Is Your Billing CA Running You?
by Erez Lirov
She pulled the X-ray from the viewbox and shook her head in disgust. One more time, and it’s over, she thought. One more personal call, one more rude comment to a patient, one more complaint and he’s gone. She was tired and frustrated, and her CA was gnawing at her last nerve. Oh well, leadership camp was 1 week away, and she was looking forward to a weekend with her mentor and the other doctors, honing their leadership skills.
“He” was her first hire. A CA from another chiropractic office that was a brilliant biller and great with patients, that is until he started working for her. Somehow, the last few months have become worse and worse, but she found it hard to imagine actually firing him.
Initially, he had been a great CA. He put together everything from her superbill to the computers in the office. He was a puppet master with technology. He even set up a server — she didn’t know what it did — but he insisted it was of the utmost importance.
Now, he worked less and less, came late, left early, and never stopped complaining. She had to hire additional staff as he became less productive and her practice grew, but he didn’t seem concerned. He liked the other staff members, and they liked him. They were often chatting together at the water cooler, wasting precious time, while she worked fervently trying to keep the practice together. She would fire him in a second, if she wasn’t so terrified of running the office on her own.
Her decision to hire a billing service with an integrated system happened suddenly. She had heard about the service from her mentor, and it seemed an answer to her problems. No servers, no software, and no superbills. She could get back to practicing chiropractic without worrying about what would happen if he suddenly decided to find another job. She had waited two days before announcing it to the staff. He waited exactly 30 seconds before lodging his first complaint.
“This is ridiculous!” he told her. “Our software is faster and better than theirs. Our billers are better trained than their staff. You can’t even make labels with it. How are we going to send patient statements?”
It was Friday, and her mind was already on camp. “We’ll talk about it next week,” she said, and opened the door to leave, hoping he would leave the office with her.
At camp, she brought up the issue with her mentor. Her mentor explained how he had faced the same resistance from his staff and how he dealt with it. She was determined to start fresh on Monday.
“I have made the decision to implement a billing service with an integrated practice management system,” she began firmly. This was her first staff meeting in months. Everyone just looked blankly. “It will be a big change. One of our biggest changes. Change is uncomfortable. We all know that. This change will be painful.. very painful. We’re all going to have to learn a new system at the same time as we enter lots of patient information, set up care plans, and upload X-ray images. Before we start, I need to know that everyone is with me. One hundred percent.”
His shocked look changed to a frown. She had to stand firm. “Anyone who doesn’t feel like this is the right decision and is not going to support me 100% can leave now.” She dared them. They just stood, thunderstruck. She plowed on. “I expect full cooperation. I expect you to come in early and put in late hours. And most of all, I expect you to maintain a positive attitude. Two hundred practices have already done what we’re about to do. Most have survived. Those that failed, failed because they didn’t have their staff’s full cooperation.”
“That is not going to happen here. We are going to band together and make this work. I’m going to ask one more time if anyone wants out. The door is behind you.” Silence. “OK. The first step is to sign on to the system and start watching the training videos. There are 12 videos. Each is about 1 hour long. There’s a test at the end of each one.”
“How will we do that while trying to handle patients?” It was his first question.
“We watch the videos during breaks, and before and after adjusting hours. Any other questions? Look. I know you’re concerned. I feel that this is the best decision we can make for the good of this practice and other practices as well. I need your help. Will you help me get this done?”
“I will.” her CA said. She looked surprised as he uttered those words. He was the last one she expected them from. One by one, they all pledged cooperation and filed out to get started. He stayed behind. She looked at him quizzically, then left the room to adjust patients.
Her mentor smiled as she narrated the story to him. “I guess he just needed direction,” he said. Perhaps they all need direction.