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Paying An Annual Fee to Keep Your Doctor
January 6, 2010 by Fran Glucroft
Filed under Opinion
I recently was informed by one of my clients that he is being “courted” by a company that helps doctors trim their practices to 400-600 patients. These patients will be invited to stay with the practice by paying an annual fee to have better and more access to their doctor by having less wait time for an appointment, longer appointments, and the doctor’s cell phone number or other personal information to use for communication.
I am not sure how I feel about this new niche being carved out on the business side medicine. I am told that it is not the same as a doctor creating a boutique practice, one in which insurance is not accepted. The company courting my client is currently reviewing various aspects of the practice not the least of which are the demographic, insurance and age factors. Through use of marketing tools as well as I guess some quantitative and qualitative analysis, the company will decide which patients should be invited to stay with the practice for an annual fee (I have heard these fees to be between $1500 and $2000 payable over four installments).
As a billing service, I will not lose this client because insurance will still be billed. The annual fee is a private contract between doctor and patient. I will make less money probably because my earnings are based on the doctor’s receipts and he will see less patients every week This is NOT why I am unsure how I feel about this relatively new idea.
My concern is for the 1400-1600 patients in his practice who will not be asked to “rejoin” the practice. Where will they go to find another primary care physician who isn’t already overloaded? Where will the patients who have no insurance go (as I don’t think they have an additional $1500 to pay for an annual fee?) Where will patients who have a Medicaid plan go as fewer and fewer doctors are participating in those plans?
So you can see why I am conflicted. For the 400-600 patients who will have more access to the doctor, this could be a way to decrease what sometimes is a stressful experience. And for the doctor who can and will spend more time with each patient there will also be a decrease in stress on all aspects of the practice. But my conflict continues.
Patients Without Healthcare Insurance
January 4, 2010 by Fran Glucroft
Filed under Opinion
As I complete my fifteenth year as a solo medical billing service,I find this year the most difficult one for patients suddenly without insurance. Over the years I have seen cycles where patients are forced onto Medicaid plans for a period of time but then move back to managed care due to re-employment or they become eligible for Medicare. While I always have some balance bills for patients who “refuse” to pay their portion under the terms of their insurance, this year is different.
There are now stacks of balance bills for patients who are unable to pay. Many of these patients have been seeing the same doctor for years (primary care or a specialist for a chronic condition). Some patients doctor hop to spread the debt around.
Some patients come in with expired insurance and if eligibility is not checked, the patient gets a free ride at least for a while. Some patients might give a check that will be returned for insufficient funds while others may think twice about using a credit card should your office accept that form of payment. Some people will simply ignore the bill because they are overwhelmed with all the other bills, so what is one more?
Now is the time to set policies for patients who have no insurance. Certainly checking eligibility makes sense even in better times. A partial payment can be advised while making the appointment and if you take credit cards, ask the patient if you can expect him/her to use it. Set up a payment plan at the end of the visit and keep one employee or your billing service informed of the arrangement. Make notes in the computer as to what was discussed. Consider a courtesy on a case by case basis especially if you can obtain payment in full at the visit. This saves time, creates loyalty, and a good feeling among the staff who collected the money.
You know your patients best and when they hopefully obtain insurance again, do you want them going to another doctor who might have been more flexible during this rough patch? Is a collection agency really the answer that may take a portion that is larger than the courtesy you may give? Most people want to pay their bills; be clear on what you are billing them for and communicate your policy with your patients
Cleaning Up Your Billing Claims For Better Results
June 16, 2009 by Fran Glucroft
Filed under Financial
I read an article in Medical Economics- August 15, 2008 issue-that was written by a practitioner in a large ob/gyn practice in Philadelphia. The practitioner mostly focused on the importance of clean medical claims with good coding techniques.
I felt compelled to respond to the article with the following letter:
“I enjoyed the article by David M, Jaspan, D.O. That I have written over and over in my head as well as lectured to offices for which I consult and bill. As a billing service and managed care consultant, (self-employed) I have often found myself between the insurance company and the doctor. While it is true that some plans are more doctor friendly than others, it is also true that the insurance companies are not always the worst enemy we have. I continuously stress to my clients and their staffs that they are the first ones touching the superbill, charge slip, routing slip, encounter form. The cleaner it is, the more advanced it is in using modifiers and trying some add-on codes that are clearly described in a CPT book/computer program the better the chance to see an improved cash flow. I also try to stress that correct is better than quick, having seen my share of superbills prepared that are sloppy and incomplete in the doctor’s haste to just get them our the door to me to do the billing from my off-site location”
After 14 years in this business on my own where I rely on a salary based on the doctor’s receipts I have no choice but to employ strict policies for myself as well as the offices with whom I have enjoyed long term relationships. And when you call insurance companies as much as I do, it helps to know what I am talking about regarding clean claims.
Fran Glucroft
Medical Office Manager
Fairfield, CT
Why Medicare Is Not The Enemy
June 8, 2009 by Fran Glucroft
Filed under .
As a billing service, I come in contact with many insurance plans on a daily basis. Every year, I have my favorites and the ones that I dread. In all the years I have been in this business, the latter change from year to year (I always have at least one on my hot list that gets my ire up); Medicare comes closer to being one of my favorites and I have had many discussions defending my opinion. Read more
Improving The Management of Your Accounts
April 27, 2009 by Fran Glucroft
Filed under Financial
One of the most frequent requests I get from physicians who are not my current clients is to visit on a quarterly basis to review their accounts receivable. The problem is that they only see what receipts come in. They really don’t know what t the staff is doing on a monthly basis to analyze these numbers. Read more
Paying An Annual Fee to Keep Your Doctor
January 6, 2010 by Fran Glucroft
Filed under Opinion
I recently was informed by one of my clients that he is being “courted” by a company that helps doctors trim their practices to 400-600 patients. These patients will be invited to stay with the practice by paying an annual fee to have better and more access to their doctor by having less wait time for an appointment, longer appointments, and the doctor’s cell phone number or other personal information to use for communication.
