Home Forums Discussions Problems Changing AC's billing company.

In all seriousness, I think AC's billing company that insists on collecting 5% of all revenue (including copayments, cash services, etc) is, at the very least, offensive. I had intended on going with this service until I read the fine print. I quickly moved to another company.

Interestingly, after looking at numerous billing companies, this practice does NOT seem to be the norm. In fact, I have yet to find another billing company that behaves like this. When I ask other companies if they do this, they always laugh and respond "of course not, that would be ridiculous."

For a software package that prides itself on being so straightforward in terms of costs, why does this practice continue? I know AC get's a percentage of collections as well, which I'm fine with. But if this practice of collecting 5% of all revenue was dropped, I think more of us would be apt to switch to AC's billing service. Wouldn't this be better for AC in the long run?

I agree that MTBC arrangement does not seem to be a good business value for practices using AC.

There are a number of companies that have a similar structure. 5% is a low percentage, and I looked at paying a lower percentage (but more revenue included) and having less hassle factor vs paying a higher percentage of a collected figure with a higher hassle factor.

Personally, I thought they were upfront about their charges, but then again, I always read the fine print. The devil, as they say, is in the details.

Amazingly, the % of Practice revenue thing seems to be an industry standard. And it will continue to be until physicians as a whole cry bloody murder about it. And they should. Yesterday, preferably.

It would seem to me that in this desperate economy, someone (perhaps an entrepreneur on this list) would jump at the chance to do billing for multiple small practices for a montly fee or a reasonable percentage of collections. If my plate were not so full I would consider it. I am sure many of us have PM programs already in place and the additional costs to add other providers would be licensing fees (where applicable) and a charge for setting up the billing info. The transmission of the info would not be difficult nor would the transmission of the reports produced. Perhaps another option would be for a group of users to come together and hire their own biller (location is unimportant), agree on a PM program and develop their own billing company. The biggest expense initially would be the purchasing of the program which could be shared by the group. Each provider would then pay for their own license and the group would then hire a billing specialist to do the rest. Just a thought. After a hard day in the office my mind is still in the "how can I come up with ways to keep my practice afloat" mode.

Leslie

Leslie, you may have hit on something.

Jon will not be working on adding PM to AC until after the CCHIT stuff which he hopes to have out by the summer (lets keep our fingers crossed)

It probably doesn't make sense to hire a programmer if he will be working on it later this year, but perhaps if we find a common program we might go down that road.

Physicians are seen as having a lot of money. We are also often not good at keeping it and are frequently taken advantage of because of the lack of collective bargaining.

Jon has said that he is not completely satisfied with MTBC.

I have been with them for somewhat over six months, they do try, they give feedback and they could be a decent base if some changes were made. Perhaps we could collectively bargain with them. Can I say that legally??? NO NO, I meant perhaps they would be willing to give a different contract to a group of doctors who request it, YEAH, that's the ticket.

I currently use Medisoft - supposedly the software itself can be purchased rather reasonably and you can enter as many different practices as you want - a billing office could purchase it and then use the progam to bill for more than one office.

To do electronic each entity would have to pay for the clearinghouse fee.

The really bad part is that as far as I can tell the companies have got you locked in once you do electronic through them - if you want to change you have to file changes with each insurance company and run the risk of not getting paid for a month, or two or three..... I actually think 5% if that includes mailing bills to pt., collecting data and such is really not too bad.

I learned the hard way that the percentage charged is NOT the most important thing. The important thing is the bottom line, how much money comes in from your billing. I went with a LOUSY company that Amazing Charts worked with called SureData. I spent way too long with them and tolerated too much all just because of the nice export utility.

Now I work with a local billing company which handles about a dozen practices. I pay a whopping 8% but have a miniscule AR over 60 days. The end result is much better. In evaluating a company, ask to contact at least 8 clients and talk to the docs or the office manager.

Collecting a % on the copay seems reasonable, because they have to deal with that data. Never pay a % on cash paying patients, however.

