Home Forums Discussions General Discussion Billing Question. All replies appreciated.

Hello all,
I recently signed up for AC and so far I'm quite satisfied. As a solo guy, I am trying to figure out the best way to "do" my billing. Since AC generates a superbill after every encounter, do I really need a independent biller to do this for me? The only reason I would hire her is because she specifically does urology billing and she is local, which is helpful, the former more so than the latter. I also recently discovered OfficeAlly which is a free clearinghouse. I went to their website and rad what they offer and it sounds too good to be true? Anyone here with any experience with them? good or bad? Your experience would be very helpful. So my final question I guess is, do I need to apy someone 4% to do this when the work seems so minimal? Everything is electronic so I can't imagine this too difficult or time consuming for her. Also, since she is not in-office, do any of your guys use something like gotomypc.com or office remote access software and allow your biller access this way? Any thoughts about that?

Thanks all for you help....

Here's one doctor's experience:

http://www.aafp.org/fpm/20070900/27seve.html

I was reading this and thought of your question. The author is an Amazing Charts user, and delegates billing. Not sure if she's posting here these days!

I am FP, and because of my broad range of practice (which includes obstetrics and procedures such as endoscopy), I personally would not feel comfortable doing my own billing. A colleague of mine with similar scope of practice got into big trouble trying to do it himself.

Your situation might be different in specialty practice.

Anyway, enjoy the article!

After having another physician's office manager provide billing services (only to have her bill for my services under another physician's name and try to run off with the money), I am a firm believer in understanding the nuts and bolts of billing (all of it!).

I would try to initially perform all billing functions yourself and use this billing resource as a consultant. Pay her for her knowledge but don't give away control of the practice. Knowledge is power. There's no point in owning your practice if you allow someone else to control your finances.

I am now too busy to perform all billing functions (posting and billing) myself. My wife does the billing and occasionally we hire someone to assist. We find errors frequently...errors we would not picked up if I didn't do it all myself.

Office Ally sounds too good to be true.... BUT IT IS TRUE! I have used them for over three years and have only had to fork over a few quarters a month (for the stray payers that doesn't participate electronically). Support is Amazingly good. I'm trying to convince my wife to using Practice Mate, however, she is sticking with Medisoft to generate the textfile to send to Office Ally.

Anyways, this is one user's opinion.

Thanks for your replies
Roy, I am excited about discovering Officeally. I would not have known about it if I had not started reading the boards. What a great resource.
Roy, question....
why do you need medisoft or practice mate? is it to generate the superbill files? can you not do everything you need to for billing with amazing charts? and then send off the bill electronically to OA?
PLease explain. thanks again

Thank you for that article. It was definately helpful. I agree with you about delegating the billing. Can I ask you how much you are charges by the biller?
I am quoted 4% by mine.

thanks!

Amazingcharts is not a practice management software. Although technically, it may be possible to generate an imagefile from Amazingcharts, you will need to keep tabulations of what you charged, what you got paid, adjustment to charges, secondary billing, etc. Although Amazingcharts has tried to have these features available, it is not functional. Therefore, at the expense of double entry of information, it would be necessary to keep track of your patient's account through use of a practice management software such as PracticeMate. PracticeMate is free and the database is downloadable, so if I was starting a practice, I would use them. My experience with Medisoft has been poor (there's much about Medisoft posted on previous posts). There's quite a lot posted about problems with tracking patient accounts with AC on previous posts, too. Hope that is helpful.

Four percent is a very good rate, in my experience. If you are not comfortable with billing, and this biller has good references, I would grab on to her.

However, let me say that while I personally delegate the task of billing, I actually agree in theory with everything Roy says.

When I started solo practice, I was really not prepared for the business side of it, and hired an office manager/biller who ended up steering my practice into a ditch. I found the billing service I use now and they bailed me out of a jam.

My present service is very reliable, but as I have grown to understand billing better, I have considered moving my billing in-house. Right now, I just don't need the stutter in my income stream that (I fear) making that change would produce.

