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LNCtips.com: Billing Blunders


As a new legal nurse consultant, you want to get paid for your LNC services. But your bill could be cut, the payment delayed or not paid at all if you make billing blunders. Don't let this happen to you!

Here are some common billing problems that legal nurse consultants make.

* No Retainer. A retainer is a fee paid to you before you do any work for the client. The retainer specifies an amount equal to a certain number of hours (I've seen 4 and 8 hour equivalents). It doesn't happen often, but some clients may be slow to pay you or not pay you at all. (See Deadbeat Clients). The solution? Charge a retainer. Some seasoned LNCs charge a retainer for every case. Others charge a retainer only for new clients without a proven track record of paying their bills on time.

* Inaccurate Tracking of Time. One of the hardest things to learn as new legal nurse consultant is keeping track of your time on all the activities related to the case. As you start to review the case, you might decide to do internet research for a while. Then you'll get a phone call that's unrelated to the case. After that, you take a break and then finally get back to the record review. At the end of the day (or worse, at the end of the week or month), you try to recreate how much time you've spent. The solution? Keep a piece of paper and a pen in your workspace and jot down your time for each related activity as the day progresses. Or you can use timer software such as Cool Timer.

* Vague Billing. Vague billing can be a problem because it looks like you're charging for the same service more than once. So instead of billing for "analysis of medical records" every time you review records, be more specific. For example, bill for "analysis of medical records of April 2009 admission to Fair Oaks Medical Center." If you work for a defense law firm and want to be even more specific for your insurance company clients, you can add the reason you reviewed the records. In that case, the previous example could read "analysis of medical records of April 2009 admission to Fair Oaks Medical Center to determine if the admission was related to plaintiff's allegation of continuing abdominal pain." And notice that I used the word "analysis" instead of "review."  I believe that paralegals review medical records while LNCs analyze them.

* Infrequent Billing. I can't tell you the number of times that experts have sent me bills long after the case has closed. The solution? Don't bill everything at the end of the case.   Bill on the first of the month after every interaction you have with the case.

* Block Billing. Block billing refers to the practice of grouping different activities into a single time entry. An example is grouping a record review, internet research, and a telephone conference and billing 6.5 hours. Block billing is frowned on because it implies that you pad your bill and/or are inefficient. The solution? Break each task down and list them separately on your bill. For example, your bill could list the telephone conference for 0.5 hours, internet research for 0.75 hours and the medical record analysis for 5.25 hours. That's still 6.5 hours but your client now has an idea of how you spent your time.

* Jargon. Don't use medical abbreviations unless they are very common (such as MD, ER, IV) and understood by the general public. Your attorney might understand the terms but the people who actually pay your bills may not. The solution? Write out all but the most common medical abbreviations and terms on your billing entries.

* Training. If you're a new legal nurse consultant, it's going to take you longer to review a case, summarize your opinions and generate reports. You shouldn't expect your client to pay for your learning curve. The solution? Many new LNCs cut their hours by a certain percentage. The percentage varies depending on the task. For example, if you've never done a chronology before and are unfamiliar with the software to create one, you would cut your hours by a larger percentage than you would if you were familiar with the software used to create the chronology.

* Billing Non-Billables. Clients generally won't pay for clerical tasks, such as filing, scheduling, and photocopying, or administrative tasks, such as training and generating invoices. Some clients feel that medical record organization is a clerical task and won't pay for it. The solution? Make sure you understand your client's billing guidelines for medical record organization and don't bill for clerical and administrative tasks.

Now that you know common legal nurse consultant billing problems, you'll never make a billing blunder!

...Katy Jones