Re: Accounts Receivable Question

[Guest guest]

I never understood the true purpose behind prohibiting "fee splitting" or the true distinction (material difference) between "fee splitting" (generally prohibited) and paying a collection agent a percentage fee on all recoveries (presumptively permitted), or the difference between giving a percentage of all recoveries to a collection agency established for that purpose and an individual retained/hired for that purpose, blah, blah, blah. However, I have a hunch the regulatory folks who tend to live in a world that's black and white might think you're fee splitting if "your" billing person takes on the job of collecting accounts receivable for a recently retired doc and is given a "split" of the fees collected, even though the actual services were rendered by another doctor. Is it germane that it's for a retired doctor? In my mind, yes. Is it germane if you purchased the accounts? In my mind, yes. But I'm not the declarer of what constitutes fee splitting and what constitutes simple business common sense. Is your billing person an employee or an independent contractor? Are you paying the billing person or is the retired doc? Who owns the accounts? If it's your employee, probably the safest bet would be to pay them an hourly rate that is at least minimum wage and then perhaps create some performance/incentive bonuses that are structurally unrelated to "fee splitting." This is just one of those areas that almost has a smell test. If they think it smells like "fee splitting" then they might declare it as such. Being accused of "fee splitting" would be my only concern with paying anyone a straight percentage of any amount recovered.

Of course the safest way of conducting business would be to never collect on any of your or anyone else's accounts and just work for the sheer joy of healing people :-)

G.

Gatti, Gatti, Maier, Sayer, Thayer, & Associates

1781 Liberty St. SE

Salem, OR 97302

1-(800) 289-3443

msmith@...

From: [mailto: ] On Behalf Of harringtondoc@...Sent: Saturday, October 08, 2011 3:11 PM Subject: Accounts Receivable Question

Listmates:

My billing person is going to take on the job of collecting the remaining accounts receivables for a doctor who recently retired. Does anyone know if she should ask for a percentage of what she collects or an hourly rate? If a percentage how much of a percentage?

Thanks!

Harrington

17620 Pilkington Road

Lake Oswego, OR 97035

503-636-2265

[Guest guest]

Hey, .. nice answer, and I see your point. Does it make any difference if it is an hourly wage employee whose hourly figure is sliding based on % of collected fees?? Just curious.

Also....why isn't an in-house bonus system where people make a percentage bonus over their hourly based on production considered a fee splitting???

And, as long as you are out there, why in the heck is it legal for windshield replacement people to advertise that they are waiving deductibles as a way to get people in the door. Why do we have the sanction of the No Out of Pocket Expense (N.O.P.E.) plan being a no-no, and their industry advertising it??

Don White, RN, DC

[Guest guest]

Good question, could any answers please be sent to the group?Rod Tilamook Accounts Receivable Question

Group,

After transitioning to a new billing system over the past year, we have discovered a number of patient accounts receivable that are pretty old (6-18 months old). To date, we have not sent a bill to these patients for the balance they owe.

My questions to you: Is there a billing etiquette where it is not acceptable to send a bill to a patient for an old balance? Do you write off the balance owed if it is past a certain point and you have never sent a bill to the patient?

I'd appreciate your input!

Thanks,

Jamey Dyson, DC

Rodney G. , DC

Tillamook Natural Health Center

309 Laurel Ave.

Tillamook, OR 97141

503-842-6532

[Guest guest]

Hi Jamey, You'll need to write off any medicare balances and some insurance contracts preclude you from back billing ..... other than that, don't think there are any regulations about back billing. SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com From: drjdyson1@...Date: Wed, 1 Feb 2012 08:34:52 -0800Subject: Accounts Receivable Question

Group,

After transitioning to a new billing system over the past year, we have discovered a number of patient accounts receivable that are pretty old (6-18 months old). To date, we have not sent a bill to these patients for the balance they owe.

My questions to you: Is there a billing etiquette where it is not acceptable to send a bill to a patient for an old balance? Do you write off the balance owed if it is past a certain point and you have never sent a bill to the patient?

I'd appreciate your input!

Thanks,

Jamey Dyson, DC

[Guest guest]

Ouch! And I only say that because I have been there. A few years back there was an insurance company that will remain nameless sending payments for out or network providers to the patients instead of the chiropractor. It took us a while to figure out what was going on and we ended up with accounts that were months over-due.This takes a lot of hand-holding. I would personally call each of them, or if your billing person is tactful, have them do it. Explain exactly why this has happened and what has been done to correct the error in timely billing. Almost all of the patients will be somewhat suspicious and confused at first. You will be making a "draw" on the good will you have built with the patient. We had a patient who

had received $800.00 in checks from the insurance company, and was just sure WE had done something wrong. Not fun conversations, but fair is fair. Eventually (six months of emails/phone calls), the patient paid, but began seeing another chiropractor. It happens. Most all of the patients were understanding. Hope this helps. Lindekugel, DCConcordia Chiropractic Center5425 NE 33rd Ave.Portland Or. 97211503-789-8923 From: Jamey Dyson <drjdyson1@...>

Oregon DCs < > Sent: Wednesday, February 1, 2012 8:34 AM Subject: Accounts Receivable Question

Group,

After transitioning to a new billing system over the past year, we have discovered a number of patient accounts receivable that are pretty old (6-18 months old). To date, we have not sent a bill to these patients for the balance they owe.

My questions to you: Is there a billing etiquette where it is not acceptable to send a bill to a patient for an old balance? Do you write off the balance owed if it is past a certain point and you have never sent a bill to the patient?

I'd appreciate your input!

