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Purchasing established practice
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Purchasing established practice - August 24, 2008 12:43:17 AM
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buckeyechad
Posts: 3
Joined: August 24, 2008
Status: offline
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I am in the process of purchasing an established practice and looking to make some changes to the current processes, one of them being billing. This company currently has 5 clinics and bills out about 2 million a year(minimum). Their current billing procedure (paper billing) employs 3 people to do the work, but is very slow and disorganized. I have thought about outsourcing it, but do not want to walk in and start firing people and making huge changes off the bat.
I would like to know if anyone has any experience with any billing software programs that can be used to aid in electronic billing as well as tracking patient accounts (copays, coinsurance,etc)
Also wondering if anyone is famliar with any electronic health record system...not for daily notes.....but more for electronic storage of d/c'd patients. Looking for software program that would allow someone to scan d/c'd files into and save by patient name. I would then destroy paper file and have this electronic file. Imagine 7 years of d/c'd charts for 5 clinics. It is a huge mess.
I appreciate any feedback and would love to have someone i could bounce ideas off of if anyone is interested in providing me with their email. I have many ideas and know what I want to do.....but would much rather talk to people who have used certain systems, programs, software and such who can provide some constructive feedback/criticism.
Thanks
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RE: Purchasing established practice - August 24, 2008 9:45:34 PM
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goodlooks58
Posts: 425
Joined: October 21, 2002
From: CA
Status: offline
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I have tried using PTOS and now I am using medrium.com ( a web based pay as you use billing software). I have good and bad aspects of both the softwares. I am now talking to billingdynamix company. I want a billing/scheduling/documentation software whereby from the documantation notes the billing software will pick up ICD-9 codes. I want all this on a web based so that I can be anywhere and would be able to access my billing. I have not found one yet, however, if anyone has ideas please chime in. office ally is a good one for sending billing out. Also in-house billing is the best way to go as I tried outsourced billing with very poor results.
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RE: Purchasing established practice - August 25, 2008 2:15:08 AM
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buckeyechad
Posts: 3
Joined: August 24, 2008
Status: offline
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Thanks for the feedback. My only concern with a web-based billing service is the frustration that may come if internet access is down and it cannot be accessed. Granted one would have the same problem if a computer crashes...but having to get onto the web adds another step that could possibly go wrong. My thoughts on the whole in-house vs. outsourcing is this: if i can employ "x" number of employees, cover their salaries, cover their medical, cover dental, cover time off, etc for the same or less than it would to outsource then i would prefer to keep it in-house.
The other factor that i need to consider is the collection rate. If outsourcing can get me a higher collecton rate than employing a billing office....that is a different story. From my experience though, the collection rate is solely dependent on me and my entire staff keeping our ducks in a row and making sure that all the proper processes are followed for each insurance company and that all necessary documentation is filed in their established timeframes.
I would be very interested in knowing what collection rate other private practices are reaching.
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RE: Purchasing established practice - September 7, 2008 11:36:50 AM
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FL_PT
Posts: 28
Joined: February 15, 2003
From: Sarasota, FL
Status: offline
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My wife and I are PT’s and own/operate 5 clinics spread between FL and OH. As we grew we outsourced our clinics until we passed the point in which it cost us more to outsource than bring it in-house. Our primary concern was that we did not know anything about billing. We made the transition over the course of approximately 1 year. We started with software from Compulink. We invested approximately $12K and I would say it was a total waste of money. The software was complicated and difficult to teach. Anytime we wanted to make changes or add electronic payment posting the company would charge us $1K to develop a new module.
Now we use EZ Claim and I think it is the best billing system on the market. I like it so much that I am actually working on developing a continuing education course to teach private practices how to bring billing in-house. I do not have any financial arrangement with EZ Claim, but I think it is the most versatile software, and the least expensive.
We submit all of our claims electronically, we post approximately 50%+ percent of our payments electronically, and have developed systems to maximize efficiency with the current staff. Each of our clinics has one administrative person who handles the front desk, enters patient demographic information and daily charges directly into the software. This person is also responsible for all patient scheduling, insurance verification, etc. Then we have one central person who works approximately 20-hrs a week sending the claims and downloading the payment reports. She also oversees operations to look for possible problems or inaccuracies. When we outsourced our administrative personnel did all the work, then the outsource company had to pay their people to do it again. Now it is done once, checked by one person, and ready to go. We also use Availity, which is a free clearinghouse for all claims we can not submit directly. We submit Medicare and Anthem BCBS directly.
I would say we now have a higher collections rate, decreased time for collections, and significantly lower billing costs. Our outsourced company charged 7% of what was collected, but they didn’t do much to collect any of the “hard to collect” money. By HTC I mean secondary insurance companies, auto and PI claims, etc.
I would be happy to answer any other questions for you. Since we can not increase third party payer reimbursement, I think making our collections more efficient will do a lot to increase our profitability. Good luck.
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RE: Purchasing established practice - September 10, 2008 1:51:28 AM
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buckeyechad
Posts: 3
Joined: August 24, 2008
Status: offline
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thank you for the input. i am heavily weighing towards doing it in house. i just feel that i can have more control over the collection process. i will look into ez claim as well. i will be contacting you via email in the near future if you do not mind. right now my mind is on our new baby (and other 3 kids) and getting new routines down. again i thank you for the input
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RE: Purchasing established practice - September 13, 2008 10:31:29 AM
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Buckeyes93
Posts: 6
Joined: June 10, 2008
Status: offline
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Good, important discussion here. I recommend outsourcing for a couple reasons. First, it's a simple math equation. You can figure that most outsourced billing companies charge 7-8% of what they collect. Compare that amount to the staff that you would need. A reputable service will do a sound job but they definitely don't go the extra mile. Cash flow will be everything to your small company. Most importantly, doing billing in-house will require a significant amount of your time to manage and ensure that processes are in place efficiently and people are working your system. Outsourcing will free up your valuable time to improve your clinic processes and grow your business as well as treat patients.
That being said, if you have a sound system in place with no cash flow problem, you can certainly work on making it most efficient and have one good manager that takes care of the billing. You will always have to have your hands on the collections, AR, etc as an owner however. For us, once clinics 4,5, and six are fully operational we are going to consider bringing our billing in-house as well. The past few years have allowed us to focus on growing our business. Best wishes and I'm interested in looking into EZ Claim as FL_PT has recommended.
_____________________________
Lee Burkam, PT, SCS, ATC
Burkam & Associates, LLC
Orthopedic and Sports Physical Therapy
www.burkamrehab.com
www.basportsmedicine.com
www.adayatthebeachllc.com
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