Guest guest Posted October 24, 2007 Report Share Posted October 24, 2007 My opinion is that even if you use an outside biller, you will still have to collect the patient's demographic and insurance info at the front desk, collect the copay, verify their eligibility. If you have an EMR that integrates with the doctor's notes and can integrate with the doctor's decisons on ICD9 and CPT levels (the doctor is really the only one qualified to do this, I think), then you have already done about 85% of the work in billing and coding. So why pay 6-8% of your gross to have somebody else merely prepare and send in the claims? The EMR should do that pretty much automatically if the right insurance and demographic info is entered in the system and the doctor is coding his ICD9 decisions and putting in a CPT code, which is just as easy for the doctor to do from the computer as for him or her to check off a paper superbill and then have somebody else enter that into a computer. I guess the 3rd party biller could track the claims and post the payments for you, but I don't think that is worth 6-8% of your gross. Caldwell Tulare, CA > > I've been asked to set up a practice for four (eventually six) doctors > (FP, peds, internist). This includes billing and coding activity. My > initial thought is outsource, why carry the overhead and the > aggravation of maintenance. Any experience/recommendations pro or con? > Anyone use athena or MDEverywhere or anyone else? > > Thanks > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 24, 2007 Report Share Posted October 24, 2007 Another argument for a billing service might be that they know the nuances and various combinations and permutations of coding sophistication better thn you, and can therefore help you maximize your reimbursement. This has a bit of merit, but still, most of your revenue will be from humm-drumm 99213s. I doubt if they know enough more than you do about coding or that you do enough things requiring complex knowlege of coding trivia to justify paying them 6-8% of you gross receipts. It would be worth the relatively small amount of your time required to learn some of the coding tricks for your specialty, since you only have to learn them once, then it's all repetitive from there. Caldwell Tulare, CA > > > > I've been asked to set up a practice for four (eventually six) > doctors > > (FP, peds, internist). This includes billing and coding activity. My > > initial thought is outsource, why carry the overhead and the > > aggravation of maintenance. Any experience/recommendations pro or > con? > > Anyone use athena or MDEverywhere or anyone else? > > > > Thanks > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 25, 2007 Report Share Posted October 25, 2007 For me, who hates the business issues involved in practice, the 6% I pay to have the biller submit claims, review rejections, write appeals, send out bills, field pt questions about bills, etc is well worth it. My opinion is that even if you use an outside biller, you will still have to collect the patient's demographic and insurance info at the front desk, collect the copay, verify their eligibility. If you have an EMR that integrates with the doctor's notes and can integrate with the doctor's decisons on ICD9 and CPT levels (the doctor is really the only one qualified to do this, I think), then you have already done about 85% of the work in billing and coding. So why pay 6-8% of your gross to have somebody else merely prepare and send in the claims? The EMR should do that pretty much automatically if the right insurance and demographic info is entered in the system and the doctor is coding his ICD9 decisions and putting in a CPT code, which is just as easy for the doctor to do from the computer as for him or her to check off a paper superbill and then have somebody else enter that into a computer. I guess the 3rd party biller could track the claims and post the payments for you, but I don't think that is worth 6-8% of your gross. Caldwell Tulare, CA>> I've been asked to set up a practice for four (eventually six) doctors> (FP, peds, internist). This includes billing and coding activity. My> initial thought is outsource, why carry the overhead and the > aggravation of maintenance. Any experience/recommendations pro or con?> Anyone use athena or MDEverywhere or anyone else?> > Thanks> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 25, 2007 Report Share Posted October 25, 2007 I have in-office billing by employees. I want IMP, but not micropractice. I agree with Dr. that it is reasonable to outsource, or at least have someone else do it. Maybe I do the actual CPT and ICD-9 coding, but I would not know where to start if I had to do the entire billing process. I think Dr. Caldwell downplays how much goes into billing. I don't think it is that easy. Now I do choose to do it in-house as we have the demographics entered etc, but I just think there is a lot of work beyond the demograhics and my coded superbill. So, you IMP graduates, how easy is it really to do your own billing? Jacques L. Guillot, MD ,_._,___ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 25, 2007 Report Share Posted October 25, 2007 Jacques: My wife and I share a practice. I work 3.5 days per week on average less. She works 2.5 on average less. I do all the billing, statements, and collections. Cost of billing services is between 5-8% of net collections for primary care rate tend to be higher the lower volume you have. If I paid a biller, it would equal 13% of what I pay myself just collecting. Most retail business could not stay in business if they paid 13% of profit to collect. My billing program is integrated to my EMR and practice management software. It completes most the work for me. and others use the same software. It is a no brainer for me. I write off less than 3% bad debt which is in line with collections nationally. Even a collection agency would write that much off so that part is a wash if you get good collections from a service or your employees. Billing is that easy. I use 20 to 30 codes over and over. Pick a level of E & M service2-5 these don't change. The software analysis helps spot problems. When you can see 2-4 patients per hour instead of doing your own billing, you can outsource or in-source. I have no employees to keep busy keeping me busy. Re: Re: Billing and Coding I have in-office billing by employees. I want IMP, but not micropractice.I agree with Dr. that it is reasonable to outsource, or at