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New Solo Practitioner - Should I do my own billing?

  • 1.  New Solo Practitioner - Should I do my own billing?

    Posted 12-22-2018 12:49
    Hi, I'm starting my new family medicine practice with my wife (front desk) and an MA. Can't decide if I should do in house billing or outsource it.

    My wife will be full time practice manager/ front desk and she said she would like to do the billing herself. If we outsource it, collection rate is 6-8%. My wife has no experience in the medical field (she was an attorney). She thinks she can learn by taking courses/ youtube but I've heard a lot that billing is VERY complicated and there are 100 other things to worry about when starting a new practice so definitely should outsource it.

    Any thoughts? Thank you.




  • 2.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-23-2018 05:30
    One of the best pieces of advice given to me 10 years ago when I started my practice was to purchase an EMR with a billing module within it to keep billing in house. I did the billing myself for 4 years before hiring an assistant.
    too many folks give this up and lose control of their AR.  Keep it in house.  You can do it!

    Chris Wenner

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    Christopher Wenner
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  • 3.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-24-2018 05:30
    I use practice fusion. I am not a computer guy. I really like it. I got it because it was free 3 yrs ago. Now I pay 99/ month. I have made some suggestions about modifying program. That will take years if they do it. I still need to start dictating my notes . I type them. Not the best.  Merry Christmas again!





  • 4.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-23-2018 06:02
    Hello. 3 years ago I started my own practice. I decided to outsource billing to A LOCAL COMPANY! YOU CAN MEET IN PERSON!! IF QUESTIONS.. I think is the best thing for a starting practice. 100 other things ! Certainly. And those increase daily. You mentioned that collection rate is about 6%. I heard is more like 20-30%. Maybe you are referring to the fee that the billing company will keep, which is about 6% of what the money that the practice receives.  I continue to outsource. My wife is my part time manager. Occasionally takes care of the front desk when my son is out of the office. He is bilingual and great with costumer service. He is 22. The front desk gets extremely busy as the practice grows. I think your wife will not have time to take internet courses. My opinion only. We are seeing about 13- 16 patients / day. Of those 3 are new every day. The amount of messages we receive through the front desk is extremely high. I don't have an MA. I do my our vitals, getting difficult. We just hired my new  daughter in law as Quality and utilization manager. Just to try to keep quality / hedis in check for the up coming changes in billing.  I really could write a book of the trajectory of these 3 years it has been an up hill battle to say the least. I have 2 high school student / athletes, and they also play club. You have to take maybe, another 10 others this in consideration after my humble opinion response. Merry Christmas!





  • 5.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-23-2018 06:05
    One more thing. Financing the practice. Will your wife continue to practice law? If not will you be matching her income as an attorney? Maybe you have a very expensive front desk? Another thing to consider. 





  • 6.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-23-2018 07:40
    I think it is worth doing/learning yourself initially.  It's hard to supervise the work someone else is doing for you if you don't understand it.  Once you get busy you can always switch to outsourcing.

    Mike Barron





  • 7.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-23-2018 14:53
    My wife quit her job a couple years ago to be a stay at home mom. So it won't be too much of a change in terms of finance. I'm starting the clinic in July 2019 and she is planning to use the next few months prepping herself to do the billing. We thought that 6-8% billing fee is rather steep if we outsource billing.

    I'm also looking for EMR and was recommended Athena but it's rather expensive ($600+/ month). Was considering Practice Fusion, $99/month (not sure if the system is good) but if I do in house billing + PF, I think it can save me quite a bit especially in the beginning.

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    IMP Guest
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  • 8.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-24-2018 07:03
    Hi
    I am using practice fusion and kareo for billing interface.  I have been in solo practice for 6 years and initially did billing myself for 4 years.  It is very doable. 
    Rashmi 





  • 9.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-24-2018 10:51
    I am reasonably happy with PF which is now $100/mo.
    If you dont want to do double entry, I believe to keep billing in-house, you will need to purchase a billing program that integrates with PF.  Their web site lists the programs they integrate with.
    I dont know how much the other programs cost but we use AdvancedMD for billing and cost is approx $250 a month.  I think it is alot but that was the most reasonable at the time that met my needs.

