Bill Sample / December 9, 2018 / Heather Patrick
But we basically searched until we found a sample very simple contract and modified it for our use. For several years we told ourselves that it was fine and if it wasnt working out for the provider then it wasnt working for us either and we should move on and find new clients. It took us a long time to realize that in several situations our simple contract was actually the reason things were not working out. When you first start your medical billing business you have no idea of the things that can go wrong in a relationship with your clients so you do not know what needs to be included in a contract. Our first contract did not even specify the responsibilities of either the provider or ourselves. It is amazing we were able to find providers willing to sign our contract.
When the doctor has signed a contract that says that he will designate a person responsible for that purpose you can nicely inform the person responsible for getting you the eobs that this is such an important issue to you that it is written into the contract that the doctor signed that you are to be provided with the eobs. You can also include a provision in the contract to specify what you can do if the provider is not providing you with the eobs. Another important example is an issue you will undoubtedly run into - your payment. Many people who start this business are used to receiving a regular paycheck. When you make the move to being an entrepreneur and owning your own business you can only write yourself a paycheck if your providers pay you.
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.