Practice Fees: Professional Services

Video Transcription

[MUSIC PLAYING] Welcome to this lesson. Here we'll cover fees associated with administration of practice and discuss approaches to utilizing professional services to support practice management. So let's break it down into the specifics.

First, fees for professional services. Next, biller. Office staff, accountant, lawyer, collection agency, credentialing, website/social media presence.

Fees for professional services may become necessary for managing the practice as it grows. Some examples include payments to a biller, office staff, an accountant, a lawyer, collection agency, credentialer, or website management. Some of these fees can be paid on a one-time basis while others can be monthly or yearly. So keep in mind that most professional services that increase productivity cost money.

It's not uncommon for a counselor to pay from a few thousand dollars upfront for professional fees. So once again, you'll need to consider your values related to how you spend the hours of your day-- either making money seeing clients or saving money and attempting to learn and complete the services yourself. Which is it going to be?

A biller a service that helps to manage clients and insurance payments. Many billers throughout the United States currently charge between 6% and 9% of money collected. Now, the percentage may or may not include other duties, such as sending out client statements, logging payments, or follow-up calls to insurance agencies.

For convenience, many billers are remote. That is, they're working off-site. If you use a remote billing company, you'll need to find a confidential way to transfer client information to the biller, which is typically done via an EHR.

On-site billers may come into the office for a limited number of hours per week, say three to five, and charge between $20 and $50 per hour. Something to consider is that money might be better spent on paying an office staff person who also knows billing or can learn billing. I brought in longtime friend and colleague Dr. Andy Brown to tell you a little bit about his experience of hiring a builder.

Hi. I'm Dr. Andy Brown talking to you today a little bit about scheduling and insurance billing. I have a private practice and have been in private practice for about 10 years. During that process, my practice grew and to the point where scheduling and billing insurance became cumbersome.

One of the things that I looked at was the amount of time that I was spending outside of my sessions calling insurance companies, sometimes staying on the phone for two hours trying to get a small bill taken care of. With the scheduling, after I'd finished a long day of practice, I would have to call people back and schedule people. People were canceling.

So I went through the process of hiring a lady to come in and help with the scheduling and billing-- one of the better decisions that I made. It improved my quality of life quite a bit-- having her call back the insurance companies when there was a discrepancy. Also, when people were calling in to book, she was able to on the spot verify their insurance, which cut down on the lag time of getting paid out.

So all of that really kind of worked together to add to the quality of life. And I really didn't miss the percentage that I was paying her. I think I would have paid even more. My only regret was not doing it earlier.

Various types of office staff can be helpful in office administration. Office staff are typically paid hourly and can be an employee or an independent contractor. Office staff typically makes between minimum wage upwards to $20 per hour, depending on what the office staff person will be doing.

You want an office staff who is comfortable completing all and any of the following. Answering phone calls, check in and assistance with clients, scheduling follow-up appointments, collecting co-pays and outstanding bills, depositing checks at the bank, calling insurance companies regarding denied or rejected claims, writing letters and generating reports, scanning and faxing various office documents, cleaning the office, purchasing supplies, and being comfortable in crisis situations.

You may elect to complete accounting on your own or hire an accountant. Accountants can range in price from an hourly fee or a monthly fee to a flat rate for a job done. Example rates for accountants range from $60 per hour to $150 per hour for payroll and quarterly filing or $400 to complete federal and state taxes.

Now, note that these are just examples of different accountants and what they will charge. And pricing for an accountant may change depending on the complexities involved in paying one's self, tax preparation, and filing. Accounting software is available for free all the way up to several thousands of dollars for do-it-yourself types. Students can purchase accounting software at a discounted price based on their student status.

So what's the difference between a lawyer and a bag of light bulbs? OK. So now is not the time for lawyer jokes, especially since you may need one someday soon. So a lawyer may be necessary during the initial setup of a business and then may be necessary on an as-needed basis for consultation. And potential legal consultation may need to occur around topics such as child custody, probation, disputes with office staff, partners, or employees, change to business structure, malpractice, or other legal suits. Lawyers typically charge between $100 and $400 an hour depending on location, skill area of expertise, and otherwise.

A collection agency assists with recouping money owed on past due client payments. A business owner should exhaust all efforts at collecting payments before contacting a collection agency. These agencies typically charge between 30% and 50% of the money collected.

So these agencies also typically need the client intake paperwork with the demographics, driver's license, and any known information about the client. So it's important to ask or to determine if the collection agency will report the debt to major credit reporting agencies. Debt reported to collection agencies remains on the client's credit report, and the client may need to eventually pay the debt in order to improve his or her credit score.

If the debt is reported to a collection agency and the client does declare bankruptcy, you will be notified. The debt may then be written off for partially or fully written off based on the client's assets. If the collection agency cannot secure payment, then typically you can hire a lawyer or file in small claims court as an attempt to secure the payment.

OK. Don't freak out. This would be a pretty extreme and rare circumstance that would dictate this kind of action. But our goal in this lesson, as with all of these lessons, is to fill you in on the possible challenges and options involved in running a private practice.

A credentialer is a person or business that helps the client get on insurance panels. Credentialing fees range from several hundred dollars for a one-time credentialing with additional costs related to ongoing quarterly and yearly updates and recredentialing, which is about every three years or so. Fees associated with credentials can be ongoing or can be a total amount paid to have the credentialer submit paperwork to insurance companies on counselor's behalf.

Just because a credentialer submits paperwork to the insurance company does not guarantee that you will be credentialed. Issues such as closed panels and counselor saturation for the area may continue to prevent you from being credentialed. Now, you can credential yourself for free. If you decide to attempt your own credentialing, you should allocate a fair amount of time and hours to learning the process of contacting insurance companies and EAPs and filling out paperwork and waiting for a follow up from insurance and EAP companies.

Now, whether a counselor pays a credentialer or does the work themselves, credentialing can take as little as three to six weeks for a determination from an insurance company to as long as six to eight months for a determination. So without being credentialed with an insurance company, counselors will be considered out-of-network with the client's insurance company. And most companies, just so you know, do not pay for client sessions when you are out of network, and they push the entire cost of the session onto the client.

Having an online presence is super important for business success. You can purchase and create your own website with mental health templates costing $25 to $30 per month for a limited amount of pages and features or purchase your own domain name and build your own website with unlimited pages and features. So if you choose to build your own site, resources such as Squarespace or GoDaddy.com make it fairly easy and cost effective to do so.

The do-it-yourself website cost includes the template to build the site, cost of photos and graphic designs, cost of written content, and some include hosting and domain name registration as well. So this is definitely the most cost-effective route. And these days, the quality of what you can build rivals most professionally built sites out there.

The cost of having a website built professionally can be as little as several hundred dollars depending on the amount of pages and design and features built into websites, such as videos and online payment and scheduling. A totally unique, high-end website design can cost $3,000 to $5,000. So the sky's the limit. And if your budget is that of rock star status, then go for it. But more than likely, yours isn't, so don't go for that five grand site.

Here's what we covered in this lesson. Fees for professional services, biller, office staff, accountant, lawyer, collection agency, credentialing, website/social media presence.

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