Bill Sample / December 10, 2018 / Mabel Cooke.
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.
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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.
It may be expected as when someone retires or it may be unexpected but you need to have a plan in place for when the relationship ends. It will be a much better parting of ways if you have a plan of action for how things will be handled. The whole reason for a good contract is to protect you but your contract can do much more than protect. You can weed out potential problem providers that will drive you crazy. If you are not in agreement with your providers on what each of you will be contributing to the relationship then the likelihood of the account going smoothly is very small. Dont make the mistake of skimping on an important part of your business that may save you from defending yourself in court down the road.
Contracts are kind of like insurance you dont need them until theres a problem. But when there is a problem its a relief to have one. There are really a lot of areas that you need to make sure you are covered in and a contract is really the only way to do that. When starting a medical billing business there are many things to think about and writing a contract is just one of them. There are many expenses in getting started and most of us just starting out dont want to spend our limited investment money on an attorney. So what do many of us do? We "google" sample medical billing contract and use what we think sounds good and make up a contract for our business. That can be a big mistake. Thats what we did sixteen years ago when we started our business except there was no "Google" then.