Outsourced Billing Nightmares - Why Billing Precision?

The two chiropractors were chatting. One was an older, experienced doctor. He had tried it all -- 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 services 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. "See, the problem is that traditional medical billing companies are built for traditional medical doctors." Now the older man was philosophizing. "We're different in many ways, but one of the most important ways is in our patient visit average. Chiropractors sometimes see dozens of visits for each of their patients. The coding and documentation is almost identical every visit. It's only if you look at an interval of time - say 12 visits - that you can see large-scale improvements in the patient's health and treatment."

"That's why a higher volume practice cannot survive without a powerful in-house system that helps you produce documentation and claims by making minimal changes every visit, and not recreating an entire encounter every time you adjust someone. Now, all of the sudden, you have two systems. One for managing your practice and seeing patients. and the other, for doing your billing. The two systems can't talk to each other, so everything becomes fragmented and things get missed."

"For example, last week I had a patient walk into the office for a routine adjustment. As soon as he scanned into my front-desk kiosk, an alert came up telling my CA that some of his previous claims had begun failing because his carrier was waiting for an insurance survey from him. If the billing system hadn't been talking directly to the front-desk check-in system, we would have missed that and could have continued treating him for free for months."

The young man look awed. His current system didn't do that. He asked the older doctor what system he was using. "Billing Precision," came the answer. Now the young doctor was confused. Billing Precision? Wasn't that a billing company? It certainly sounded like a billing company. But, then, what was the old guy talking about? He had to find out.

"Do you mean your software is called Billing Precision?" he inquired.

"No," responded the older man. "The software is Vericle. I outsource my follow-up and EOB entry to a company called Billing Precision, and they supply me with the software. Billing Precision is not a traditional medical billing company. Their software is web-based, so it's really my office software. I use it just like a regular practice management system. But the best part is that Billing Precision accesses it from their location to do their follow-up and EOB entry."

"It gives me the best of both worlds. I get the efficiency and control of an in-house system, without having to continuously hire and train billing staff. My patients' charts come up automatically at each adjusting station when they scan their key-chain tags. It takes me 10 seconds to document and bill a repeat visit at the table. The data is then automatically pushed to the insurance companies or accrued on the patient's account if it's a cash patient. The whole process takes seconds."

"I also get real-time access to my vital stats and all of my financial reports. Not just in the office. I took a trip to Italy last summer. Halfway through, I really wanted to see how my associate doctor was doing while I was away. I logged on to the system from an Internet Cafe, and in seconds, I was able to see reports and stats."

The young doctor was hesitant. It sounded very different from the typical in-house or outsourced setups he had read about or seen in other offices. "Does it work?" he asked.

"It worked for me," mused the older man, "but I knew what I was getting into. I had experienced both traditional approaches to billing and I knew both didn't work for me. I wanted to focus on building my practice without having to train and manage a team of billers, but I didn't want to give up control of my billing. This was the only solution that let me have it both ways."

The older man smiled and thought back to the first time he talked to Billing Precision and received a demo of the software. It looked nice, but his stomach was doing backflips at the thought of another outsourcing billing nightmare. Now that everything was up and running, he was glad he made the right decision.

He was concerned for the young doctor. Would he appreciate the benefits of Billing Precision's non-traditional service without first experiencing the pain of traditional approaches? He thought about that for a while.

"You have to decide for yourself," he finally said.