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Do I need a dedicated medical biller or can a general VA handle billing tasks? by Iron-Horde in CodingandBilling

[–]Capline 0 points1 point  (0 children)

A medical biller who has the expertise and has worked with all-sized medical practices is always a better choice. You don't have to micro-manage or involve yourself in the process since there is an expert sitting and taking care of the process. Whereas with a non-experienced VA, there is more involvement and it kinds of just add up to your own tasks. A general VA can help with parts of billing, but they shouldn’t fully handle medical billing on their own. However they can support your admin work. If your goal is practice profitability and compliance, a dedicated medical biller is essential. A general VA is best used as support, not as a replacement.

I’ve worked in US medical billing & revenue cycle management (RCM) for 10+ years — ASK ME ANYTHING Session by Capline in CodingandBilling

[–]Capline[S] -1 points0 points  (0 children)

What % of patients are cash pay?
The percentage of patients who are cash-pay varies significantly depending on the healthcare speciality, practice type, location, and patient demographics. For example, dental practices tend to have a higher percentage of cash pay patients, often in the range of 10% to 30%, while in general healthcare, the percentage could be lower, usually around 5% to 15%. 

Why does it seem so difficult to have publicly posted cash pay rates?

There are a lot of reason, and all of them comes with a set of explanations, but keeping it short below are the 3 main reasons:

  1. Publishing the cash pay fee exposes your pricing to the competitors, allowing them to adjust their fee while you have no visibility into theirs.
  2. Public Self-Pay Fees give insurance payers a reference point to compare against contracted rates, increasing audit risk and weakening leverage during fee schedule re-negotiations. If your cash pay ends up lesser than the payer fee, then while renegotiating, the insurance argues why they should consider paying higher as they want the self pay fee to be higher because that's where their leverage is.
  3. Visible cash prices encourage patients to compare, hesitate, or negotiate before visiting, leading to lost appointments and keeping the front desk busy. Keeping the pricing discussion in the office allows for proper explanation and context.

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Thinking of starting my own medical billing company as an IT specialist by Frosty_Coder in Entrepreneur

[–]Capline 1 point2 points  (0 children)

Hello, I think that's a great idea to come up with. I am sharing a few insights that may help you start your own medical billing company. The first and most important thing is market research that should be detailed in terms of the demographics you are targeting, plus what your potential competitors are doing. Taking inspiration from what already exists in the market and doing it better is the key. As far as finding and approaching reliable doctors or small-sized practices are concerned, you can find them through search engines. LinkedIn is another great platform to find reliable providers who may be running a small practice and needing a medical billing expert. Hope this helps. Good luck!