Bill Sample / December 8, 2018 / Daphne Pope
The same can be said of a sample contract. If nothing bad ever happens the sample contract is fine. But if a problem occurs it may not work out so well. When starting your new business no one wants to think about things going wrong but unfortunately in this business things do go wrong and we all need to be covered by a comprehensive contract when this happens. It may not be anything you did wrong and it may not even be anything the provider did wrong but sometimes things happen that are beyond our control. If you do use a sample contract and then two years later find yourself in court with a former client you are going to wish you had looked into writing the contract a little more. Just having a contract doesnt cover it. You need to make sure the contract is very specific to your company.
You want to imagine a symbiotic relationship with your providers and then list the reasons this relationship works and put those actions in your contract as responsibilities of yourself or the provider. You need a list of everything that you have ever heard of going wrong in a medical billing business between the provider and the biller. You need to decide how you would avoid those situations if possible and cover how it would best be handled in your contract if unavoidable. What you are charging your provider and how you will get paid is a fairly important part of your contract. Are you charging a percentage a flat rate or a per claim fee? Is it clearly defined how you are charging? Is the percentage on what is billed out or what is received? Are patient payments included? If charging per claim what constitutes a claim? Is it a line on a claim form or is it per page? You also need to take into account what will happen when the relationship ends.
Useful metrics must be comprehensive and simple. They must combine both complete end-to-end processes and their individual components. Metrics must be used consistently over time and compared to standards. Obviously different standards apply to different medical specialties patient demographics payers and samples of CPT codes. Medical billing metrics typically include compliance cash balances charges accounts receivable and collection ratios to help monitor cash flow. This article focuses on performance metrics. For discussion of compliance program see companion article on Medical Billing Compliance. Collection Ratios Traditional metrics include gross and net collection ratios. Both metrics are subjective to individual practice because they compare (often arbitrary) charges to (allowed) payments.