Billing options for independent contractors

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lejeunesage

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I'm now a couple of years out of training, and I'm now at the point where I'm thinking about practice optimization.
I work as medical director of an inpatient rehab unit.
I have 2 sources of revenue:
1. My medical director stipend.
2. My collections from billing insurance companies.

I have a contract with a billing company that I established a relationship with in my first job. They take a 6% cut of my collections (which is pretty good, from what I've heard), and I've generally been happy with my collections. But as a Millennial in good standing, I have one that bug me: the process is cumbersome a f.
1. In the beginning, I used to write my billing codes on a printed facesheet, then fax it to my billers on the day of discharge.
2. Now, I copy the facesheet into a word document, add billing codes daily, then drop it into a shared folder in the cloud. I still fax the occasional payment denial letter, but my billing process is really annoying and time consuming.

We use Epic at my hospital, and if I were employed, all this would take me 2 clicks. Click on billing. Click on the billing code for the day. Done.
But because I'm not billing through the hospital, I have to jump through all these hoops.
My question is this:
1. What kind of billing models and costs have you all encountered in practice?
2. Is anyone aware of any billing company that integrates with your EMR?

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I'm now a couple of years out of training, and I'm now at the point where I'm thinking about practice optimization.
I work as medical director of an inpatient rehab unit.
I have 2 sources of revenue:
1. My medical director stipend.
2. My collections from billing insurance companies.

I have a contract with a billing company that I established a relationship with in my first job. They take a 6% cut of my collections (which is pretty good, from what I've heard), and I've generally been happy with my collections. But as a Millennial in good standing, I have one that bug me: the process is cumbersome a f.
1. In the beginning, I used to write my billing codes on a printed facesheet, then fax it to my billers on the day of discharge.
2. Now, I copy the facesheet into a word document, add billing codes daily, then drop it into a shared folder in the cloud. I still fax the occasional payment denial letter, but my billing process is really annoying and time consuming.

We use Epic at my hospital, and if I were employed, all this would take me 2 clicks. Click on billing. Click on the billing code for the day. Done.
But because I'm not billing through the hospital, I have to jump through all these hoops.
My question is this:
1. What kind of billing models and costs have you all encountered in practice?
2. Is anyone aware of any billing company that integrates with your EMR?
6% is okay and not great. I would negotiate to go down to 5% or tell them you are taking your business somewhere else. Plenty of other options. If you need help I can send you a few.
I would also ask them to pay for a charge capturing app for you. Options include pMD

We ended up developing our own. Through the app you can input the CPT, ICD-10 and MIPS. Can also 'scan' the facesheets through the app using your phones camera.
the way you are operating is what docs were doing 15-20 years ago.
 
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6% is okay and not great. I would negotiate to go down to 5% or tell them you are taking your business somewhere else. Plenty of other options. If you need help I can send you a few.
I would also ask them to pay for a charge capturing app for you. Options include pMD

We ended up developing our own. Through the app you can input the CPT, ICD-10 and MIPS. Can also 'scan' the facesheets through the app using your phones camera.
the way you are operating is what docs were doing 15-20 years ago.
Thanks! I figured there had to be a better way.
 
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My billers also charge 6%. A few mid-career physiatrists who’d worked in a number of major metro areas said that was the prevailing average/perhaps slightly better. But I sure wouldn’t mind 5% as PMR2008 suggests.

I send my billers an excel sheet with patient names/billing code for each day of the week/ICD10 code. Then they call medical records and request facesheets. I send one spreadsheet for the whole week, though I could send it daily or monthly-it’s up to me.

So it’s more cumbersome than when I was a resident and didn’t have to do anything since the billers just scoured the medical chart and did their own thing, but it’s not a whole lot of work on my end either.
 
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6% is okay and not great. I would negotiate to go down to 5% or tell them you are taking your business somewhere else. Plenty of other options. If you need help I can send you a few.
I would also ask them to pay for a charge capturing app for you. Options include pMD

We ended up developing our own. Through the app you can input the CPT, ICD-10 and MIPS. Can also 'scan' the facesheets through the app using your phones camera.
the way you are operating is what docs were doing 15-20 years ago.

The company I work for as a 1099 uses MDCoder. Works similar to what [mention]PMR2008 [/mention] described above. I think the charge capturing app is very efficient. If I see 35-40 patients per day, it only takes me about 15 minutes that day to input all CPT, ICD-10, MIPS; and scan facesheet through app using phone camera.
 
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The company I work for as a 1099 uses MDCoder. Works similar to what [mention]PMR2008 [/mention] described above. I think the charge capturing app is very efficient. If I see 35-40 patients per day, it only takes me about 15 minutes that day to input all CPT, ICD-10, MIPS; and scan facesheet through app using phone camera.
How does the charge capture process work? I'm completely unfamiliar with it.
Does it sync with your hospital's EMR?
I especially like the idea that it will help with MIPS.

Also, 35-40 patients a day!!! Jesus Christ!
SNF or IPR? And do you have a midlevel working with you?
 
My billers also charge 6%. A few mid-career physiatrists who’d worked in a number of major metro areas said that was the prevailing average/perhaps slightly better. But I sure wouldn’t mind 5% as PMR2008 suggests.

I send my billers an excel sheet with patient names/billing code for each day of the week/ICD10 code. Then they call medical records and request facesheets. I send one spreadsheet for the whole week, though I could send it daily or monthly-it’s up to me.

So it’s more cumbersome than when I was a resident and didn’t have to do anything since the billers just scoured the medical chart and did their own thing, but it’s not a whole lot of work on my end either.
Still sounds a bit cumbersome.
 
How does the charge capture process work? I'm completely unfamiliar with it.
Does it sync with your hospital's EMR?
I especially like the idea that it will help with MIPS.

Also, 35-40 patients a day!!! Jesus Christ!
SNF or IPR? And do you have a midlevel working with you?
Does not sync with the EMR. You basically open up the app, add the patient name, sex and DOB once. Next you put in the CPT code and a few ICD 10/diagnosis codes. The codes are usually listed on the EMR or can be searched on the app. After that you submit the charges. For follow ups you change the CPT level if needed and submit. It takes me 15 minutes a day for 25-30 SNF patients. Will take about the same for 12-15 IRF patients. Completely secure and paperless.
 
Does not sync with the EMR. You basically open up the app, add the patient name, sex and DOB once. Next you put in the CPT code and a few ICD 10/diagnosis codes. The codes are usually listed on the EMR or can be searched on the app. After that you submit the charges. For follow ups you change the CPT level if needed and submit. It takes me 15 minutes a day for 25-30 SNF patients. Will take about the same for 12-15 IRF patients. Completely secure and paperless.
And when you submit the charges, they go to your biller?
 
Still sounds a bit cumbersome.

I find it very simple. It’s about 5 minutes of work to set it up for each week and about one minute to enter the charges each day. So about 10 minutes per week dealing with billing. No hassle with phone apps, which I personally would prefer to avoid (though I can understand the benefits)
 
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I find it very simple. It’s about 5 minutes of work to set it up for each week and about one minute to enter the charges each day. So about 10 minutes per week dealing with billing. No hassle with phone apps, which I personally would prefer to avoid (though I can understand the benefits)
To each their own. I used the excel system years ago and found it cumbersome because I was seeing 22 follow ups and 5 new a day.
 
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