Medical Billing Coding - New biz start up- Help please!, cpt, codes
medical billing and coding forum

BC Advantage Magazine


Outsourcing your Billing/Coding

New Topic  |  Search

Thread Topic: New biz start up- Help please!
Topic Originator: Beth Eddy
Post Date August 28, 2009 @ 1:28 PM
New biz start up- Help please!

Beth Eddy
August 28, 2009 @ 1:28 PM Reply  |  Email Friend   |  |Print  |  Top

I am in the process of starting my home-based business. I have the name registered and my EIN #. There are so manythings for me to preare for- very overwhelming- but I am a woman on a mission! Hopefully, someone out there will be willing to help me out , maybe become a lifeline to me!!! What percentage do you charge?  Do you deposit directly into physician accounts, or would it be best to have all monies sent directly to the physician? Do you have the errors and ommisions insurance? Are you bonded (Fidelity?)?  Contracts for physicians- There is one in a book I have that I can use, but is quite lengthy. Anyone have one willing to share?  What billing software do you use?
I know these questions may be alot, but I am sure, since everyone had to start somewhere, you've all been there!!!
I was thinking about starting with Kareo software until I get a few clients. There are no contracts or start up fees. So, not out a ton of money upfront and as oon as get better established, then invest in like NueMD or Medisoft, etc.
I appreciate anyones answers, and will reply back. Thank you in advance.    Beth Eddy   Assurance Medical Billing

September 11, 2009 @ 11:16 AM Reply  |  Email Friend   |  |Print  |  Top

Q: What percentage do you charge?

A:  This is basded upon the due diligence.  Depending upon how many claims the provider produces, the dollar amount per claim, the payor mix.  These all determine the percentage.  An internist or GP will probably be somewhere near 7 to 8 percent.  A specialist that has a high dollar claim will be lower.  This is because it takes less time to collect the money.

Q:  Do you deposit directly into physician accounts, or would it be best to have all monies sent directly to the physician?

A:  All of our providers handle their own money.  This keeps my company out of any ethical or legal binds with the providers.  Providers then scan into our system's document storage the daily cash sheets with the deposits.  We also utilize the ERA and EEOB for those payors that send electronically.

Q:  Do you have the errors and ommisions insurance?

A:  We carry a million dollar E and O.

Q:  Are you bonded (Fidelity?)?  

A:  We do not do hard collections, so we are not bonded.  We also do not handle any money.

Q:  Contracts for physicians- There is one in a book I have that I can use, but is quite lengthy. Anyone have one willing to share?

A:  Here is the table of contents for our contract.  I have edited out the sub headings.  This is to show you what needs to be covered so both parties have equitable standing and compliance.  WE also include the Business Associate Agreement because our providers never have one.  You can get the BA from the website.

ARTICLE VII: TERMINATION                    
ARTICLE VIII:  MISCELLANEOUS                    
SCHEDULE 1.1 DEFINITIONS                    

Q:   What billing software do you use?

A:  We currently use Kareo, but we are looking for a more robust system with integrated EMR and handhelds already in place in the software.  We only use web-based software.  This allows us to bill for clients coast to coast.  Currently from California to DC and Virginia, some states in between, and soon to many more states .

Beth Eddy
September 11, 2009 @ 5:42 PM Reply  |  Email Friend   |  |Print  |  Top

Wow! Thank you so much Dan! You helped me greatly! I am happy to say that I have my first "client". I am working for a psychologist, you also specializes in equine therapy for a multitude of diagnosis- from autism, troubled children & adults, mental , chemical and alcohol dependancy to marriage counseling. I work in-house there, but I am considered an independant contractor. It is a great foot in the door for me!
Thanks again, Beth Eddy

July 19, 2010 @ 12:26 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Beth,
Also to add to Dan's answers:  
Your questions:
1.     You need to verify the state in which your client operates.  There are a few states where billing percentage is illegal.  I believe New York, Florida and Illinois are the states.  You may want to charge a flat rate with a revenue review every 3-6 months, depending on what you and your client agree on. This way you know what to expect every month and protect yourself from the percentage billing when dealing with multiple states.  How you can come up with a flat rate is review practice accounts receivable (received) in the past 6 months.  Get the monthly total and do the math of what you would charge as a percentage.  Average that sum and use that as a starting point for a flat rate.  As you begin to work you account still run the numbers the same and record the differences.  When the time comes to review and modify your flat rate, you base off the records you maintained.  Make sure your note your fee structure in your contract and re-iterate the way it works to client at the time you sit down to sign.

2.     I agree with Dan.  ALL monies are to go directly to the provider/practice.  No monies are to be directed to the billing company.  That way no fault or assumptions are made about you or your company.

3.     Its always good to have insurance.  Talk with your state because every state is different you want to ask what are the requirements for your business structure.  There is such a thing as too much insurance.

4.     Bonding is required if you plan to be a collection agency, this also requires a business license of that area of expertise and various other requirements.  Bonded is not necessary if you plan to do soft collections, i.e.: notices from the doctors office and phone calls from doctors office.

5.     I agree with Dan.  Also there are a few biller organizations you can join that can also help you.  Once you find a contract, you want to have a lawyer review it.

6.     I am currently using Lytec which has EMR and mobile capacity.

I am open to talking with you and helping you with your business.  I know how it feels to get started.  I am 6 years in, so feel free to contact me 1stsbs@gmail or 704.351.4375.
Good Luck :)

Copyright © 2008 Billing-Coding Inc