Jay
(solo Immigrant Health Practice, Brewster, NY)

I too replied for more info and went so far as to get a contract. Not only do they want 5% of the copayments you collect in your office, the fine print also includes a clause that locks you in for a full year even if you hate the service AND if they fail to collect something for any reason - including gross negligence - you have no legal remedy.

I decided to stay away and continue to happily do billing myself, with the help of a 3rd party clearinghouse/back-office online organization tool provided by a KY-based company called Zirmed. I have been very happy. www.zirmed.com

And I agree the marriage with this company is a curious and un-amazingchartish association.

How about instead a billing service that DOESN'T charge a percentage, but charges per-claim...as low as $1.85/claim including claim submission and posting payments. Check out our website, www.mbpros.com. The biggest rip-off in the industry are billing services charging a percentage. If a billing service knows what they are doing, follow-up on claims is not as important. The most important thing is that the billing service send claims out accurately and promptly so as to minimize rejections. We do not offer follow-up services as we believe that sending claims out accurately reduces the follow-up rate to approx 5%, while increasing the cash flow to practices. And it's easy providing information to us (securely uploading a PDF file of claims you generate in AC to our secure website). Check out our website and references, www.mbpros.com.

We use Gateway EDI...they charge a flat rate. about $115 per month per provider...for unlimited claims!! They have an excellent web interface that will upload your claim files. Initial setup is $200. For an extra $25 a month I get unlimited online eligibility verification with my payers, including remaining deductibles, copays, etc. The web site shows and archives all rejections and remittances, along with a just about all other claims related info. Check them out.

I've been solo 4 years, and we've always done in-house billing. I like the fact that my biller is right under my roof and I can talk to her anytime I want, face-to-face.

I would caution anyone against using a service that doesn't have followup on claims.

A rejected claim is a rejected claim, and there is money to be gained by reviewing the rejected ones. I am in favor of obtaining every single penny owed to my business, provided it doesn't cost a dollar to collect the penny.

Ditto, Adam. Plus, the biller can be cross-trained to do other office duties and fill in for absent employees. I would never (I think) send my billing out and I have been in practice for 22 years. I need to know where my money is.

Leslie

Hey I'm glad to hear you say that Leslie.
I've been an attending 6 years, and the last 4 solo.
I intuitively have felt that I need to know where my money is, and several people with experience in practice management have advised me the same.

However it's great to see someone a few years my senior recommending to continue doing what I am doing.

My biller helps out front but I rarely allow it. Her job is more important than answering phones. It's getting my money so I can pay everyone. however she helps me pickup the kids and take them to middle of the day doctor appts.....and other misc stuff.

Mine also cooks our lunch a lot of the times!! Plus, she brings her dog, Mabel, to the office and that always gives me a pick-me-up. She sits in the window on the credenza in the billing office and patients wave at her as they get out of their cars. Those who want to can go in and make over her. The majority of them seem to approve.

Leslie

Very cute!

Our dog is named Mabel!

Really I think $1000 is too high for a setup charge. Plus, I checked out MTBC as a billing and EMR company before I stumbled upon AC. The rep actually refused to take me on for billing and thus fork over the free EMR software after I told him how small my practice is; he didn't think it was a "wise business decision."

We have 3 in-house billing staff that work charge entry, insurance claims (follow ups, corrections) and one who does self pay accounts. All 3 also fill is as receptionists and help with the phones. For self pay accounting billing, we've made an agreement with our forms company to provide statement paper, sort, stuff and mail out statements for a fixed fee per statement. Claims we've started using Office Ally which I'm loving! They are free and give back good detailed reports on claims that are scrubbed immediately as well as reports back from the insurance companies when the claims are accepted. We looked at alot of PM programs to jump to when we made the move to AC, but everything is so expensive if you want to outsource it. 5% - 10% of collections was the norm. yikes! I just wish AC would get the PM program out.