by pdirector » Tue Nov 22, 2011 6:50 pm
Direct business is more if you target the right carriers. No medical company will give you all carrier pricing, but many show you what your percentage is and your payment so you can back into these prices. For example, if you know you are getting 85% and you are paid $85, you know the carrier paid $100. You can then target direct exams for carriers that pay average or above average fees. On the direct side, you should be receiving around $70 per test on average. Work for companies such as Western Reserve Life, Pacific Life, Farm Bureau of Iowa, the Standard, and others will pay you at or above these rates. Work for companies such as MetLife may pay you less than the Standard rates you are getting paid as a sub-contractor since all Direct Examiner contracts should be percentage based and MetLife pays around $59 at 100%, which puts your 85% billing fee at only $50. Factor in the extra time and cost of supporting the agent directly and you may end up at the $35 rate you would have received had that case come from EMSI to you.
Properly targeted, you should see about 2-2.5x the income from direct exam work as you do from sub-contract work, but be sure to factor your costs for marketing, an exam tracking system, and even kit inventory, as well as equipment, phone, etc.
Good luck with this. Growing a medical service company is a lot of work and can be a lot of fun.