Wiki Billing set up

[debi7478]

I have been asked by a friend what they would charge for billing? flat fee per month based on average payments? a % over that agreed amount? WHAT IS THE GOING % RATE TO CHARGE FOR BILLING?

Anyone out there with expertise in this endeavor please let me know asap

Thanks

 

[thomas7331]

There isn't a quick answer for this - how much a biller charges will depend on what exactly the biller is required to do and this can vary a lot. Some things to consider in setting a charge are:

• What is the average claim amount and claim volume? A high volume of low-dollar claims (e.g. lab, radiology, family practice) will be a lot more work than a billing for a practice with a small volume of high-dollar claims (e.g. surgeons), but at the same time, more complex claims can be sometimes involve more work on the back end in appeals and authorization issues, so the rate would need to take these factors into account.
• What is this scope of the work - is it just insurance billing, or does it require billing and collecting from patients too?
• Will the biller be responsible for the existing accounts receivable, and if so, what is the aging of those accounts? It is much easier to collect accounts that are current than it is to recover aged AR.
• What else is the biller responsible for - just sending bills, or will the biller be taking inbound calls from patients and insurance companies, responding to medical record requests and audits, writing appeals, doing any coding corrections, creating financial reports for the providers or other consulting/educational services, etc.?
• Will the biller be using their own software or billing from the provider's system? If the biller must purchase and maintain their own computer systems, buy claim forms, postage and other supplies, those are additional costs that have to be considered in the rate that is charged.

In short, how much to charge is a business decision that can be rather complex, so it's important to take time to evaluate all of the factors and look at the contract and come up with an appropriate rate. The handful of billing services I've had contact with generally charge a percentage of the amounts collected and I've seen rates in the 6-10% range, sometimes more for aged accounts, but I wouldn't recommend settling on a number without having taken a hard look at everything involved first.