contractual or adjusted rate

[jsaul]

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for those of you out there who are not independent...

My contractual or adjusted rate recently went to .31. This is the rate of collections based on billing. I do the majority of my procedures in the office. about at 65-45 percentage split.

I was expecting it to be about 39-41 percent.

what about others?

 

[101N]

for those of you out there who are not independent...

My contractual or adjusted rate recently went to .31. This is the rate of collections based on billing. I do the majority of my procedures in the office. about at 65-45 percentage split.

I was expecting it to be about 39-41 percent.

what about others?

I'm in PP with a fixed overhead deal, so we live in different worlds. How long have you been at this position? If you've only been there a year or two this could represent write-off's between billed and collected, and thus just a 'reality check'. But, do you really use a 69% overhead?

 

[jsaul]

I'm in PP with a fixed overhead deal, so we live in different worlds. How long have you been at this position? If you've only been there a year or two this could represent write-off's between billed and collected, and thus just a 'reality check'. But, do you really use a 69% overhead?

thanks for the reply. But this "contractual" or "adjustable" represents the percentage of total billing that they figure will be collected based on the past history of collections. This rate is so that they can pay me for the month... in other words they pay me by multiplying this contractual rate to my total billing for the previous month. Then subtract overhead and expenses and all that --- then i get a monthly check....

the issue I have is that 31 percent seems low. They collect only 31 percent of my billing????? I would expect 39-41 percent. I see patients in the office, do 65 percent of my flouro procedures in the office. the rest outside at surgery centers.

 

[SSdoc33]

thanks for the reply. But this "contractual" or "adjustable" represents the percentage of total billing that they figure will be collected based on the past history of collections. This rate is so that they can pay me for the month... in other words they pay me by multiplying this contractual rate to my total billing for the previous month. Then subtract overhead and expenses and all that --- then i get a monthly check....

the issue I have is that 31 percent seems low. They collect only 31 percent of my billing????? I would expect 39-41 percent. I see patients in the office, do 65 percent of my flouro procedures in the office. the rest outside at surgery centers.

depends how much you bill, no? if you are billing out 5 grand for every epidural, then the % collected will be way low. i can tell you that i collect much less than 31% of what is billed. getting paid on how much is billed can get pretty dicey.

 

[Dr. Ice]

for those of you out there who are not independent...

My contractual or adjusted rate recently went to .31. This is the rate of collections based on billing. I do the majority of my procedures in the office. about at 65-45 percentage split.

I was expecting it to be about 39-41 percent.

what about others?

I get anywhere from 29 - 46% of my billings, and the more I try to get it, the less it makes sense. I work for a very large practice. I assume that some of the difference in collections represent a lag in payment, becuase one month I will bill out much more and collect less and vice versa the following month. On average for the year, I am at 37% which is lower than the 39 - 40% range I have seen the years prior. Perhaps this represents reduced reimbursement?

 

[Jcm800]

depends how much you bill, no? if you are billing out 5 grand for every epidural, then the % collected will be way low. i can tell you that i collect much less than 31% of what is billed. getting paid on how much is billed can get pretty dicey.

totally true. If you bill 5 x medicare, and you have a contracted rates that average out at 100% of medicare (taking into consideration managed care, medicaid) or whatever, just to keep the math simple...

then your collection rate should be TWENTY percent...

so if you bill 3 x medicare and have a ****ty contractual rates/payer mix (as i do) then 31% is good

find out what multiplier you use, and you answer should be there.

 

[101N]

totally true. If you bill 5 x medicare, and you have a contracted rates that average out at 100% of medicare (taking into consideration managed care, medicaid) or whatever, just to keep the math simple...

then your collection rate should be TWENTY percent...

so if you bill 3 x medicare and have a ****ty contractual rates/payer mix (as i do) then 31% is good

find out what multiplier you use, and you answer should be there.

Also depends upon the payor mix. All medicare then 31%.

 

[Dr. Ice]

Arent we all screwed with four more years of Obama anyway? What difference does it make...I cant believe I just said that...they are already winning!

 

[ampaphb]

This seems like a regional or practice by practice issue.

If you have any reason to doubt your accounting office, ask for the actual numbers they are basing 31% on. I suspect you will find out your contractual rates were reduced, or more of the codes you are billing are no longer reimbursable