Contract For Medical Billers

If you are going to try and build up your own medical billing company, you ought to have a medical billing contract. You can either have a basic contract, or have an attorney draft up a contract.

A several guidelines for you when doing a contract

  • Name of the billing company and the name of client.
  • Effective date of contract and expiration date (if any).
  • Where will the insurance payments go to? I recommend having the payments go to the physician’s office to keep away from any legal matters. There ought to be a contract stating the provider will send copies of EOB’s of all payments.
  • Providing every month reports or meeting five times a month or quarterly.
  • How will payments be made? You can charge by percentage. A quantity of the average ranges are 8 to 15% or an average of $4 to $10 per claim. Things to think about are the patient volume, average income and if the client is established or not.
  • Who will do the coding? You will require an interview with the company that you will be outsourcing, to make sure they are not doing anything illegal. You don’t wish to do billing for a company that is in violation.
  • Client is responsible for:
  • Provide true and correct data (the client will be responsible for any submission of false data that can be prosecuted by law)
  • Confirmation of insurance
  • Client will be responsible for his/her own credentialing
  • Client won’t offer kickbacks or professional courtesy to client. This means the client can not wave copay or give free services to preferred or special patients. This is actually against the law.
  • Note that claims and patient information belongs to the property of the client and the billing company is only using it while contracted with the client.

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This entry was posted on Monday, May 24th, 2010 at 4:08 pm and is filed under General. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.


51 Responses to “Contract For Medical Billers”

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