Medical Billing Coding - CPT/ICD-9 coding - pay by piece?, cpt, codes
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Thread Topic: CPT/ICD-9 coding - pay by piece?
Topic Originator: Jon
Post Date June 6, 2006 @ 1:26 AM
CPT/ICD-9 coding - pay by piece?

June 6, 2006 @ 1:26 AM Reply  |  Email Friend   |  |Print  |  Top

Just curious if anyone pays for this services by the piece.  I've had it suggested to me, by non-medical persons, who think this is a good way to ensure those working at home, will be productive.

Does anyone have any experience on this?

June 6, 2006 @ 10:48 AM Reply  |  Email Friend   |  |Print  |  Top

Are speaking of coding specifically, or piecerate in general?

June 6, 2006 @ 10:59 AM Reply  |  Email Friend   |  |Print  |  Top

I'm speaking of both, in conjunction with another.  In other words, there is always a fear with at home workers, that they will not be as productive, given the distractions at home, or in some cases, the fact that they are not supervised, so they slack off.  

My thought is if perhaps you could pay by charts coded (piece work), then the person is incentivized to be more productive.  If they don't work hard, then they don't earn as much.  

But, if others use piece work in other areas, I'm interested...because I may be able to adapt to CPT coders.


June 6, 2006 @ 3:23 PM Reply  |  Email Friend   |  |Print  |  Top

I did piecework for 3 years in another industry.  I then worked for the same company as a salaried supervisor.

The money motivated me.  But then, I'm a self-motivated, responsible employee anyway.

You can and should treat your piecerate employees the same way you do any employee - reward the top with raises and bonuses, correct the bottom with discipline and termination.  The reason is, you have so much work each week that you need your employees to do in order to meet your clients' expectations.  The piecerate incentive is a double-edged sword - sure, it will motivate your go-getters (who really don't need incentives to be valuable and productive because that's in their nature) but 90% of your other *I'm married and my husband already makes plenty of money and I'm just doing this because I'm bored/need shoe shopping money/need an excuse to shut my bratty kids that I can't handle out of the room* employees will still do only enough to keep from getting fired, because they're not working for the money anyway.

The advantage of piecerate is that it's an excellent way to reward your most productive, efficient, accurate employees.  It also ensures you a steady profit rate (assuming you are also charging your client by the piece).

But it's not a sure-fire method of eliciting more production out of your employees.

Keep in mind, also, your employees are still entitled to minimum wage, and as such, they will still have to keep time records and you will now have to record and track hours as well as pieces, and if the pieces don't equal minimum wage, you will be required by federal law to pay the employee more than what their piecerate is.

June 6, 2006 @ 3:44 PM Reply  |  Email Friend   |  |Print  |  Top

You make excellent points.  I hadn't thought of the minimum wage issue, although I suppose I could make them independent contractors.  Then again, I would imagine I could get in some hot water there too.

I guess I need to figure out a template & compare that against a current employee....then maybe try it out.

Thanks for your input.

June 20, 2006 @ 7:50 PM Reply  |  Email Friend   |  |Print  |  Top

I was approached to do medical coding for a FP practice, but not sure how to price the client.  I was considering hiring sub-contractors to do the work, but don't want to under price myself and all monies will be going to them.  Any suggestions?

June 20, 2006 @ 9:55 PM Reply  |  Email Friend   |  |Print  |  Top

I would figure out how much of your fee goes to ongoing expenses such as marketing, phone, internet, postage, office supplies, software support, etc, then add a percentage for the profit margin you're used to making and pay your subcontractor the remainder.  Remember, if your subcontractor is going to have some of those fees, too, such as phone, internet connection, etc, you may have to figure about half your cost instead of your entire cost.

In other words, pay them what you value your time to actually do the work is, plus their expenses.  If you've figured in that your time is worth $10/hr when you figure your fee, then pay your subcontractor that amount plus, oh, say $30.00 for their internet and phone.

If you plan on paying them by piece, then calculate the above figure, the number of pieces, then calculate how many hours it would take to complete the needed work.  Finish up the math and you've got your number.

For instance, say you think the subcontractor should be paid $10/hr.  You have 500 pieces to do each week.  "Pieces" would depend on the work you are doing, but let's say for the sake of argument we're talking about keying 500 superbills into your billing system.  You figure it should take the normal person 10 hours to key those 500 superbills.  That means your piecerate should be 20¢ per superbill - 500 superbills at 20¢ per piece equals 100 hours, divided by $10/hour - 10 hours.  $10/hour then equals 20¢/piece.

June 21, 2006 @ 10:02 AM Reply  |  Email Friend   |  |Print  |  Top

Great.  Those numbers look close to what the provider stated for the office (he sees between 200-500 patients per week).  Thanks for the information.

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