Thanks,

Jamey Dyson, DC

[Guest guest]

Hi Jamey,Good question; we've all had to deal with it. It's disappointing to do your best with each patient and not have them do the same with you, but we're all in process so throwing stones doesn't really help. I think a consistent philosophy is helpful. My approach to health care is to bring the patient as close to an understanding that we are each responsible for our own health status, that we're each doing the best the we can at any particular time, as we can. If, for whatever reason, a patient doesn't pay, we send bills for a few months, make phone calls to offer options for paying monthly, and see how they respond. At some point, usually when the billing person thinks it's a lost cause, I send a letter to them. In this letter, after reminding them of the need for the service date (their subjective presenting complaint) and my sincere efforts to help them, I tell them it's their turn to live up to their responsibilities. We won't be sending any more bills to them, but if they refuse to accept responsibility for this obligation, the consequences will fall to them alone. I want them to know that I feel good about what we did together, and hope they can as well; but it's up to them now. We know that good health is a myriad and complex phenomenon, based heavily in personal responsibility. Everything we do that contributes to more personal responsibility well-taken, the healthier we are. This is no less true for a pain in the butt than it is for the pain of paying our bills. I wish them the best of luck, and let it go at that. It's surprising sometimes how people respond to circumstances. It's embarrassing as a human, but by assuming we each are doing our best each moment, the responsibility always returns to the actor him or herself. I say, let our final interactions with such patients be consistent, that we are each responsible for ourselves finally. All the rest, so to say, is commentary. Sears, DC, IAYT1218 NW 21st AvePortland, Oregon 97209v: 503-225-0255f: 503-525-6902www.docbones.comOn Feb 1, 2012, at 8:34 AM, Jamey Dyson wrote: Group, After transitioning to a new billing system over the past year, we have discovered a number of patient accounts receivable that are pretty old (6-18 months old). To date, we have not sent a bill to these patients for the balance they owe. My questions to you: Is there a billing etiquette where it is not acceptable to send a bill to a patient for an old balance? Do you write off the balance owed if it is past a certain point and you have never sent a bill to the patient? I'd appreciate your input! Thanks, Jamey Dyson, DC

[Guest guest]

I ran into something similar when I was injured and wasn't keeping track of things as usual.I didn't go past the 6 month mark. Sent a letter saying that we were in the process of doing an review of all financial billing for the last 6 months and came across a discrepancy in their account, leaving them with $X.xx balance. Then, copping to having made that accounting error, I gave them a substantial discount, saying that I was willing to 'eat' a certain amount, still leaving them with a balance but 'sharing the burden'. It's an individual decision regarding how far back up to a year you are comfortable with, as well as what if any discount you might offer to soften the situation...Just my thoughts on a Wednesday afternoon...Ann DCFrom: " Lindekugel" <pdxchiroguy@...>"Oregon DCs" < >Sent: Wednesday, February 1, 2012 10:19:16 AMSubject: Re: Accounts Receivable Question

Ouch! And I only say that because I have been there. A few years back there was an insurance company that will remain nameless sending payments for out or network providers to the patients instead of the chiropractor. It took us a while to figure out what was going on and we ended up with accounts that were months over-due.This takes a lot of hand-holding. I would personally call each of them, or if your billing person is tactful, have them do it. Explain exactly why this has happened and what has been done to correct the error in timely billing. Almost all of the patients will be somewhat suspicious and confused at first. You will be making a "draw" on the good will you have built with the patient. We had a patient who

had received $800.00 in checks from the insurance company, and was just sure WE had done something wrong. Not fun conversations, but fair is fair. Eventually (six months of emails/phone calls), the patient paid, but began seeing another chiropractor. It happens. Most all of the patients were understanding. Hope this helps. Lindekugel, DCConcordia Chiropractic Center5425 NE 33rd Ave.Portland Or. 97211503-789-8923 From: Jamey Dyson <drjdyson1@...>

Oregon DCs < > Sent: Wednesday, February 1, 2012 8:34 AM Subject: Accounts Receivable Question

Group,

After transitioning to a new billing system over the past year, we have discovered a number of patient accounts receivable that are pretty old (6-18 months old). To date, we have not sent a bill to these patients for the balance they owe.

My questions to you: Is there a billing etiquette where it is not acceptable to send a bill to a patient for an old balance? Do you write off the balance owed if it is past a certain point and you have never sent a bill to the patient?

I'd appreciate your input!

Thanks,

Jamey Dyson, DC

[Guest guest]

If you wait greater than one year to bill a patient, I believe you are not able to collect. It has to do with 'timely billing' laws. So if some of those accounts are greater than one yr old and you hadn't billed the patient, you have to take the loss. If, however, you've been billing and only delayed by 60 days, you can continue billing. Once you stop billing for over a yr for any reason, it loses the perception of timely billing even if you have billed prior. I don' tknow the exact law.

I do know that if you wait a yr past the date of service to 'first time bill' you lose rights to collect.

Minga Guerrero DC

abowoman@...

Accounts Receivable Question

Group,

After transitioning to a new billing system over the past year, we have discovered a number of patient accounts receivable that are pretty old (6-18 months old). To date, we have not sent a bill to these patients for the balance they owe.

My questions to you: Is there a billing etiquette where it is not acceptable to send a bill to a patient for an old balance? Do you write off the balance owed if it is past a certain point and you have never sent a bill to the patient?

I'd appreciate your input!

Thanks,

Jamey Dyson, DC

[Guest guest]

You made and error. But errors happen. But  a person should be billed promptly, if they are going to be billed at all. I would send one billing/mailing accompanied by an apologetic letter with explanation. Letter, signed by you and hand-customized with patient's name if possible. Then, some will pay up and some will not. After 30-60 days write it off.

It was your mistake.john collins-- Note: In future please use this Gmail address instead of: cdc@... and Spbkchiro@.... Thank you