subject: Medical Billing And Coding - Picking The Most Suitable Pricing Plan [print this page] Medical billing services offer multiple choices for practitioners to pay for their services. Every practice has unique needs and the right alternative for you depends on the volume, type, and value of claims. Following is a list of the billing alternatives available to health care offices, with their minus and plus points.
1. Percentage based fee
This is the most common type of billing option offered by medical billing services. You pay a proportion of the net amount received or of the gross claims submitted to the covering agency. Percentage rates vary from four percent to sixteen percent as they depend on the services included in the contract, claim amount and monthly average count of claims. Percentage based contracts are suitable for most medical practices, especially if you turn over the complete operation to the medical billing service . This method of charging provides motivation to the billing service to submit and follow up claims rigorously - an excellent benefit for the customer. The one downside of percentage based pricing is that the billing service could possibly pay less attention to smaller claims as the small payments do not justify the vigorous follow up necessary to collect. You can get over this problem by paying a somewhat higher percentage for the smaller claims to make them worth the effort.
2. Flat fee per claim
You pay a fixed rate for each submitted claim. The charge could range from $1 to $8 based on the service. This choice is suitable for medical practices that see high value but low count of claims or claims that are tough to collect (as from a particular insurer). The downside of this agreement is that the billing service is not motivated to pursue the claims aggressively. You should accept this alternative only if you stipulate follow up in the contract and release the fees after the claim has been collected.
3. Hybrid Billing
Hybrid billing is a good choice to get the best of both percentage and flat fee service. In a hybrid option, pricing stipulations are specific to the category of claim and the insurance carriers. This form of billing contract is perfect for any hospital that sees varying claim amounts and a moderate to high level of claims. This also allows health care practices comply with the flat fee regulations stipulated for Medicaid and Medicare claims in some states. The percentage-based fee structure is applied for private insurance claims. The major drawback of hybrid billing is that it introduces billing complexity into practices with low volume of claims.
Before selecting the price structure you want with the medical billing service, go over your claims volume, value of claims, and the kind of patients and insurers. Ask the billing service to project results based on your volume, sum of claims and payers so that you have some idea of the amount you would pay under each kind of billing agreement. Think in terms of the future growth of your practice before you choose the best payment agreement. There is a medical billing service out there for each kind of practice; it is just a matter of learning the ropes and making an informed decision in hiring the right service for your practice.
