Last week, we started a series of blog posts, with the intention to identify positions in healthcare that may be underappreciated. Our first post was written about the “often unnoticed, medical receptionist”. This week, I decided to highlight the medical biller.
About five years ago, if asked about medical billing in a practice, I would have suggested the practice outsource the billing to a medical billing company. Within just the past three years however, my opinion has definitely changed. Through experience in practices I owned, as well as ones we have been contracted to manage, I have witnessed the consequences of outsourcing the billing. From my experience, what I’ve witnessed when outsourcing it, is the medical billing companies recruit decent billers, but then expect them to oversee a large amount of accounts. As a result, they’re unable to be efficient with any of the accounts they are working on, nor are they able to follow up on denials, or any other issues that result. I recognize there are likely some great medical billing companies out there who are not doing this, but I can say that this is what we have experienced with trying three of them.
If there’s a problem, then there must be a solution. We could not attempt trying a 4th medical billing practice. For 1.) Transferring your billing to a different company, is a significant amount of work; and 2.) time is of the essence to ensure the billing is running optimally, considering it is the life line of any medical practice. So, our solution was to hire a biller in house. Yes, technically the practices are still outsourcing it by contracting with us, but they have a person who is not overseeing too many accounts, who stays on top of any rejections and/or denials, understands all of the local insurances, and is held accountable by our leadership team. Therefore, we can guarantee positive results.
Having billing in house, has really opened my eyes to all that they do, and it is not for everyone. First, there’s the actual billing side; reviewing superbills, submitting, claims, posting payments, etc. But then, let’s face it, we all know the payers will do anything not to pay! And God forbid there’s an issue, because you have to try and get a human on the phone when you call, which is nearly impossible. And let’s not forget the constant change of how things are done. Everyone was freaking out about the introduction of ICD 10, and now I heard to expect ICD 11; understanding copays, deductibles, co-insurance, blah, blah, blah. That’s just billing. But to be successful, there’s the dealing with patients side. If you are unable to handle confrontation, this is not the job for you. Good medical billers must be able to call patients about outstanding balances and attempt to collect on those debts. There’s no guarantee you’re going to get a friendly response, and most of the time, you don’t. So, you try to stay calm, while explaining to the patient the details of what their insurance covers, despite the fact that they chose the plan, and likely knew it had a $5,000 deductible. If they didn’t, they do now!
In saying all of that, you can imagine what the personality must be like for most billers. We have an inside joke at CM Healthcare, that they’re like Roz, on the movie, Monsters Inc. I would place a bet, that our “Roz” is way cooler than yours. Stephanie O’Geen works for CM Healthcare, contracted to a couple different locations. Despite dealing with patients that may yell or curse her out, as well as having to deal with our leadership team on her back asking a thousand questions, she continues to be her graceful, and overly entertaining self. When she is in the office, there is no such thing as having a bad day. If you were having a bad day, she would certainly cheer you up, as she hits us left and right with some of the funniest things that just seem to come out of nowhere. Considering what she endures on a daily basis, you’d think we would have to be the ones to cheer her up. And if that’s not enough, if she’s not making us laugh, she’s making mugs or t-shirts for the staff, or most recently, peach pie, with peaches from one of the nurse’s trees.
I recently sat down with Stephanie to ask her a few questions about what it’s like to be a medical biller. Below are the questions and paraphrased responses.
What is the best part about being a medical biller? With her witty personality, she exclaimed, “When the payments come in…cash money!”
What is the worst part about being a medical biller? Dealing with upset patients.
Did you choose medical billing, or did it choose you? She let me know that it definitely chose her. It wasn’t something she dreamt about as a little kid.
What is something people would be surprised about? Whenever I call the insurance, it’s never just an easy call, and then everything is fixed. There’s nothing easy about dealing with insurance companies. She also said, that many would be surprised by the amount of little details that produce a large amount of work.
If you have a medical biller in your office, although they’re not likely as cool as ours, be sure to thank them. If you’re in need of one, give us a call!