I've been using OfficeAlly for almost a year. I started using them, at the billing company I was using, was not doing the billing. I have never billed before, and had to figured out very quickly, as there was no cash flow. I found OfficeAlley to be amazingly easy.

As soon as Practice Mate came out, I started using them as well. We've not used EZclaims or medi-soft.

Yes, it's free. The only time I had to pay OA was when I submitted 3 months of Medicare bills at one time (that was part of getting caught up). The do charge $20.00/mo if your Medi/Medi claims are greater than 50% of your total claims.

I have to say, Roy is right on the money. Learning about your billing, doing it yourself, it really brings home the points about what you're doing in your practice that gets paid and doesn't get paid. Learning to bill, wasn't nearly as painful as I had imagined.

Our receptionist has a background in billing and coding, so we work together in order to get it done. Actually, she does the majority of it now.

If I were to start over again, I would start it from the beginning doing my own billing. As so many people have quoted before, nobody cares about your money like you do.

I finally read that article today. It is very good, and pretty much mirrors what I tell my sister (Dr. C) and clients.

When Vicky asked me to help her practice, I was totally new to this industry. But within a week I knew what she needed to do to get the ball rolling on a conventional practice (well, I have a consulting background so I jump between industries pretty easily).

1) Get on the insurance plans.
2) Continue to outsource billing---you really don't want to try to do the massive follow-up.
3) Watch your biller closely. Ours is good, but not perfect. I am working with her to improve her offerings. She is very open to my suggestions.
4)Get an EMR. I researched them and selected AC.
5)Keep your cost down. This also becomes part of the EMR & PM system selection.
6) If you hire an MA, they really need to be good.
7) Automatate ANYTHING you possibly can.
8) Oh, you do need an accounting system.

There are a few other things (marketing, website, etc.) but following these basic principles get a small practice up profitable in about a year in NYC.

Wayne

Hi Rainy
I used to work in Seattle. Great city, I loved the Northwest. I miss it alot. Are you in a solo practice?
Question about OA, can you tell me exactly how you use OA?
after you generate a bill from AC, do you then go to practice mate and eneter more data? or is that pretty easy to do with minimal time investment? also what do you do after that? does practice mate "sync" with OA? I've also read on previous posts that some users with AC were having problems with OA. The problems they sited had to do with some ID, or something maybe UPIN, NPI, group numbers? Have you had any problems with that and if so, can you tell me how you figured it out.
I appreciate you time.

Thanks for you reply.

What type of accounting system do you recommend? which do you use? I recently became s incorporated and it would be great if I can buy a software that can do that for me instead of paying a CPA who charges an enormous amount of money. Any suggestions?
thanks again

You may still need your accountant to help you set things up. But then you can maintain it. Quickbooks is an excellent program for small businesses.

Seattle is great...if it wasn't for the traffic! I think that's one of the biggest reasons I'm no longer there.

I am in solo practice, though I do have an Acupuncturist in the office who sees people a few days a week.

This is how we use OA/Practice Mate.

1. Patient arrives and is registered. In addition to our receptionist inputting the patient into AC, she also adds them and their data to Practice Mate.
2. When I have completed my documentation, she takes the superbills and goes into Practice Mate to bill.
3. I use to do this myself on the weekends. Once the patients are already in your data base, it goes quickly. I have a "superbill" set up in PM, so we just had to point and click. Sometimes, I had to add a charge manually, but still...it's quick.
4. The biggest thing to remember is you need to get your DOS correct in PM...it always defaults to the current date. I've messed up in that area more than once.
5. I don't try to "upload" to OA/PM. I don't know if those issues with the numbers have been corrected.

It's been working well as far as the billing end of it goes. We are now playing catch up to use their system to actually track payments and the like, so I cannot report on that part of it yet.

I average 15-17 pts per day. I think if I was seeing 30 (like some of your are), doing this by hand might become a bit too time consuming. As it is, I'm still not as quick with AC as I was with dictation and always have charts left over at the end of the day. Anyway, while not perfectly automated, this is working for us.

Hope this helps.