Marketing Medical Billing
Services to Physician
John R. Mazza, President & CEO
Financial Healthcare Management, Inc.
1400 Johnson Ave., Suite 4-S
Bridgeport, WV 26330
E-mail: firstname.lastname@example.org Web: www.fhcm.net
“IF A PERSON DOES NOT MAKE NEW
ACQUAINTANCES AS THEY ADVANCE
THROUGH LIFE, THEY WILL SOON
FIND THEMSELVES ALONE.”
WHY DO I NEED TO MARKET
CLIENTS ARE SWITCHING BILLING
COMPANIES JUST FOR THE SAKE OF
CHANGING OR COULD IT BE…..
+ PRICE (We are their 2nd largest expense)
+ UNREALISTIC EXPECTATIONS
+ MERGERS AND ACQUISITIONS
(Change Driven by External Forces)
American Recovery and Reinvestment Act of 2009:
As it relates to: Health Information Technology (Health IT). Provides approximately $19 billion for
Medicare and Medicaid Health IT incentives over five years.
Electronic Medical Record Implementation
Provides financial incentives through the Medicare program to encourage physicians and hospitals to
adopt and use certified electronic health records (EHR) in a meaningful way (as defined by the Secretary
and may include reporting quality measures). Authorizes ONCHIT to provide competitive grants to
states for loans to providers.
Medicare incentive payments would be based on an amount equal to 75% of the Secretary’s estimate of
allowable charges, up to $15,000 for the first payment year. Incentive payments would be reduced in
subsequent years: $12,000, $8,000, $4,000, and $2000, after 2015. Physicians who report using an EHR
that is also capable of e-prescribing would be eligible for EHR incentives only.
Early adopters, whose first payment year is 2011 or 2012, would be eligible for an initial incentive
payment up to $18,000. In 2014, the payment limit would equal $12,000. Adopters, whose first
payment year is 2015, would receive $0 payment for 2015 and any subsequent year.
(Change Driven by External Forces)
Electronic Medical Record Implementation: (continued)
For eligible professionals in a rural health professional shortage area, the incentive payment amounts
would be increased by 10 percent.
Incentives under the Medicaid program are also available for physicians, hospitals, federally-qualified
health centers, rural health clinics, and other providers; however, physicians cannot take advantage of the
incentive payment programs under both the Medicare and Medicaid programs. Eligible pediatricians
(non-hospital based), with at least 20 percent Medicaid patient volume, could receive up to $42,500,
and other physicians (non-hospital based), with at least 30 percent Medicaid patient volume, could
receive up to $63,750, over a six-year period.
Physicians who do not adopt/use a certified Health IT system would face reduction in their
Medicare fee schedule of -1% in 2015, -2% in 2016, and -3% in 2017 and beyond. E-prescribing
penalties would sunset after 2014.
(Change Driven by External Forces -continued)
Transition from ICD-9 to ICD-10 October 1, 2013:
ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service,
and inpatient claims with dates of discharge on and after October 1, 2013. Otherwise, your claims and
other transactions may be rejected, and you will need to resubmit them with the ICD-10 codes. This
could result in delays and may impact your reimbursements, so it is important to start now to prepare
for the changeover to ICD-10 codes.
About the Version 5010 Transition on January 1, 2012:
On January 1, 2012, standards for electronic health care transactions change from Version 4010/4010A1
to Version 5010. These electronic health care transactions include functions like claims, eligibility
inquiries, and remittance advices. Unlike the current Version 4010/4010A1, Version 5010
accommodates the ICD-10 codes, and must be in place first before the changeover to ICD-10. The
Version 5010 change occurs well before the ICD-10 implementation date to allow adequate Version
5010 testing and implementation time.
If providers do not conduct electronic health transactions using Version 5010 as of January 1, 2012,
delays in claim reimbursement may result. If health plans cannot accept Version 5010 transactions from
providers, they may experience a large increase in provider customer service inquiries affecting their
Preparing for ICD-10 and Version 5010 – including potential updated software installation, staff
training, changes to business operations and workflows, internal and external testing, reprinting of
manuals and other materials, and more – will take time.
Marketing The Fear
Experts predict a practice will spend over 80K per
Physician to Implement ICD -10 and 5010.
Reimbursements on average will continue to decline.
Operating costs (malpractice, benefits, ect.) will continue
Third party payers will ramp up claim denial patterns
and enforce regulatory compliance.
On-going trend of increasing self pay patient outstanding
Strategy For Consistent Lead
Build referral relationships
Educate yourself on the entire Revenue Cycle
Revenue Cycle Management is defined as the
Administrative duties, clinical and financial,
that facilitate the collection of all revenues for
the provision of care.
Sales Goals (what are they)
Two to three physicians or healthcare
providers signed per calendar quarter, with
each generating approximate $2,500-$3,500
per month in contracted revenue.
Example: Billing company collects 50K for Doctor X client
in a month.
$50,000 * 6% (contracted rate) = $3,000 (monthly revenue to
Define your target market by specialty, size, and
location of physician prospect.
Defining your prospects will allow you to
concentrate your marketing efforts in the right
Establish a dynamic web presence easily found
through multiple search engines.
Write article for various trade journals that are
targeted to prospects.
Volunteer to speak at various trade events.
Key Actions (continued)
Attend prospect trade events as
Direct mail solicitation to target markets.
Institute an aggressive telemarketing
NETWORK, NETWORK, NETWORK
If you are not Networking, then you are
Current obstacles encountered: