What's a good benchmark for net collection rate for pathology?

[stickyshift]

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This is a question for the guys in private practice.
What's a good net collection rate? Something in the high 80s/low 90s? Higher? Lower?

 

[coroner]

High 80s-low 90s?!?! Are you kidding? No one collects even near that unless you're charging a nickel for every biopsy you sign out . Our 12 month average collection rate is 21% with approximately 40% of our payor mix coming from Medicare. I recently asked our billing company rep how other regional practices are doing and she said even top benchmarks for other private groups would be in the mid 20's.

 

[musom]

Wait....really? So you're saying for every 100k that I bill, that an average I should expect to collect 21kish? Based on that....maybe I should remain employeed. I'm shocked.

 

[AZpath]

Wait....really? So you're saying for every 100k that I bill, that an average I should expect to collect 21kish? Based on that....maybe I should remain employeed. I'm shocked.

We did low 30s. We updated the charges which were unchanged since 1970s. We collected more but the % dropped seven or eight percent to the low to mid twenties. So it also depends on your pricing.

If you are going private, it helps to have a consultant with practice estimates and selecting you own biller. Things like Part A contract and do you want to do PC component billing are important.
Btw, often the biggest mistake you can make is letting the hospital do coding and billing. The toughest part is getting a decent insurance contract.

I recommend Vachette Pathology Services. They helped me get my practice started.

 

[schrute]

Yeah if you can collect 80% please sign me up with whatever mobster is collecting for you.
I think we avg 30-40% as well; 36% for January. Depends on the month.

 

[stickyshift]

You guys must all be dividing collections by gross charges--how else could your rates be that low?
I think the net collection rate = collections/(gross charges-contractual adjustments). That's the figure that I'm asking about.

 

[schrute]

You guys must all be dividing collections by gross charges--how else could your rates be that low?
I think the net collection rate = collections/(gross charges-contractual adjustments). That's the figure that I'm asking about.

i guess, yeah...our net receipts/net charges are closer to 70% I think...

 

[Torsed]

I agree with low 20's. How can it be that low a comedian asks? Insurance screws you.

Should have been an attorney.

 

[LADoc00]

If you are raw collecting 80%+, then your sticker charges are wayyyyy too low.

Raw collection percentages are meaningless though because they go up as you lower charges. For me: Gross collections per FTE pathologist is the primary number you want to focus on.

But yeah Net Collection Ratio, that should be 90%+ unless you are in the ghetto or doing something horribly wrong with coding....

 

[stickyshift]

If you are raw collecting 80%+, then your sticker charges are wayyyyy too low.

Raw collection percentages are meaningless though because they go up as you lower charges. For me: Gross collections per FTE pathologist is the primary number you want to focus on.

But yeah Net Collection Ratio, that should be 90%+ unless you are in the ghetto or doing something horribly wrong with coding....

What's a good gross collections/fte? $500k? $1 million?

 

[stickyshift]

If you are raw collecting 80%+, then your sticker charges are wayyyyy too low.

Raw collection percentages are meaningless though because they go up as you lower charges. For me: Gross collections per FTE pathologist is the primary number you want to focus on.

But yeah Net Collection Ratio, that should be 90%+ unless you are in the ghetto or doing something horribly wrong with coding....

Used to hit really close to 90% a couple of years ago, now more like low to mid 80s. Ah, good times, good times.

 

[stickyshift]

What's a good gross collections/fte? $500k? $1 million?

If you are raw collecting 80%+, then your sticker charges are wayyyyy too low.

Raw collection percentages are meaningless though because they go up as you lower charges. For me: Gross collections per FTE pathologist is the primary number you want to focus on.

But yeah Net Collection Ratio, that should be 90%+ unless you are in the ghetto or doing something horribly wrong with coding....

Our collections/fte is probably too low , because we have a lot of hospitals and every one requires an onsite pathologist. When the typical surgical volume is 3000 to 4000, most of us are underworked. It's a structural problem that seems insoluble. We wish we could just funnel all the work to our central lab and crank through the work with a small but productive core of pathologists, but we haven't figured out a way to do this.

 

[schrute]

If you are raw collecting 80%+, then your sticker charges are wayyyyy too low.

Raw collection percentages are meaningless though because they go up as you lower charges. For me: Gross collections per FTE pathologist is the primary number you want to focus on.

But yeah Net Collection Ratio, that should be 90%+ unless you are in the ghetto or doing something horribly wrong with coding....

I guess for 2015 our net charge/collection ratio was 93% looking at insurance reimbursements anyway, so that sounds right.

 

[stickyshift]

I guess for 2015 our net charge/collection ratio was 93% looking at insurance reimbursements anyway, so that sounds right.

Crazy jealous of you!

 

[LADoc00]

$1,000,000/FTE/year+ would be essentially Godmode if you are talking about PC only because your overhead is so low. Would be about median to top 25percentile for TC+PC so it very much depends on your set up.

 

[Torsed]

I like GodMode LADoc00

Sounds like you used to play Doom.

 

[pathstudent]

We collect about 35% of our charges but after adjustments its upper 90s.

 

[stickyshift]

Our collections/fte is probably too low , because we have a lot of hospitals and every one requires an onsite pathologist. When the typical surgical volume is 3000 to 4000, most of us are underworked. It's a structural problem that seems insoluble. We wish we could just funnel all the work to our central lab and crank through the work with a small but productive core of pathologists, but we haven't figured out a way to do this.

Another big problem is that a lot of our pathologists move around a lot to cover for vacations, so our billing company says that it has to match up each pathologist with each case to see where it was signed out. I'm not sure I believe this, but it supposedly increases the amount of time it takes to process our charges. Does it account for a net collection rate in the low to mid 80s? I don't know.

 

[Path or bust]

It depends on location and insurance % in your area. We are like 40% uninsured, 40 medicare/medicaid, 20% insured.

 

[Path2009]

It all depends on your what you set your charges at.