Billing company is responsible for following up on
unpaid claims ,patient billing , paper and
electronic submission of claims
If you are going to try and create your own medical billing
company, you should have a medical billing contract. You can either have a
basic contract, or have an attorney draft up a contract.
In the contract there are some things to consider
Name of the billing company and the name of client.
Effective date of contract and expiration date if any.
Where will the insurance payments go to? I recommend having
the payments go to the physician's office to avoid any legal matters. There
should be a contract stating the provider will send copies of EOB's of all
payments.
Providing monthly reports or meeting once a month or
quarterly.
How will payments be made? You can either charge by
percentage. Some of the average ranges are 8 to 15% or an average of $4 to $10
per claim. Things to consider are the patient volume, average income and if the
client is established or not.
Who will do the coding? You will want to interview the
company that you will be outsourcing with to make sure they are not doing
anything illegal first. You do not want to do billing for a company that is in
violation.
Once you have interviewed with them, you can either agree to
have coding stay with them or choose to outsource coding as well for an
additional fee.
Things that the client is responsible for:
provide true and accurate data(the client will be
responsible for any submission of false date that can be prosecuted by law)
verify insurance
client will be responsible for his/her own credentialing
client will not offer kickbacks or professional courtesy to
client(this means the client can not wave copay or give free services to
preferred patients, THIS IS AGAINST THE LAW)
Note that claims and patient information belongs to the
property of the client and the billing company is only using it while
contracted with the client.
Billing company is responsible for
following up on unpaid claims
patient billing
paper and electronic submission of claims
You might also like:
Selecting the Right Medical Billing Service - 5 Things to
Consider
Medical Billing as a Home-Based Business
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