Kareo Billing

[JSizzles]

Anyone using kareo for private practice billing? My group just switched over and Im having difficulty reading the billing summary.

It has 4 headers:
Charges, Payments, Adjustments Balance

For example: Mr. X 99308 encounter in the nursing home:

Charge: 150
Payment 48.78
Adjustment 78.65
balance 12.57

I am supposed to receive 70 percent of collects not sure if adjustment is what we received from insurance? It does not seem like 48.78 would be the collection from insurance seems way to low for a 99308 the 78 is more in line with the reimbursement.

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[trophyhusband]

Anyone using kareo for private practice billing? My group just switched over and Im having difficulty reading the billing summary.

It has 4 headers:
Charges, Payments, Adjustments Balance

For example: Mr. X 99308 encounter in the nursing home:

Charge: 150
Payment 48.78
Adjustment 78.65
balance 12.57

I am supposed to receive 70 percent of collects not sure if adjustment is what we received from insurance? It does not seem like 48.78 would be the collection from insurance seems way to low for a 99308 the 78 is more in line with the reimbursement.

That math doesn't make sense. $150 - 78.65 = $71.35 which should be your reimbursement but the insurance payment of $48.78 + the patient's cost share $12.57 = $61.35 so you're missing $10 in there somewhere. Since the balance is roughly 20% I'm guessing this is a Medicare claim so you can look at the Medicare Physician Fee Schedule Lookup to see what they pay for a 99308 in your area.

 

[JSizzles]

Thanks for the link! It looks like my reimbursement should be in the upper 70s around 78. If 48 is the actual reimbursement it makes this gig a waste of time because I only get a percentage of that 48 and its 1099 so minimum 30 percent tax on that.

 

[trophyhusband]

Thanks for the link! It looks like my reimbursement should be in the upper 70s around 78. If 48 is the actual reimbursement it makes this gig a waste of time because I only get a percentage of that 48 and its 1099 so minimum 30 percent tax on that.

Well it's $48.78 + $12.57 (if you can collect it from the patient). But there's still $10 missing from the equation... maybe that's the company's cut? Can't tell without more info. But it would be strange that the coinsurance of 20% is only applied to your portion.