    If anyone else knows of other programs that can work with PF and are less or even free, please let me know.

    But I would also weigh in on keeping your billing "in-house".   I agree you will need to learn the complicated insurance billing system regardless, even if you outsource.    People who outsource, say they still need to have someone track the activity of the billing company, correct errors, deal with patient calls about bills, figure out why something is denied, etc.

    Good luck.   Feel free to ask more questions.

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    Michael S. MD
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  • 10.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-24-2018 13:57
    Thank you all for your insights. For those of you who keep billing in house, what coding/ billing prep would you suggest that I do prior to opening my practice July next year?

    My wife wants to take care of the billing but we are pretty confused as to what prep she would need. I believe that ICD 10 codes are suggested by the EMR and I just need to do determine the correct CPT. That means we don't need to memorize any diagnosis code? And her job would be submitting claims, finding out why when a claim gets denied and say if its a wrong code, we can always refer to the ICD10 book/ app and correct it?

    Then does she even need to take a coding class? When we look online we found coding certification like CPC which covers other specialities like radiology, pathology etc. Seems like an overkill. But we want to be prepared so we know how to bill our first patient. Any advice is much appreciate. Thanks.

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    IMP Guest
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  • 11.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-25-2018 07:26
    I am of the   hire a biller ilk
     It  is important to know coding unfortunately but billing?  Best left to experts I pays 8% Now think about  what hiring someone costs and finding someone when they leave and space for them to work and a break room and their parking spot  and  you had better supervise and pay workers comp insurance and benefits and do Secret Santa and remember their birthday and give them time off  when their father dies.
    :)
     My billler has a wonderful way with people so she explains that yes they have to pay it. she tells me the right code for the  updated darn flu shot every yr   She also  can see my charts on practic fusion( about which I think "meh"- could be better could be worse) and this year picked up a few people I never billed for!! LOst $$   And I thought I never forgot to do an encounter form !
     BTW I have been  open close  to 14 yrs   have 4 hrs a week of an MA care coordinator    closet -cleaning envelop licking  all round brilliant young woman
    I certainly spot check- did we get paid for this or that   etc  The EOBS come to me except for MCr and medicaid and the checks come to me.
    I do not  need the headache of billing and clearing houses etc  MAkes me angry
    But courses are everywhere to be a medical biller.
    btw  use google chrome and use  dictation.io      USe it to dictate  Use it in front of you  for deaf patients Free instant and largely accurate( do not  say patient names as god knows what goggle is collecting ... wonderul tool!

    best
    Jean

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    Jean Antonucci
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  • 12.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-29-2018 09:05

    The answer depends on how much you know about medical coding and if you can find a system that meet your needs. Many colleges offer medical coder certification program. Just taking one or two courses will help you a lot. Alternatively, you can hire a part-time medical coder to help out and learn from the experience. As for billing system, use one that is integrated with your EHR. This will help you avoid a lot of pain.

    My clinic is currently using Solismed EHR, and its integrated billing function is relatively easy to use.  The nice thing is that it's only $50 a month for the entire clinic.



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    Jerry Benson
    St Paul MN
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  • 13.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-29-2018 20:00
    I use Practice Fusion, with Kareo software to bill.  Kareo is fairly simple, although daunting at first. No one cares about your money as much as you do.  I had a corporate representative for a billing company come to my clinic, I considered it, then decided to continue doing my own billing. Good luck.

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    Marie Amina Aryan, NP-C
    FNP
    Lakewood Family Health Clinic
    303-578-8191
    Lakewood, Colorado
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  • 14.  RE: New Solo Practitioner - Should I do my own billing?

    Posted 12-31-2018 11:26
    Hi,

    I can recommend you a very profession billing company, you can call them any time or meet them in person. They are very helpful for new solo practices.

    here is the contact number for them

    315-975-3500

    Regards,

    Dr. A Z Khan

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    IMP Guest
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