Elementary Questions

No one seems to care more about my money then me, so I’d like to ask are few basic questions to see if it is feasible to do the billing work myself.

 

My husband is a physician in an office of one.  We currently have a billing person (outsourced), but I think our rolling outstanding A/R is too high and I would like to weigh the option of saving paying the collection and billing service fee and try to do it myself. 

 

Would someone be so kind as to answer some budget numbers for me?

 

We use Medisoft for scheduling and billing.  Our billing person provides the network server.  If I was to do the billing, would I have to buy a server or are there companies that I can tap into their server and just bill from home and if so, what is a reasonable number $ for this connection or for a networking server and set up?

 

If I took some Medisoft training classes and a billing class or two, would that be enough to get me going?  Or what would you recommend?

 

Since we are an office of one provider, how many hours a day after I was trained and up and going would it take me to post and make phone calls – ball park number is good.

 

What is the rule of thumb for outstanding A/R?  Is there a “typical” number for amount billed per month or per year? 

 

Thank you for your time!

Hi & welcome.  I'm unsure of the rule of thumb, but our office carries about 100 to 120% of our monthly charges in outstanding A/R.  Could be a little more depending on how much "dead wood" you carry; delinquent patient accounts.  We tend not to send delinquent accounts out to a collection agency, but rather work them ourselves.  A good portion of these pts will call or show up at some point down the line, and most pay-up when they realize they're getting jack squat until they pay-up.

Also, what kind of collect ratio is your billing service collecting?  If you charge $100k per mo. and biller collects $65k that's a 65% collect ratio.  This varies too, but we average mid 60s here (altho its been mid 70s too).

 I used Medisoft for years (up to ver8), it was good straightforward software; fairly simple compared to what we're using now (GE Centricity PM/Millbrook).  We ran it without a support contract.  What Medisoft calls a "server" does not really need to be a hi-powered server running a server OS.  Any Windows computer less than a few yrs old should be fine.  Yes, you should be able to "remote" into it from home fairly easily using either the built-in RDP (RemoteDesktopConnection) or VNC (virtual network connection).  Training is great, but I had none, just jumped in and learned on-the-job.  If you have good attention to detail, you'll do fine.  I dare say, as the Drs spouse you'll be more motivated and more likely do a better job than your billing service.  Keep in mind that insurers adjudicate & pay claims differently - may take you awhile to learn all their separate 'rules.'
 

My husband is also a solo-practice doctor and I took over the billing several years ago for similar reasons.  Our A/R has gone down dramatically since I took the billing over.  Unlike the two previous billing services that we had, I take the time to follow through on unpaid claims and I file appeals when claims are unfairly denied.  Our practice lost a lot of money when we outsourced our billing because the billing companies never filed any appeals or followed through on unpaid claims.  They also made a lot of errors that cost us money.  You will be a lot more motivated than any billing service or employee that you might hire.  

Thank you very much for the responses.  I have more things to think about before i take a big leap, but your comments have helped me a lot!

 

 

I am curious to know what you ended up doing? I will say I used Medisoft over 8 years ago and wasn't in awe with it as other people but some people absolutely love the product. Billing services and small doctor offices are now upgrading to web-based products so they have more "access" to the software and can log in from home anytime to pull charts, patient files, or complete the charge entry.

I have consulted a lot of billing services and sometimes find that those who have never done billing make the best billers. They are willing to listen and learn and they actually try new things to see what happens. I believe that anyone can do medical billing and that it just takes time and someone to bounce questions off of. 

Medisoft is server based which means you can work from home if you VPN (virtual private network) or purchase a online service that gives you access to the servers or link your computer to the main server. You can also look at web-based (ASP) products that allow you instant access to any changes made to the software. A good place to start is http://medicalbillingsoftwarepro.com/Medical-Billing-Software-Reviews.html

Once you have your software in place it's entering the charges and submitting the claims, posting the payments, following up with the denials, sending patient statements and working collection accounts.

Billing Services like any other Vendor are good and bad. 

Sometimes bringing the data in house is better and sometimes Outsourcing is better but it is truly a case by case basis. 

I would sincerely not recommend doing billing without any experience,  the financial health of your office can be made worse.

Medical Billing and the techniques outside of schooling,  come from years of dealing with companies.

My recommendation is do not lump all Billing Services as all not being competent.

Norv

 

 

Lynn4:

You will be a lot more motivated than any billing service or employee that you might hire.  

 

 

I respectfully beg to differ with you on this point.

 

Billers are good and bad and in between, and billing services are good and bad and in between.  Since my specialty is a/r cleanup, I can tell you for a fact that the ratio of good to bad is equal on both sides of that fence.

 

I would agree that it really depends upon the speciality your husband is in and the workload.  Medisoft is a third tier program, but might just be suitable for your needs, it would depend on the speciality of the provider.  AR is usually about 100% to 120% of the monthly gross charges, and again it depends on if you are carrying "dead" AR, capitated charges, inclusive charges, contractual adjustments, etc.  A lot of billing companies have left a sour taste in people's mouths.  But some are actually decent.  It would not make much sense for you to take on this burden.  Try looking for a comprehensive solution, some tips

look for a company that gets paid based on what they collect - that is their incentive.  They will be more inclined to collect than someone getting paid whether they collect or not

see if the company will provide software, not their own home grown but a good reputable one - Intergy, Next Gen, etc. and the most important thing is that you should have access to the software, nothing should be hidden from you

All IT solutions should be handled by the company

The rate shouldn't be ridiculous it should be at the highest 7%

Check out this company www.dsouzainc.com