Outsourced Billing Nightmares – Why Billing Precision? – Part I
by Erez Lirov
The two chiropractors were chatting and billing companies came up. One was an older, experienced doctor. He had tried it at low volume, high volume, cash, insurance, care plans, fee-for-service. And several times, he had tried to outsource his billing — and failed. The younger doctor, having practiced for only a couple of years, had just brought up the subject of billing, and remarked at how time-consuming billing had become for his growing practice.
His CA, he estimated, was now spending almost 20 hours per week entering charges, sending claim batches, printing and submitting secondary claims, and posting EOBs. With all her other duties, there was less and less time for claim follow-up, and the younger doctor was concerned that patients were not getting the personal attention they deserved. Worse, he was working harder, but revenues seemed to decrease as claim after claim was simply not paid. He finally said it: “I’m looking at hiring a billing company. Got any ideas?”
The older, wiser doctor immediately frowned. His experience with traditional billing companies were complete and utter disasters. Each time, he had had to move the billing back in-house, find and train new staff and recover from financial issues. The billing companies he tried were simply not equipped to handle his volume of claims. Besides, there were lots of other issues.
“Such as?” asked the younger doctor, obviously distraught at the prospect of having to hire and train a separate billing clerk for his office. He had hoped there was a simple solution – a silver bullet that he could simply sign up for and that would let him get back to doing what he loved — treating his patients.
“Control, for one,” answered the older doctor, still frowning. It was a problem that plagued almost every billing service out there. Billing companies tend to work in their own software systems. It makes them more efficient at follow-up and data entry, since their billers need to learn only one system. It also allows them to monitor and control all employees centrally. But it wreaks havoc on the provider’s office. Few billing services provide any kind of remote access to their billing system. Often, remote access is slow and cumbersome, and the office never utilizes it. It’s hard to run a practice when the vital statistics are so hard to access. Harder still to control the billing and follow-up process when the claims and audit trails are out of reach.
And that was just for starters. Lack of efficiency followed lack of control. With in-house billing, the charges flowed from one screen to the next, with no paperwork in-between. Once the process and data were moved out of the office, the staff started spending hours faxing superbills to the billing company. The faxes invariably died in the middle or came back as unreadable, causing no end of frustration.
But that wasn’t the worst of it.
Continued in Part II…