June Special
All customers who sign up for
eMediClaims this month will
receive 50% off setup fees.
Why Outsource?
Hidden In-House Costs
Cost Comparison
Survey
eMediClaims
Survey
Name:
(required)
Specialty:
(required)
1a. Do you currently do your billing in-house?
Yes
No
If so, how many employees are dedicated to billing?
How many employees with other office resposibilities assist with billing?
2. How many patients do you see on average per day?
3. How many paper and electronic claims do you submit per month?
Number of Paper Claims/Month
Number of Electronic Claims/Month
Medicare
Medicaid
Tricare
Blue Cross/Blue Shield
Commerical
HMO
Other
4. What is the average dollar amount submitted per claim? $
5. If you already outsource your billing, how much do you pay per claim (flat rate or percentage)?
6. If you submit paper claims in-house, what is your cost per claim (Be sure to include overhead costs, such as employee salary/benefits, office equipment/space, supplies/postage, telephone/utilities)? For an example, click
here
. $
7. What is your insurance rejection rate?
0-10%
11-20%
21-30%
> 30%
8. How much time is spent following-up on unpaid and/or rejected claims?
9. How many patient statements are prepared and mailed each month?
10. What is your outstanding accounts receivable (in percent)?
0 to 30 days
31 to 60 days
61 to 90 days
91 to 120 days
> 120 days
Insurance
%
%
%
%
%
Patient (Out of Pocket)
%
%
%
%
%
11. On average, how long does it take to receive payment on your claims?
< 2 weeks
2-4 weeks
4-6 weeks
longer
12. Would you like us to contact you to schedule a free consultation?
Yes
No
If so, please provide the following information:
Contact Name:
Phone Number and Ext.:
Best Time to Call:
Email:
Check this box if you would like to be notified when survey results are available.
(Be sure to provide us with at least one method to contact you.)
© Copyright 2004, 2005. eMediServ, LLC
