Bill Sample / December 7, 2018 / Mary Anthony
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.
This lag time roughly averages across all payers making DAR an effective comparison metric between payers for individual provider but invalidating it across multiple providers. One obvious advantage of DAR metric is its independence of charges. The averaging feature of this metric eliminates sensitivity to specific day or CPT but also hides the behavior shape of the accounts receivable curve. First-Pass Pay (FPP Rate) and Denial Rate FPP is the percentage of claims paid in full the first time upon submission (subject to federal or state timely payment regulations: 15 days for electronic submission and 30 days - for paper). Denial rate is the complementary metric to FPP rate. It counts the percent of claims that require followup and therefore cost more to process.
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.