Medical Billing Services To Offer Your Clients


Billing medical billing services For PractitionersWhat Medical Billing Services Should I Offer Doctors &
How Much Do I Charge For Them?


That varies from one medical billing business to another depending on how much work you are willing to do for a client.


However to be truly competitive with the other medical billing businesses in your local here is a list of the most asked for medical billing services doctors expect to be offered:


The entry of patient data (also known as patient demographics),


The entry of charges related to the practice, hospital, clinic, etc.,


The submission of medical claims electronically (directly or via a clearinghouse) or by paper to the insurance carriers (also known as Payors),


The posting of payments into their practice management system (also known as medical billing software),


The handling of adjustments, appeals and denials on every claim,


The accounts receivable process to include following up on aged accounts to get them paid,


Take care of the billing of patients,


Generating daily, weekly, monthly or annual reports to give an overview of how the claims process is impacting (negatively or positively) the practice’s financial health.


Business Plans For Home Based medical biilling businessWhy Should I Listen To Your Medical Billing Service Fees Advice?


Great question and I would be shocked if you didn’t want to know!!! Hello, my name is Paul G. Hackett and I thank you for taking the time to visit today!


Listen… I could list all the accomplishments that have made me the billing, coding and transcription business expert I am today however, I created this page specifically for your benefit so I will not do so here!


However, you deserve the opportunity to learn more about me so here is a link that is dedicated to who I am, what I’ve gone through in my own businesses, why I have chosen to mentor others, etc., so please click here. Now let’s continue…



Depending On Your Clients Needs You May Need To Offer Them Additional Medical Billing Services Such As:


Perform insurance verification and authorizations.


Medical coding,


Updating of diagnostic and procedural codes on patient encounter forms,


Auditing the practice, it’s patient’s charts and the claims work flow,


Consult the practice on any compliance, HIPAA and fraud/abuse issues,


Fill out and submit medicare enrollment forms for the doctors of the practice, and lastly


Provide the practice with guidance on medical billing software purchases and provide troubleshooting when things go awry.


3 Medical Billing Services Fees Examples Charged By A Medical Billing Business Owner In New Jersey:


As you can clearly see there are several medical billing services that you could be asked to perform however, these functions can be grouped into 3 distinct service levels:


1) Submission of Claims Only –This is when you input the information from the patient encounter form/superbill into your billing software and submit it (electronically or paper) to either a clearinghouse, the insurance carrier, or print a copy to be mailed to the insurance company.


Anything done beyond this point will be handled by the physician’s office. This is rare but you will bump into a few physicians that will ask you to do it (business wise to a practitioner it doesn’t make sense to pay a full time billing staff and then employ you to perform this singular procedure creating another expense for the practice),


2) Submission of Claims With Follow-Up –This is the same as the submission of claims only with the exception that you will be responsible for the tracking of each claim until your clients are paid for each claim.


Please Note – with the first two options you have the opportunity to charge for additional medical billing services that the physician might need done from time-to-time, and the third is…


3) Full Practice Management –in this package you (the billing service) are in charge of the entire practice from the evaluation of CPT 4/ICD 9 Codes used on the patient encounter forms/superbills, verifying patient eligibility and benefits, making sure applicable managed care authorizations and referrals are on file for the services, gathering and entering of patient demographics into your practice management software, submitting of claims (electronic and paper), follow-up, reports, checking of EOB’s, posting payments, providing secondary and tertiary claim submission when applicable, collections, resubmissions, appeals, patient calls, and mailing of any patient statements and invoices.


Each practice has different needs so you will need to be flexible with the services you offer. From time-to-time I research my competition to see what extra medical billing services they are offering to see if there is something I have neglected to incorporate into my business. You will not be able to (or even want to) do everything another company is doing but make that choice with your client’s future in mind.


To make what I have covered crystal clear here is an example of how a home based medical billing company may configure their pricing schedule with respect to the 3 customary functions (you can add or take away any item you wish and price it accordingly):


Submission of Claims Only

$3.00 per Claim

Reviewing of Claims
Transmission of Claims (Paper and/or Electronic)
Generation of Transmittal/Rejection Reports

***Other Individualized Services Are Listed Below***


Submission Of Claims With Follow-Up

$4.00 per Claim

Reviewing of Claims
Transmission of Claims (Paper and/or Electronic)
Generation of Transmittal/Rejection Reports
Follow-up Each Claim Until Payment is Received

***Other Individualized Services Are Listed Below***


Full Practice Management Service


0-3000 claims: $6.50 Per Claim

0-3000 claims: $5.50 Per Claim

3001-5000 claims: $5.00 Per Claim

***All Overages Are An Additional $0.50 Per Claim***




Of Monthly Collected Revenues

Reviewing of Claims/Entering of Claims
Transmission of Claims (Paper and Electronic)
Generation of Transmittal/Rejection Reports
Checking of E.O.B.’s
Posting of Electronic Remittance Advice
Generation of Accounts Receivable Statements
Weekly and/or Monthly Activity Summaries
Generation of Aging Reports (30-60-90 Days)
Generation of Patient Collection Letters Birthday, Holiday and/or Thank You Cards

***All Appeals and Re-submissions of Claims are Conducted at an Additional Charge***


Other Individualized Services:


All Appeals Conducted on Denied Claims
$3.50 per Appeal

Physician Credentialing and Submission Of Forms
$25 Per Hour

Preparation and Submission Of Medicare Enrollment Forms
$25 Per Hour

Resubmission of Rejected Claims
$2.50 per Resubmission

Aging Reports Generated (30-60-90 Days)
$2.00 per Report

Each Patient Collection Letter
$1.00 per Letter

Each Birthday, Holiday and/or Thank You Card (Includes Postage)
$2.50 per Card


Please understand that the information above is only a brief overview and there are other ways medical billing businesses charge for their services. Online, the different methods of charging clients is an ongoing debate and most of the time the conclusions are very misleading!


To address the issue, my friends (Alice & Michele – successful 16 year mother and daughter home based medical billing business team that have gone from 0 to 60 clients) created a book which I have all my students read. I suggest you do the same instead of listening to people that do not have enough experience in the industry to correctly guide you:


Pricing Your Billing Services


There is another book that goes directly hand-in-hand with this topic and is also written by Alice & Michele. This book is a mandatory read for all my students and I am certain you will want to read it too:


Secrets to Signing Up Your First Doctor


Now you know how to charge for your medical billing services, let’s move on and discuss…


Clearinghouses & Why Medical Billing Businesses Need Them


I really enjoyed sharing with you today and I hope you have a better understanding of medical billing services fees that you will charge your clients.


  Here’s To Your Success!


External Medical Billing Service Fees Resources


Medical Billing As Defined By Wikipedia


Starting Medical Billing Business From Youtube Video


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90-39 179 Pl
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