Re: Re: Question regarding doing own billing rather than farming it out to service.

[Guest guest]

I don't understand your comment about your volume being too low to justify

bringing your billing back in house. Shouldn't it be the other way around, keep

it in house until volume is so high that it justifies outsourcing it?

>

>

> Date: 2006/02/11 Sat PM 07:56:56 EST

> To: < >

> Subject: Re: Question regarding doing own billing

rather than farming it out to service.

>

> RE Cost for submitting EOBs, etc.

>

> 6-8% of collections my area.

> My volume is still too low for me to consider bringing this in house, but I

> see all EOBs, and I review and quiry the biller for every inconsistency.

>

> Dr Matt Levin

> Pittsburgh, PA

> Using SOAPware at point of care since 1997.

>

> Question regarding doing own billing rather

> than farming it out to service.

>

>

> > For those of you doing your own billing and find that your market

> > requires you to participate with numerous insurance plans, what

> > percent do you feel is fair to pay to a billing company for posting

> > back to eob's, scrubbing claims, answering phone dealing with billing

> > issues etc? If your do this yourself and had to figure overhead, what

> > value would you give it? I guess what I am asking is that in doing

> > your own posting etc it gives you a chance to correct what you are

> > doing in order to maybe get paid and limit the stuff that pays little

> > and this also has value to the bottom line so I would like that

> > intangible added somewhat. Much of what we do in Alteer is done thru

> > a clearing house. I would be over half.

> > I am just trying to get a handle on whether it would be cost effective

> > to bring this back home for a two doctor busy practice. We do not do

> > the low volume. It is not unusual to have 60 encounters of some type

> > a day for two doctors and 4 nurses.

> > Help?

> > Brent

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

RE Volumes low and economies of scale.

1) If you do billing IN house, you really need to post billings immediately,

to ensure cash flow.

2) If you have low-volume billing, 6-8% of your collections cannot justify

cost of either

A) Paying someone to be full time to take care of billing, posting,

mailing bills, reviewing EOBs.

Paying to keep software up to date.

C) Paying someone to keep up to date on all billing issues.

D) Having redundancy for your billing company (more than 1 person) will

be easier to do as outsource than insource.

3) I anticipate having, ultimately, $30K/month of billables. At 7%, this

will cost me, in postings, mailing of bills, $2.1K/month. So, this would

cost me, if in house, a $500/week employee. I'd need to decide then if the

costs are worth it. That's why my volume, now at about $10K/month

billables, I cannot afford a billing person, other than outsourcing, for

$700/month.

Just my figuring....

Dr Matt Levin

Question regarding doing own billing

>> rather

>> than farming it out to service.

>>

>>

>> > For those of you doing your own billing and find that your market

>> > requires you to participate with numerous insurance plans, what

>> > percent do you feel is fair to pay to a billing company for posting

>> > back to eob's, scrubbing claims, answering phone dealing with billing

>> > issues etc? If your do this yourself and had to figure overhead, what

>> > value would you give it? I guess what I am asking is that in doing

>> > your own posting etc it gives you a chance to correct what you are

>> > doing in order to maybe get paid and limit the stuff that pays little

>> > and this also has value to the bottom line so I would like that

>> > intangible added somewhat. Much of what we do in Alteer is done thru

>> > a clearing house. I would be over half.

>> > I am just trying to get a handle on whether it would be cost effective

>> > to bring this back home for a two doctor busy practice. We do not do

>> > the low volume. It is not unusual to have 60 encounters of some type

>> > a day for two doctors and 4 nurses.

>> > Help?

>> > Brent

>> >

>> >

>> >

>> >

>> >

>> >

>> >

>> >

[Guest guest]

Matt: My collections are about 12000/ month between my wife and I. I realize we are 1.5 FTE but in patient care about 1.0 FTE that leaves me .5 to be office manager so to speak. It takes me time to do the following: 1. Statements monthly 2-3 hours. 2. Posting 3-4 hours per 3-4thousand dollars (this will decrease as I sign up with autoposting from bcbs clearing house) 3. Banking 4 hours per month 4. Calling Insurance companies unknown as I have just implemented a procedure to track delinquent claims. Estimate is 20-30 hours per month. Savings $12000*.08 = $960 Per hour $32-48 This is still higher than I pay myself after overhead on the medical care I provide. If I had patiewnts to see instead, I may not be able to

