Bill Sample / December 10, 2018 / Rosalie Cain
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.
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 we used a very simple contract that really didnt cover much at all. When situations arose that were problems our contract was no help. We had to re-write it once we had been in the business for a while and knew what needed to be covered. So where does a new billing service start when they havent been in business long? Its hard to write a contract covering all areas and what to do when you havent experienced it yet. Most new billing services are working on limited capital and dont like to spend money on a lawyer writing a contract for them. Unfortunately many new services cut corners here to save money but thats not a good idea. Your contract should be at least looked over by a lawyer if not written by one. If possible you should try to find a general practice attorney who specializes in contracts.