EMR and Billing

[solopain]

Hey everyone,

I am in the process of starting my own practice. Does anyone have any advice on EMR software and integrating it with billing?
Any advice on coding?
Also, what's a reasoned percentage of collections for billers to charge? I've heard 4-6%..

Thanks for y'all advice

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[painfree23]

Hey everyone,

I am in the process of starting my own practice. Does anyone have any advice on EMR software and integrating it with billing?
Any advice on coding?
Also, what's a reasoned percentage of collections for billers to charge? I've heard 4-6%..

Thanks for y'all advice

Heard 6% is reasonable, epic does a lot of this billing for u ..u have to fill out the diagnosis and codes etc, and makes the coders job easier I think so maybe they take less ?

 

[Cholula]

I've had my own solo practice 3 years and am happy by not having EMR and doing billing in house. I recommend doing your own billing, you will learn more and it will be cheaper in the long run. Costs are fixed and lower than with a billing service. As my revenue grows, my fixed costs decrease as a %. I use practicesuite.com for practice management software and billing, at $200/month. I have my own biller in house I pay part-time at $16/hour (this is average in my area). I fill out my own superbill and she submits the claim through practicesuite. She follows every claim through payment, and posts the payments in the PracticeSuite software where I can see the payments itemized for every CPT code. That is a service you may not get from a billing service provider. Payments come directly to my bank account, not someone else's billing services lockbox. My thought is if you don't start off by doing your own billing, you will never do it. A billing service will be more expensive. Over the life of your practice the cost difference will be significant. PracticeSuite has an EMR too, I'm just not ready for EMR. Other EMR's also have billing services, if that is what you want there are many to choose from. Best of luck.

 

[painfree23]

I've had my own solo practice 3 years and am happy by not having EMR and doing billing in house. I recommend doing your own billing, you will learn more and it will be cheaper in the long run. Costs are fixed and lower than with a billing service. As my revenue grows, my fixed costs decrease as a %. I use practicesuite.com for practice management software and billing, at $200/month. I have my own biller in house I pay part-time at $16/hour (this is average in my area). I fill out my own superbill and she submits the claim through practicesuite. She follows every claim through payment, and posts the payments in the PracticeSuite software where I can see the payments itemized for every CPT code. That is a service you may not get from a billing service provider. Payments come directly to my bank account, not someone else's billing services lockbox. My thought is if you don't start off by doing your own billing, you will never do it. A billing service will be more expensive. Over the life of your practice the cost difference will be significant. PracticeSuite has an EMR too, I'm just not ready for EMR. Other EMR's also have billing services, if that is what you want there are many to choose from. Best of luck.

So you use paper charts? Also, do u feel like you may miss some reimbursements bc ur employee is part time (not really incentivized to follow thru with unpaid stuff, vs someone getting 6% of collections is incentivized) just wonderin

 

[drpainfree]

I agree to do in-house billing is the way to go. More importantly, in-house claims/payment follow-up.

 

[Cholula]

So you use paper charts? Also, do u feel like you may miss some reimbursements bc ur employee is part time (not really incentivized to follow thru with unpaid stuff, vs someone getting 6% of collections is incentivized) just wonderin

I do use paper charts. No, I do not feel like I may miss some reimbursements. My employee is directly accountable to me and she goes after every claim denial. Some denials need 20 minutes on the phone to clear up. If she was incentivized by 6% of the reimbursement, it wouldn't be worth the effort to her to fix the problem with the claim. But as an hourly wage employee, work is work and she gets paid no matter what she is doing. Whereas a billing service may just go after the low hanging fruit because pursuing denials is not efficient use of their time.

 

[SpectrumMD]

We work (and have worked) with several vendors over the years. Would be happy to match you to a very low cost solution for your practice that can fit a single doc to a multi-provider group. In our experience, the right billing solution will more than pay for itself in increased billing and lower staffing costs.

 

[scrawford]

Athena is a good EMR system and integrates well. 6 percent is typically the industry standard for outsourced medical billing. I would second in-house billing but make sure you hire the right people. It makes all the difference! Billing solutions are notorious for not going after denials or following up on insurance requests.

 

[promethius]

I've had my own solo practice 3 years and am happy by not having EMR and doing billing in house. I recommend doing your own billing, you will learn more and it will be cheaper in the long run. Costs are fixed and lower than with a billing service. As my revenue grows, my fixed costs decrease as a %. I use practicesuite.com for practice management software and billing, at $200/month. I have my own biller in house I pay part-time at $16/hour (this is average in my area). I fill out my own superbill and she submits the claim through practicesuite. She follows every claim through payment, and posts the payments in the PracticeSuite software where I can see the payments itemized for every CPT code. That is a service you may not get from a billing service provider. Payments come directly to my bank account, not someone else's billing services lockbox. My thought is if you don't start off by doing your own billing, you will never do it. A billing service will be more expensive. Over the life of your practice the cost difference will be significant. PracticeSuite has an EMR too, I'm just not ready for EMR. Other EMR's also have billing services, if that is what you want there are many to choose from. Best of luck.

So I am deciding between in-house billing versus outsourced billing. Sounds like the general consensus is in-house billing is the way to go if one wants tighter control over the reimbursement claims. What is the difference between the softwares for practice management and billing? Are comprehensive practice management and billing softwares pretty much the same in terms of capabilities? Is $200/month for a comprehensive practice management and billing software reasonable in the open market?

 

[Michael Hatwell]

Athena is a good EMR system and integrates well. 6 percent is typically the industry standard for outsourced medical billing. I would second in-house billing but make sure you hire the right people. It makes all the difference! Billing solutions are notorious for not going after denials or following up on insurance requests.

I have been surfing the Internet on this topic. Athena is good along with Kareo, AdvancedMD, and P3Care for medical billing outsourcing to name a few.

 

[promethius]

I posted these questions in another thread, but did not get any responses. Maybe this thread is a better place to discuss this topic.

What is the policy with Medicare regarding seeing patients once you submit the enrollment application online? I heard you can see Medicare patients the day you submit your Medicare application online, but you cannot bill those patients until your application gets approved, which may take up to 3 months. If that is correct, what do you do with copays and deductibles during the meantime? Are you able to collect those at least at the time of appointment, even if your application is not yet approved? Do you have to keep track of the billing information for all of the Medicare patients you have seen while your application is getting processed, and then submit them all at once when your application is finally approved? I heard you can only do this retroactive billing with Medicare, but not with any other insurances.