justify the expense. But at this point, I cannot justify paying someone else $11000 for collecting $132000 whwn I pay myself and my wife $75k wages and $25000 in company perks. Just sending out electronic billing I collect 80-90% accounts receivable. So in my position it makes no sense to pay them $11,000 to collect $13-26,000. Perhaps when and if I would higher a secretary or office manager they could perform that functin as part of their salary justification to allow me to see patients or develope chronic disease management. Collections have averaged 80% of billed charges Bad debt 5.8% Levin wrote: RE Volumes low

and economies of scale.1) If you do billing IN house, you really need to post billings immediately, to ensure cash flow.2) If you have low-volume billing, 6-8% of your collections cannot justify cost of either A) Paying someone to be full time to take care of billing, posting, mailing bills, reviewing EOBs. Paying to keep software up to date. C) Paying someone to keep up to date on all billing issues. D) Having redundancy for your billing company (more than 1 person) will be easier to do as outsource than insource.3) I anticipate having, ultimately, $30K/month of billables. At 7%, this will cost me, in postings, mailing of bills, $2.1K/month. So, this would cost me, if in house, a $500/week employee. I'd need to decide then if the costs are worth it. That's why my volume, now at about $10K/month billables, I cannot

afford a billing person, other than outsourcing, for $700/month.Just my figuring....Dr Matt Levin Question regarding doing own billing >> rather>> than farming it out to service.>>>>>> > For those of you doing your own billing and find that your market>> > requires you to participate with numerous insurance plans,

what>> > percent do you feel is fair to pay to a billing company for posting>> > back to eob's, scrubbing claims, answering phone dealing with billing>> > issues etc? If your do this yourself and had to figure overhead, what>> > value would you give it? I guess what I am asking is that in doing>> > your own posting etc it gives you a chance to correct what you are>> > doing in order to maybe get paid and limit the stuff that pays little>> > and this also has value to the bottom line so I would like that>> > intangible added somewhat. Much of what we do in Alteer is done thru>> > a clearing house. I would be over half.>> > I am just trying to get a handle on whether it would be cost effective>> > to bring this back home for a two doctor busy practice. We do not do>> > the low volume. It is not unusual

to have 60 encounters of some type>> > a day for two doctors and 4 nurses.>> > Help?>> > Brent>> >>> >>> >>> >>> >>> >>> >>> >

[Guest guest]

You know, Brent - I don't know if it could be extrapolated- he does billing for three people in may office - we all share the same PM/computer system. One is a therapist, sees 30/week, but the billing is easier than mine - always the same codes. The other is a PT/myofascial therapist who sees 35-40 a week, all paper billing with practice notes attached, lots of automobile insurance and lawyers... It looks as though he's spending about 15 hours/week for all of us, roughly. I also use him to send out med records, get PAs and rename and sort my faxes to electronic records every week, for an additional 2-3 hours/week. We have 4 phone/fax lines for the three of us and that's no problem. We split supplies, and a small business office between the three of us, which is part of the rent we pay into our shared group. It's very efficient sharing these services. He's in the office about 3-4 hours/day most days of the week, depending on the work. do you think that this would be typical, 6-7 hours per 40 patients a week and could be extropalated to busier practices? What about costs of phone, supplies, space and your time to answer phone regarding billing questions? > > > RE Cost for submitting EOBs, etc. > > > > 6-8% of collections my area. > > My volume is still too low for me to consider bringing this in  > > house, but I > > see all EOBs, and I review and quiry the biller for every  > > inconsistency. > > > > Dr Matt Levin > > Pittsburgh, PA > > Using SOAPware at point of care since 1997. > > > > Question regarding doing own  > > billing rather > > than farming it out to service. > > > > > > > For those of you doing your own billing and find that your market > > > requires you to participate with numerous insurance plans, what > > > percent do you feel is fair to pay to a billing company for posting > > > back to eob's, scrubbing claims, answering phone dealing with  > > billing > > > issues etc? If your do this yourself and had to figure overhead,  > > what > > > value would you give it?  I guess what I am asking is that in doing > > > your own posting etc it gives you a chance to correct what you are > > > doing in order to maybe get paid and limit the stuff that pays  > > little > > > and this also has value to the bottom line so I would like that > > > intangible added somewhat.  Much of what we do in Alteer is done  > > thru > > > a clearing house.  I would be over half. > > > I am just trying to get a handle on whether it would be cost  > > effective > > > to bring this back home for a two doctor busy practice.  We do  > > not do > > > the low volume.  It is not unusual to have 60 encounters of some  > > type > > > a day for two doctors and 4 nurses. > > > Help? > > > Brent > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

