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- Dec 16, 2010
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I saw a recent discussion about client billing on the Kevin MD website. This physician claims he uses client billing for his cash pay patients. Boy, it has been the exact opposite for us over the years. The cash payers are the ones that ARENT client billed. We get stuck trying to collect on those, with little to no luck. He admits to a 30 percent markup on lab work and also claims preventing doctors from profiting on the services they order doesnt save money. Yea, right.
Here is comments about client billing for your amusement:
"As for the "client bill" tirade, I use client bill primarily for my cash pay patients, to insulate them from the rapacious laboratory companies and local hospitals. I order a metabolic evaluation for all my patients, including a CMP, CBC with differential and several metabolic markers. This exact panel is billed at $600-$1100 directly to the patients by the various stand-alone laboratory companies and hospitals in town. I buy the labs myself and charge my patients $100.
You are correct in that I could buy the labs and bill the cash pay patients whatever I wanted to. I seriously doubt that I could charge $700 for the labs and keep any patients. As for insurance companies, client billing is not allowed for Medicaid or Medicare in any state.
The insurance companies pay me according to their fee schedule, which is about 30% more than the cost of the labs. Every insurance company that I contract with has a "medically necessary" clause that would make ordering of laboratories for no reason a bad business decision.
Client bill benefits everyone. The insurance company benefits because they have direct economic leverage over the physician responsible for ordering the test. The patient benefits because they can argue the bill with the physician responsible for ordering the test. And the lab benefits because they get paid without annoying the physician for incomplete paperwork, arguing with an insurance company, or dealing with irate patients.
Preventing doctors from profiting on the services that they order does not save money. It never has. Two generations of double digit medical inflation in the midst of ever more intrusive and onerous Stark laws should at least have disabused every doctor of that notion.
What lowers costs is the patient paying for the service."
Here is comments about client billing for your amusement:
"As for the "client bill" tirade, I use client bill primarily for my cash pay patients, to insulate them from the rapacious laboratory companies and local hospitals. I order a metabolic evaluation for all my patients, including a CMP, CBC with differential and several metabolic markers. This exact panel is billed at $600-$1100 directly to the patients by the various stand-alone laboratory companies and hospitals in town. I buy the labs myself and charge my patients $100.
You are correct in that I could buy the labs and bill the cash pay patients whatever I wanted to. I seriously doubt that I could charge $700 for the labs and keep any patients. As for insurance companies, client billing is not allowed for Medicaid or Medicare in any state.
The insurance companies pay me according to their fee schedule, which is about 30% more than the cost of the labs. Every insurance company that I contract with has a "medically necessary" clause that would make ordering of laboratories for no reason a bad business decision.
Client bill benefits everyone. The insurance company benefits because they have direct economic leverage over the physician responsible for ordering the test. The patient benefits because they can argue the bill with the physician responsible for ordering the test. And the lab benefits because they get paid without annoying the physician for incomplete paperwork, arguing with an insurance company, or dealing with irate patients.
Preventing doctors from profiting on the services that they order does not save money. It never has. Two generations of double digit medical inflation in the midst of ever more intrusive and onerous Stark laws should at least have disabused every doctor of that notion.
What lowers costs is the patient paying for the service."
