Bill Sample / December 10, 2018 / Dionne Boone
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.
Followup may take the form of a phone call to payer to discover a lost claim or to receive interpretation of denial message correction of earlier submitted data resubmission of the original claim consultation with the provider and medical notes or denial appeal. Both FPP and Denial rates are very important metrics often used for billing process improvement. The upside of FPP/Denial metric is that it is charge-invariant but its downside is that it hides the differences between process imperfections on the claim submission and claim payment sides. To identify patterns of problem CPT codes or payers FPP/Denial metric needs to be computed and compared across all pairs of payer-CPT code which is a standard feature for modern billing technologies.
When we started our Medical Billing Service in 1994 there was very little information available on medical billing services let alone medical billing service contracts. In fact some of the information indicated that you really didnt even need a contract if you didnt want one. That couldnt be further from the truth! Having a contract for your Medical Billing Service is very important to protect both you and the provider. Many new billing services ask us for a sample contract or a copy of our contract. Using a sample contract or somebody elses contract is not a good idea. It would be like taking somebody elses will whiting out their name and writing in yours. The only time it will hurt you is when you die and then your family could be in trouble.