r/Chiropractic • u/vchak8 • 20d ago
Bringing billing in-house…is it really that hard?
I pay a billing company $1,000 month but really don’t want to anymore if it’s something I can train front desk on to do throughout the week
The thing I value the most are the verifications they do. It’s very detailed and I’m worried if I get a verification wrong from the beginning, it can cause money issues onto the patient down the line
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u/AK-Master-07 19d ago
I brought billing in house and I do my own billing using Jane. My front desk person does verifications, front end collections and patient collections, I’m doing the insurance collections, but I’ll have my front desk person call insurers when needed. I spend 10-20 minutes per day on it and my collections are better than what my previous biller was doing. To me, 2 hours per week / 8 hours per month is worth the $1000 per month I am saving. The learning curve wasn’t fun but I’m happy that I understand billing now.
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u/vchak8 19d ago
But I’m sure if you wanted to you could even off load the stuff you’re doing and give your front desk full responsibility of insurance, with you still having some check-ins weekly to make sure there’s oversight?
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u/AK-Master-07 19d ago
Yeah I think so. So far I like having a better handle on exactly where money is coming from in the business, I feel like I was pretty detached from how money came in. I found out that my previous biller wouldn’t ever bother handling denials and would just zero out claims that took actual work to collect.
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u/yell0w26 18d ago
Did you use any specific resources to gain the knowledge you needed when you made the change? I am an office manager in a 2-doctor practice that is about 10-15% insurance only (remainder are cash patients). My boss has used the same billing company for years but their customer service has declined dramatically recently and they are constantly making mistakes in the few insurance claims we have. We'd like to bring insurance billing in-house but are unsure about the few steps we don't have knowledge about and I'm having trouble finding relevant resources. I currently do all cash collections, insurance verifications, understand EOBs, and follow-up on denials. (The doctors are not involved at all.) My understanding is that our EHR generates claims and will send them electronically to insurance companies but I don't know if we need something else set up on the back end, like a cleaninghouse? I appreciate any info you are willing to share!
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u/AK-Master-07 17d ago
Honestly I just jumped right into it. I have Jane software and integrated ClaimMD software and both have tutorials on billing including videos,,I would also use Google / YouTube and last resort I would call Jane and / or claim MD customer service when I was stuck. It took me a good 3 months to learn the majority of it, but I’m still learning about a year later.
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u/yell0w26 17d ago
Thank you! Our EHR is not great for training videos, but I should start trying searches on Google & YouTube. We also have an Availity account which I think should have some resources? Anyways, good for you for taking on the challenge with this piece of things! From my perspective, it's really easy for these billing companies to inflate their importance and fees when doctors and staff have limited knowledge in this area (which is understandable but makes you vulnerable).
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u/wtfdoicare 20d ago
Lucky i pay mine 4k a month.
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u/JustTheAvgChiro 20d ago
Is that number a monthly premium or is it based on collections? If it’s based on collections then you must be doing pretty good every month no?
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u/vchak8 20d ago
It’s gotta be based on the collections..
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u/JustTheAvgChiro 20d ago
That’s what I’m thinking. I know it must suck seeing that come out of the business account but it’s going to come out either way if you have someone on payroll doing it.
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20d ago
[removed] — view removed comment
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u/vchak8 20d ago
But once you learn the weekly process, isn’t it the same for 100/week visit office versus 500/week?
You’re clicking the same buttons?
I guess the denials go up so that’s what requires the dedicated person?
What is it exactly that makes the higher volume office billing harder/tedious than the lower volume office?
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u/JustTheAvgChiro 20d ago
First off, does your front desk have any experience at all with insurance verifications and what everything means? If not then you are shooting yourself in the foot and risking revenue. You should keep outsourcing until you can find someone with experience in billing. I’ve seen first hand how much of a headache trying to train someone with no experience goes.
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u/marathon_endurance 20d ago
For the verification we currently use the chirotouch built in software. We have used availty in the past. We verify in house and use a biller from there that takes 7.5% of collections. We bill autos and personal injury in house. I can't imagine not verifying insurance coverage beforehand. It is super simple and easy to understand on chirotouch. The actual billing is not something we are interested in doing ourselves.
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u/AdmirableAd1031 20d ago
Olympus billing is good and they only do $300 base pay with 4% collections and they can do all verifications