least have someone else do it.Maybe I do the actual CPT and ICD-9 coding, but I would not know where to start if I had to do the entire billing process. I think Dr. Caldwell downplays how much goes into billing. I don't think it is that easy. Now I do choose to do it in-house as we have the demographics entered etc, but I just think there is a lot of work beyond the demograhics and my coded superbill.So, you IMP graduates, how easy is it really to do your own billing?Jacques L. Guillot, MD ,_._,___ __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 25, 2007 Report Share Posted October 25, 2007 agree PLus I get someone to ask questions of they actually know alot I think it is all in how you keep your overhead low your care pateitn centered in general . Some people do not think billing is work .SOme do. That's it. Re: Re: Billing and Coding For me, who hates the business issues involved in practice, the 6% I pay to have the biller submit claims, review rejections, write appeals, send out bills, field pt questions about bills, etc is well worth it. On 10/24/07, Caldwell < alcald2000yahoo (DOT) com> wrote: My opinion is that even if you use an outside biller, you will still have to collect the patient's demographic and insurance info at the front desk, collect the copay, verify their eligibility. If you have an EMR that integrates with the doctor's notes and can integrate with the doctor's decisons on ICD9 and CPT levels (the doctor is really the only one qualified to do this, I think), then you have already done about 85% of the work in billing and coding. So why pay 6-8% of your gross to have somebody else merely prepare and send in the claims? The EMR should do that pretty much automatically if the right insurance and demographic info is entered in the system and the doctor is coding his ICD9 decisions and putting in a CPT code, which is just as easy for the doctor to do from the computer as for him or her to check off a paper superbill and then have somebody else enter that into a computer. I guess the 3rd party biller could track the claims and post the payments for you, but I don't think that is worth 6-8% of your gross. Caldwell Tulare, CA > > I've been asked to set up a practice for four (eventually six) doctors > (FP, peds, internist). This includes billing and coding activity. My > initial thought is outsource, why carry the overhead and the > aggravation of maintenance. Any experience/recommendations pro or con? > Anyone use athena or MDEverywhere or anyone else? > > Thanks > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 25, 2007 Report Share Posted October 25, 2007 I think it's all about how well integrated your EMR system works in terms of integrating the note writing and medical records with the billing process and creating a work flow in your office that allows you to have the right info available in the right place at the right time. If you are doing your note with the computer and you have all the demographic and insurance info already entered correctly, and you have a computerized list of ICD9 and CPT codes from a master list to pick from, or better yet, from a sublist of ICD9 codes that have already been used on that particular patient, and a CPT list narrowed down to the ones you use in your practice, which will likely be repeated over and over again for all their visits, it is very simple to generate an insurance claim with a computer. You can generally have the claims done before the patient leaves the exam room. It does not take long to learn some of the finer points of billing and coding, like the example that you have to select multipliers for actinic keratosis. Admittedly, you will make many mistakes, but the school of hard knocks is a good teacher and you will learn quickly. I'm not saying I know all the fine points of billing, but you can get a cash flow going pretty quickly and then you will have some time to refine your knowlege of coding tricks to improve and maximize your reimbursement as you go along. Caldwell > > > > I've been asked to set up a practice for four (eventually six) > doctors > > (FP, peds, internist). This includes billing and coding activity. My > > initial thought is outsource, why carry the overhead and the > > aggravation of maintenance. Any experience/recommendations pro or > con? > > Anyone use athena or MDEverywhere or anyone else? > > > > Thanks > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 14, 2007 Report Share Posted November 14, 2007 Jacques, What EMR do you use? I will need to purchase one when I open my practice and would like one that makes billing easier. Thanks Egly wrote: Jacques: My wife and I share a practice. I work 3.5 days per week on average less. She works 2.5 on average less. I do all the billing, statements, and collections. Cost of billing services is between 5-8% of net collections for primary care rate tend to be higher the lower volume you have. If I paid a biller, it would equal 13% of what I pay myself just collecting. Most retail business could not stay in business if they paid 13% of profit to collect. My billing program is integrated to my EMR and practice management software. It completes most the work for me. and others use the same software. It is a no brainer for me. I write off less than 3% bad debt which is in line with collections nationally. Even a collection agency would write that much off so that part is a wash if you get good collections from a service or your employees. Billing is that easy. I use 20 to 30 codes over and over. Pick a level of E & M service2-5 these don't change. The software analysis helps spot problems. When you can see 2-4 patients per hour instead of doing your own billing, you can outsource or in-source. I have no employees to keep busy keeping me busy. Re: Re: Billing and Coding I have in-office billing by employees. I want IMP, but not micropractice.I agree with Dr. that it is reasonable to outsource, or at least have someone else do it.Maybe I do the actual CPT and ICD-9 coding, but I would not know where to start if I had to do the entire billing process. I think Dr. Caldwell downplays how much goes into billing. I don't think it is that easy. Now I do choose to do it in-house as we have the demographics entered etc, but I just think there is a lot of work beyond the demograhics and my coded superbill.So, you IMP graduates, how easy is it really to do your own billing?Jacques L. Guillot, MD ,_._,___ __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.