Billing and Collections

[painisfear]

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Hi,

I am looking into PP models.

I am wondering:

1. What percentage of collections the folks in PP are paying to the billing company. 3% 5% 7% etc.

2. What is the average rate of collection? I hear 80 something percent is kind of the norm. Is the accurate?

3. What do you think the primary reason is that the rate of collection is not higher? Is it that the payment is denied, lost in shuffle, or delayed or something else?

4. Any strong recommendations for a billing company

Thank you in advance.

 

[gdub25]

Billing rates vary but 5% is a good ballpark. Rates will typically go down as the collection numbers go higher. For example, a practice generating 300k of collections per month might only pay 3.5%.

When you say rate of collection, we need to make sure we're talking about the same thing. Amount collected of the billed charge or amount collected of the allowable. Collections of billed charges is a useless metric because we all bill different amounts so one guy saying they collect 80% of billed charges vs another collecting 30% of billed charges doesn't tell you anything. Collections of allowable is what we want to know, meaning, how much of the money you're contractually able to collect are you capturing. This number should be way higher than 80%. Our standard is that it should be 98% or better.

In our practice the number reason we don't collect is because the patient can't afford it. Any other reason to not get paid is avoidable and should not happen. Denials, no authorization, or any other issue should not happen.

 

[Dr. Ice]

Athena captures low hanging fruit only. Also depends on the EMR

 

[painisfear]

Thank you both this is helpful.