Billing Alternatives
Per Claim Method: Most electronic claims processors charge between $2-3.50 per claim filed, not including the clearinghouse fee. As a MedOffice™ franchisee, when you add processing and mailing of patient statements, you can bill another $1-2.00 per statement including postage. With this billing method, your income potential is based upon the number of claims you process each month for each doctor.
Percentage Method: This billing method is most appropriate when you are doing "full practice management" services, meaning that you are assisting your clients with many financial aspects of their business including electronic claims billing, patient statements, soft collections, a variety of reports, and posting of receivables. Electronic claims processors usually charge from 6-10% of each doctor's total monthly billings. Charging for your services with the percentage method is generally more lucrative than the per claim method; however, such billing requires a greater level of expertise about health insurance, managed care and medical office operations.
Operating Expenses Defined
Clearinghouse Fees: Clearinghouse services will cost you between 35˘ to 47˘ per claim. Some clearinghouses also charge a minimal annual fee averaging $50 per year, plus initial set-up fees, if any.
Postage: If you decide to provide statement mailing services, you must include your postage costs multiplied by the number of statements that you will mail monthly for each doctor.
Stationery: Consider your expenses for letterhead, envelopes, business cards and other items that you'll need..
Marketing/Advertising/Direct Mail: Your promotional costs will be determined by the amount of advertising and self-promotion that you plan to do. If you live in a small town where people generally know each other, your promotional costs may be nil. If you live in a big city, or if you plan to expand your business to a large number of medical practice clients, you'll probably want to advertise in at least one local medical publication and send several mailings a year.
Telephone: Consult with your phone company about rate options for your home-based business. Since the majority of your medical practice clients may be near you, you'll probably not incur many long distance calls having to do with your MedOffice™ franchise business.
Answering Service/Voice Mail: Whether you choose a "live" phone service or voice mail, it is important that you receive phone messages. Professional services and voice mail help promote your professional image.
Employees: Depending upon the growth of your MedOffice™ franchise start-up, you may need to employ one person to assist you. And/or, you may want to temporarily employ a professional direct salesperson to market you and your services to the medical profession.
Miscellaneous: There may be a few extra expenses such as taking a doctor to lunch, sending flowers to an office manager, etc.
