Bill Sample / December 8, 2018 / Daphne Pope
You need an understanding with your providers as to when you are going to be paid for your services. Doctors are often not the best businessmen and are sometimes not very good about paying bills on time. Especially when you are first starting your business it is vital that your provider understands when you expect payment and that you have something well written to protect you if you end up with someone interpreting the language of your contract in court. Each year you are in business you find additional things that need to be added to your contract. New situations arise that you realize should be covered in your contract. So how do you cover everything that needs to be covered? You need a list - actually several lists. You need a list of what you feel the providers responsibilities are. You need a list of what you feel your responsibilities are.
All the better if he or she has some experience in the medical billing field. You can save money by preparing carefully before you meet with your lawyer. Start by making a list of things you want to cover in your contract. List all of the services you will be providing and how you charge for them. In addition to how you will charge you will want to list how and when you expect to be paid. Add the providers responsibilities to the list. List how you will receive the patient and claims information and what information you expect from the provider. Other terms you will want to cover are what happens if you dont get paid how either party can terminate the contract and what happens when you do term. There are really a lot of important issues that you need to cover - many potential situations to think about.
Net collection rate is defined as a ratio of Total Collections and Total Charges less Adjustments. Gross collection rate is defined as a ratio of Total Collections to Total Charges only.) According to Medical Group Management Association (MGMA) 1998 Cost Survey adjusted fee-for-service collections (net collections) for family practices in 1997 averaged 98.65 percent. A declining net collection ratio may be symptomatic of increased contractual write-offs or insufficient number of denial appeals. This metric is especially useful in the absence of modern computer technology when comparison of every payment to allowed amount is impossible or when appeal process of denials is too expensive. Otherwise the use of charges in defining gross and net collection metrics precludes them from productive discovery of process improvement opportunities.