The Real Cost of in House Billing - Part 1

dy">Total Cost of Outsourced Billing (at 8%) (TCOB)
The single biggest mistake doctors make is· TCOB = Total Insurance Collections X
forgetting to calculate what it will cost them toBilling Company Fee
manage the staff they hire to do billing in house. It· $432,000 X .08 = $34,560
is one of the golden rules of business. PayFAQ
yourself first. There are other hidden costs whenQ: What if I found one super biller that could work
it comes to managing a billing team as well. The20 hours per week they can get it done?
numbers below are based on numbers that wereA: You would still need to manage that person 2
given to the doctor from a very well knowhours per week and it is not worth the time.
chiropractic coach, not numbers I came up with.Your staff salaries would drop to $15,600, but
· Projected number of weekly patientyou would still be paying yourself $48,000, giving
visits: 500 patient visits/weekyou a total of $63,600 or 14.72% of insurance
· Projected Total Collections(TC): $60,000collections. You would not be under 8% until you
month x 12 = $720,000/yearspent less than 45 minutes per meek managing
· Total Insurance Collections (TIC): 60%one part time person to do billing for a 500 per
insurance = $432,000week office.
Total Staff Cost (SC)Here is what you should be asking:
· Staff hours per year (SHY):o 3 part1. Can one part time person handle the billing for
time staff = 3 x 20 hours/week = 60 hours peran office seeing 500 patients per week? Claim
week x 52 weeks = 3120 hours/yearsubmission, EOB posting and follow up?
· Average hourly rate (SHR):o $15/hour2. Since this person is not paid based on a
· (SC) = (SHR) $15/hr X (SHY) 3120percentage will they really fight for every dollar?
hours = $46,0003. What happens if they are out sick for three
Management Cost (MC)days?
· Doctors hourly compensation (DHC)o4. What if they get a better job? How will you
Hours worked = 30hrs/wee X 52 weeks = 1,560find the time to replace them?
hours/yearo Total Collection = $720,000/yearo5. Will they be attending seminars to learn the
DHC = (Total Collection) $720,000 / (Hourslatest in coding?
Worked) 1,560 = $461/hour6. Will they be processing thousands of claims per
· Hours spent managing billing staffmonth like a professional billing service would and
personally (HS): 2 hours/week x 52 weeks = 104be able to analyze data to make sure they stay
hours/yearahead of the insurance companies?
· MC = (HS) 104 hours/year X (DHC)7. Will they give you compliance reports showing
$461/hour = $48,000you exactly when you raise a red flag for an
Total Cost for in house billing (TCIB)insurance audit?
· TCIB = Staff Cost (SC)+ Management8. Will they provide real time reports and accurate
Cost (MC)call logs on every claim so you can check their
· TCIB = (SC) $46,000 + (MC) $48,000productivity at any time?
=$94,0009. What if insurance collections go down? Will your
TCIB as a percentage of collections (TCIB%)staff take less pay?
· TCIB / Total Insurance Collections =10. Would an in house biller agree to a percentage
TCIB%of collections as compensation?
· $94,800 / $432,000 = 21.94%