New payment schedule effective 10/16/24:
Billing Schedule
Notes are due EVERY week on sunday night irrespective of when they are billed.
1st Week of the month (starting with the first Tuesday)
no-fault billing
work comp billing clients A-J (by first name)
3rd Week
no-fault billing
work comp billing clients K-Z (by first name)
Payment Schedule
1st Week (starting with first Tuesday):
No Fault payments
Work comp advances from previous billing.
3rd Week
No-Fault Payments
Work Comp advances from previous billing
Pay Rate
The BIMN works on a percentage. We charge 10% for billing, 12% for case management, and for network clients we send you, we charge 11% for network administration. This amounts to the following amounts deposited in your account:
Auto and Work Comp - Network Client $90
Auto and Work Comp - Your Client $105
We collect and pay the retail portion of the GE tax and you are only responsible for the wholesale portion which is a minimal 1/2 of 1%.
We encourage you to decline cash tips for sessions paid by insurance, it is not customary for medical treatment.
Pay Timeline
No fault car accident claims are usually paid within 6 weeks from the date the session is billed but can take longer if there are problems. We send you your portion of the pay within 2 weeks of receiving it from the insurance company. Each billing issue that arises can easily add another 6 weeks to the payment timeline. This is a situation where it really helps to have a NPI number because it minimizes the billing issues.
Pay Advance
Because work comp takes so long to pay, we are experimenting with advancing your pay once the session is billed. Its a win win situation because you don’t have to wait so long, and on our side, it gives us more time to handle the many problems that come up with bills without worrying that your pay is going to be delayed. This service can be hard on our bank account and may not always be available.
If a session were ever to be denied, we’d have to investigate the cause. If it was from an error on your behalf like not sticking to the details of the treatment plan, then we would ask you to return the advance. If there was a mistake on our part we would absorb the loss. If it was for some other reason, we would work together with you to decide how to handle the advance.
Workers Comp Payment Risks
Your payment risk is very low. Various reductions do occur but we are usually able to absorb those losses without affecting you. To date, we have not had to ask for an advance to be returned except when the mistake was clearly made by a therapist in not following the prescription or accidently submitting notes for a session they didn’t do.
NO Fault Payment Risks
Auto insurance does NOT preauthorize payment for sessions and this creates some risk. We actively screen all no-fault cases for potential problems and proactively address anything could be a barrier to payment. By doing this we achieve 90%+ pay rate by the insurance company for no fault cases. That still leaves a little risk of non payment that you need to understand.
The client promises to pay anything not paid by the insurance company; however, it’s not guaranteed that they actually will. You have a closer relationship to the client than we do and can better assess the likely hood and/or ability to pay, and this can help you determine how much risk you are willing to take.
If the client has a lawyer, unpaid sessions can be paid by a settlement, this can take 1-2 years. In this scenario, we work with the lawyer to make this happen. If it seems like a low risk scenario we can often advance your pay so you don’t have to wait.
The main reason why sessions don’t get paid is when the client uses up their healing fund (called their PIP). We coach the client on how to track how much is available but it not a simple task.
If a payment is denied by the insurance company, we will let you and the client know as soon as possible. At that point, the BIMN will forfeit our portion of payment and let the client know they need to pay you at a rate of $90 per hour. The client will pay you directly. The BIMN will not try to forcefully collect payment from any client.
So what can you the therapist do?
Let us know if the client thinks they are getting to the end of their PIP.
Let us know if the client gets any expensive procedures that could eat up their PIP (like a MRI or CT scan, surgery, etc)
If a client is seeking a renewal of their prescription, remind them to verify that there are enough funds to cover it.
If there is any concern about risk for a specific case, lets have a conversation about it.
Car accident 3rd party claims
In a no-fault car accident, once the PIP runs out, sometimes there is still a chance for more coverage. IF the other guy has admitted fault, the patient can go to a Lawyer who will help them get paid through the other guys bodily injury coverage. This type of coverage does not pay for individual sessions one at time, rather it pays for them in a lump sum once the client has reached their maximum improvement. These often take 18-24 months to get paid but sometimes longer. You are under no pressure to continue to treat your client when the PIP runs out, but if you want to continue to help them, and they want to get a lawyer, this is a way more treatment can be covered. Often we are able to advance your pay for these so you don’t have to wait for the case to settle.