Subject: Gastroenterology billing proposal request

Hello,

We are a U.S. gastroenterology practice comparing billing companies.
Please send a written proposal that answers each point below.
We are not sending any patient information with this request.

ABOUT OUR PRACTICE
- State(s):
- Number of physicians and other providers:
- Number of locations:
- Current EHR, practice-management and endoscopy-reporting systems:
- Systems we want to keep:
- Where we do procedures (office, our own surgery center, outside surgery center, hospital):
- Bills we need covered (mark each): physician / facility / anesthesia / pathology / infusion
- Billing entities we are responsible for:
- Biggest insurance payers:
- Average monthly collections, by type of bill (use the same period for every quote):
- Unpaid claims we have now, and how old they are:
- Why we are looking:
- When we want to start:

1. WHAT YOU WILL DO
For each task, tell us: included / costs extra / stays with our staff / not offered.
- Checking insurance eligibility
- Prior authorizations (first request and renewals)
- Coding
- Entering charges and sending claims
- Posting payments
- Working denials and appeals
- Patient statements and patient phone calls
- Credentialing and payer enrollment
- Collecting our old unpaid claims

2. WHAT IT COSTS
- Your rate or flat fee.
- Exactly which payments the rate applies to (insurance only, or patient payments too).
- Whether drug payments for infusions are counted in that total.
- If drug payments are excluded, how infusion billing is priced.
- Monthly minimum, if any, and whether it applies before or after extras.
- Setup, software, interface, statement and card-processing charges.
- The fee for collecting old unpaid claims.
- Any price change after the first months.
- Total required monthly extras and one-time charges. Mark any unknown cost;
  do not treat it as zero.

3. YOUR GI EXPERIENCE
Using made-up examples, show us how you handle:
- A Medicare screening colonoscopy where a polyp is removed.
- A colonoscopy after a positive Medicare-covered stool or blood screening test.
- A biopsy of one lesion and snare removal of another in one session, and how you tell a correct
  payment cut from an underpayment.
- Coordinating physician, facility, anesthesia and pathology claims and handoffs
  for the billing entities we need covered.
- (If we do infusions) One drug from authorization to paid claim.
Please also give us two GI practices we may call, with their permission.

4. SOFTWARE AND REPORTS
- Will our claims run in our system or yours?
- Any software we must buy or switch to, and the cost.
- A sample monthly report, with how each number is counted.
- Can we log in and see our own claims at any time?

5. STARTING AND LEAVING
- A start plan with dates, and who works our open claims during the switch.
- Contract length and how it renews.
- Notice needed to cancel, and any exit fee.
- Who finishes open claims after we leave, and at what fee.
- How we get our data back, in what format, and what it costs.
- Your business associate agreement, and whether any work is done by
  subcontractors or outside the U.S.
- Safeguards, incident reporting and subcontractor controls for protected
  health information.

Please list anything you assumed or left out.

Thank you,
[Name, title, practice, email]