You know, Brent - I don't know if it could be extrapolated- he does billing for three people in may office - we all share the same PM/computer system. One is a therapist, sees 30/week, but the billing is easier than mine - always the same codes. The other is a PT/myofascial therapist who sees 35-40 a week, all paper billing with practice notes attached, lots of automobile insurance and lawyers... It looks as though he's spending about 15 hours/week for all of us, roughly. I also use him to send out med records, get PAs and rename and sort my faxes to electronic records every week, for an additional 2-3 hours/week. We have 4 phone/fax lines for the three of us and that's no problem. We split supplies, and a small business office between the three of us, which is part of the rent we pay into our shared group. It's very efficient sharing these services. He's in the office about 3-4 hours/day most days of the week, depending on the work. do you think that this would be typical, 6-7 hours per 40 patients a week and could be extropalated to busier practices? What about costs of phone, supplies, space and your time to answer phone regarding billing questions? > > > RE Cost for submitting EOBs, etc. > > > > 6-8% of collections my area. > > My volume is still too low for me to consider bringing this in  > > house, but I > > see all EOBs, and I review and quiry the biller for every  > > inconsistency. > > > > Dr Matt Levin > > Pittsburgh, PA > > Using SOAPware at point of care since 1997. > > > > Question regarding doing own  > > billing rather > > than farming it out to service. > > > > > > > For those of you doing your own billing and find that your market > > > requires you to participate with numerous insurance plans, what > > > percent do you feel is fair to pay to a billing company for posting > > > back to eob's, scrubbing claims, answering phone dealing with  > > billing > > > issues etc? If your do this yourself and had to figure overhead,  > > what > > > value would you give it?  I guess what I am asking is that in doing > > > your own posting etc it gives you a chance to correct what you are > > > doing in order to maybe get paid and limit the stuff that pays  > > little > > > and this also has value to the bottom line so I would like that > > > intangible added somewhat.  Much of what we do in Alteer is done  > > thru > > > a clearing house.  I would be over half. > > > I am just trying to get a handle on whether it would be cost  > > effective > > > to bring this back home for a two doctor busy practice.  We do  > > not do > > > the low volume.  It is not unusual to have 60 encounters of some  > > type > > > a day for two doctors and 4 nurses. > > > Help? > > > Brent > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Just wanted to say that 2 1/2 yrs in I am now doing all our billing. I didn't have a clue how to do it when we started so we had an outside biller. Switched to a different MI biller after one year. Left that biller last August because they weren't spending any time calling insurance companies re old claims. They were charging 8% of net but they had Alteer so we felt we had to use them. I then hired an outside biller, who worked from her home, for 5% of net. After two months of constantly watching "over her shoulder" I realized she was making a lot of posting mistakes in Alteer (posting a copay to an older claim rather than posting it the date the patient was seen, for example) which while seeming to be minor, cause continual problems with balances and confuse patients when they see statements. I am really glad I've taken it on because a lot of small goofups in accounts are getting straightened out. Our 30-60 claims are way down and I sometimes handwrite notes on certain patient statements to better explain something. Our patients are much happier. They call me when they have a problem and I try to fix it as soon as possible. Overall I am estimating that it takes me, on average, about 8 extra hours per week to file claims, post payments, generate and mail statements, etc.

My experience is that outside billers will spend a tiny portion of their time calling insurance companies trying to figure out why old claims haven't been paid.

If you can find someone who can be in your office and they are willing to spend 8-10 hrs per physician doing billing and you completely trust them to be detail-oriented and courteous, why not pay them a percentage of net rather than a per-hour wage? They will be motivated to be efficient and accurate. Just a thought.

a Mintek, office/business manager

Downtown Allegan Family Practice

Rian Mintek, MD

Allegan, Michigan

Visit your group "" on the web.

[Guest guest]

Just wanted to say that 2 1/2 yrs in I am now doing all our billing. I didn't have a clue how to do it when we started so we had an outside biller. Switched to a different MI biller after one year. Left that biller last August because they weren't spending any time calling insurance companies re old claims. They were charging 8% of net but they had Alteer so we felt we had to use them. I then hired an outside biller, who worked from her home, for 5% of net. After two months of constantly watching "over her shoulder" I realized she was making a lot of posting mistakes in Alteer (posting a copay to an older claim rather than posting it the date the patient was seen, for example) which while seeming to be minor, cause continual problems with balances and confuse patients when they see statements. I am really glad I've taken it on because a lot of small goofups in accounts are getting straightened out. Our 30-60 claims are way down and I sometimes handwrite notes on certain patient statements to better explain something. Our patients are much happier. They call me when they have a problem and I try to fix it as soon as possible. Overall I am estimating that it takes me, on average, about 8 extra hours per week to file claims, post payments, generate and mail statements, etc.

