnover and our collections rate is very high and few surprises.   The person I use also serves as my medical assistant both front office and back.  My philosophy is I would rather pay a dedicated employee, who helps me and the patients in so many ways, then 6-8% to a billing company for collecting low hanging fruit.   I do pay approx $250 monthly for my billing software, fees, statements, etc.

    At this point I just circle some charges on a paper routing slip and MA / biller enters the charges, collects from patient, and hits send once a week.  .  You would have to do that anyway with an outside biller.   The electronic remittance deposits the money in my bank account and automatically does the patient adjustments, and sends a statement for any residual patient responsibility.

    Regardless of  whether you keep it in house or send billing out, you should spend some time reviewing EOBs to learn what is covered, denied, etc, in order to maximize reimbursement.    I spend maybe 15 minutes a week on that, and maintain a spread sheet with allowable charges and codes for the companies I participate with.   A critical piece, as mentioned by others, is the up front collections and patient info, knowing what is covered, what to bill privately for, etc.

    Michael S. MD

  • 7.  RE: Billing Companies

    Posted 03-21-2018 12:31
    thank you . we have a lot to think about.

    Orange Doc
    Orange Doc Family Medicine,PLLC
    Clermont FL

  • 8.  RE: Billing Companies

    Posted 03-22-2018 06:54
    Would you be willing to post your spread sheet?

    Melissa Weakland, MD
    Ballard Neighborhood Doctors
    5416 Barnes Ave NW
    Seattle, WA 98107
    Phone: (206)-297-7678
    Fax: (206)-297-5930

  • 9.  RE: Billing Companies

    Posted 03-25-2018 09:34
    Hello Adolfo. I see you have been a little more active here.  I use a local billing company. Here in Clermont. I am in this group because of you. Affordable medical billing solutions talk to Ruby Khalid (407)925-6072. 6% up to now she is talking about increasing. We need to get together one of these days!!

  • 10.  RE: Billing Companies

    Posted 03-27-2018 12:32
    Hello Edgar, thanks for the info. I will give that information to my wife. she will contact them and find out about their services.
    I am thinking also looking into a collection agency. We have a long list of abusers.
    we get busy and can not contribute to the IMP discussions but we need to go back our roots.
    Yes indeed we need to make the effort to get together and chat.

    Orange Doc
    Orange Doc Family Medicine,PLLC
    Clermont FL

  • 11.  RE: Billing Companies

    Posted 04-30-2018 00:03
    if anyone agree on 3.5% then please start discussion on it.

    IMP Guest