I am not sure how I feel about this new niche being carved out on the business side medicine. I am told that it is not the same as a doctor creating a boutique practice, one in which insurance is not accepted. The company courting my client is currently reviewing various aspects of the practice not the least of which are the demographic, insurance and age factors. Through use of marketing tools as well as I guess some quantitative and qualitative analysis, the company will decide which patients should be invited to stay with the practice for an annual fee (I have heard these fees to be between $1500 and $2000 payable over four installments).
As a billing service, I will not lose this client because insurance will still be billed. The annual fee is a private contract between doctor and patient. I will make less money probably because my earnings are based on the doctor’s receipts and he will see less patients every week This is NOT why I am unsure how I feel about this relatively new idea.
My concern is for the 1400-1600 patients in his practice who will not be asked to “rejoin” the practice. Where will they go to find another primary care physician who isn’t already overloaded? Where will the patients who have no insurance go (as I don’t think they have an additional $1500 to pay for an annual fee?) Where will patients who have a Medicaid plan go as fewer and fewer doctors are participating in those plans?
So you can see why I am conflicted. For the 400-600 patients who will have more access to the doctor, this could be a way to decrease what sometimes is a stressful experience. And for the doctor who can and will spend more time with each patient there will also be a decrease in stress on all aspects of the practice. But my conflict continues.
Patients Without Healthcare Insurance
January 4, 2010 by Fran Glucroft
Filed under Opinion
As I complete my fifteenth year as a solo medical billing service,I find this year the most difficult one for patients suddenly without insurance. Over the years I have seen cycles where patients are forced onto Medicaid plans for a period of time but then move back to managed care due to re-employment or they become eligible for Medicare. While I always have some balance bills for patients who “refuse” to pay their portion under the terms of their insurance, this year is different.
There are now stacks of balance bills for patients who are unable to pay. Many of these patients have been seeing the same doctor for years (primary care or a specialist for a chronic condition). Some patients doctor hop to spread the debt around.
Some patients come in with expired insurance and if eligibility is not checked, the patient gets a free ride at least for a while. Some patients might give a check that will be returned for insufficient funds while others may think twice about using a credit card should your office accept that form of payment. Some people will simply ignore the bill because they are overwhelmed with all the other bills, so what is one more?
Now is the time to set policies for patients who have no insurance. Certainly checking eligibility makes sense even in better times. A partial payment can be advised while making the appointment and if you take credit cards, ask the patient if you can expect him/her to use it. Set up a payment plan at the end of the visit and keep one employee or your billing service informed of the arrangement. Make notes in the computer as to what was discussed. Consider a courtesy on a case by case basis especially if you can obtain payment in full at the visit. This saves time, creates loyalty, and a good feeling among the staff who collected the money.
You know your patients best and when they hopefully obtain insurance again, do you want them going to another doctor who might have been more flexible during this rough patch? Is a collection agency really the answer that may take a portion that is larger than the courtesy you may give? Most people want to pay their bills; be clear on what you are billing them for and communicate your policy with your patients
Cleaning Up Your Billing Claims For Better Results
June 16, 2009 by Fran Glucroft
Filed under Financial
I read an article in Medical Economics- August 15, 2008 issue-that was written by a practitioner in a large ob/gyn practice in Philadelphia. The practitioner mostly focused on the importance of clean medical claims with good coding techniques.
I felt compelled to respond to the article with the following letter:
“I enjoyed the article by David M, Jaspan, D.O. That I have written over and over in my head as well as lectured to offices for which I consult and bill. As a billing service and managed care consultant, (self-employed) I have often found myself between the insurance company and the doctor. While it is true that some plans are more doctor friendly than others, it is also true that the insurance companies are not always the worst enemy we have. I continuously stress to my clients and their staffs that they are the first ones touching the superbill, charge slip, routing slip, encounter form. The cleaner it is, the more advanced it is in using modifiers and trying some add-on codes that are clearly described in a CPT book/computer program the better the chance to see an improved cash flow. I also try to stress that correct is better than quick, having seen my share of superbills prepared that are sloppy and incomplete in the doctor’s haste to just get them our the door to me to do the billing from my off-site location”
After 14 years in this business on my own where I rely on a salary based on the doctor’s receipts I have no choice but to employ strict policies for myself as well as the offices with whom I have enjoyed long term relationships. And when you call insurance companies as much as I do, it helps to know what I am talking about regarding clean claims.
Fran Glucroft
Medical Office Manager
Fairfield, CT
Why Medicare Is Not The Enemy
June 8, 2009 by Fran Glucroft
Filed under .
As a billing service, I come in contact with many insurance plans on a daily basis. Every year, I have my favorites and the ones that I dread. In all the years I have been in this business, the latter change from year to year (I always have at least one on my hot list that gets my ire up); Medicare comes closer to being one of my favorites and I have had many discussions defending my opinion. Read more
Improving The Management of Your Accounts
April 27, 2009 by Fran Glucroft
Filed under Financial
One of the most frequent requests I get from physicians who are not my current clients is to visit on a quarterly basis to review their accounts receivable. The problem is that they only see what receipts come in. They really don’t know what t the staff is doing on a monthly basis to analyze these numbers. Read more
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