My experience is that outside billers will spend a tiny portion of their time calling insurance companies trying to figure out why old claims haven't been paid.

If you can find someone who can be in your office and they are willing to spend 8-10 hrs per physician doing billing and you completely trust them to be detail-oriented and courteous, why not pay them a percentage of net rather than a per-hour wage? They will be motivated to be efficient and accurate. Just a thought.

a Mintek, office/business manager

Downtown Allegan Family Practice

Rian Mintek, MD

Allegan, Michigan

Visit your group "" on the web.

[Guest guest]

I've often wondered the same thing, if you're too busy to do it yourself, and you have an employee who's competent, maybe the best arrangement is your employee doing it for, say, a 2 or 3% of net bonus on top of their hourly wage.Mintek wrote: Just wanted to say that 2 1/2 yrs in I am now doing all our billing. I didn't have a clue how to do it when we started so we had an outside biller. Switched to a different MI biller after one year. Left that biller last August because they weren't spending any time calling insurance companies re old claims. They were charging 8% of net but they had Alteer so we felt we had to use them. I then hired an outside biller, who worked from her home, for 5% of net. After two months of

constantly watching "over her shoulder" I realized she was making a lot of posting mistakes in Alteer (posting a copay to an older claim rather than posting it the date the patient was seen, for example) which while seeming to be minor, cause continual problems with balances and confuse patients when they see statements. I am really glad I've taken it on because a lot of small goofups in accounts are getting straightened out. Our 30-60 claims are way down and I sometimes handwrite notes on certain patient statements to better explain something. Our patients are much happier. They call me when they have a problem and I try to fix it as soon as possible. Overall I am estimating that it takes me, on average, about 8 extra hours per week to file claims, post payments, generate and mail statements, etc. My experience is that outside billers will spend a tiny portion of their time calling

insurance companies trying to figure out why old claims haven't been paid. If you can find someone who can be in your office and they are willing to spend 8-10 hrs per physician doing billing and you completely trust them to be detail-oriented and courteous, why not pay them a percentage of net rather than a per-hour wage? They will be motivated to be efficient and accurate. Just a thought. a Mintek, office/business manager Downtown Allegan Family Practice Rian Mintek, MD Allegan, Michigan Visit your group "" on the web.

[Guest guest]

I've often wondered the same thing, if you're too busy to do it yourself, and you have an employee who's competent, maybe the best arrangement is your employee doing it for, say, a 2 or 3% of net bonus on top of their hourly wage.Mintek wrote: Just wanted to say that 2 1/2 yrs in I am now doing all our billing. I didn't have a clue how to do it when we started so we had an outside biller. Switched to a different MI biller after one year. Left that biller last August because they weren't spending any time calling insurance companies re old claims. They were charging 8% of net but they had Alteer so we felt we had to use them. I then hired an outside biller, who worked from her home, for 5% of net. After two months of

constantly watching "over her shoulder" I realized she was making a lot of posting mistakes in Alteer (posting a copay to an older claim rather than posting it the date the patient was seen, for example) which while seeming to be minor, cause continual problems with balances and confuse patients when they see statements. I am really glad I've taken it on because a lot of small goofups in accounts are getting straightened out. Our 30-60 claims are way down and I sometimes handwrite notes on certain patient statements to better explain something. Our patients are much happier. They call me when they have a problem and I try to fix it as soon as possible. Overall I am estimating that it takes me, on average, about 8 extra hours per week to file claims, post payments, generate and mail statements, etc. My experience is that outside billers will spend a tiny portion of their time calling

insurance companies trying to figure out why old claims haven't been paid. If you can find someone who can be in your office and they are willing to spend 8-10 hrs per physician doing billing and you completely trust them to be detail-oriented and courteous, why not pay them a percentage of net rather than a per-hour wage? They will be motivated to be efficient and accurate. Just a thought. a Mintek, office/business manager Downtown Allegan Family Practice Rian Mintek, MD Allegan, Michigan Visit your group "" on the web.