Issues Facing Medical Billing Companies in 2014 THERE ARE OPPORTUNITIES By Dave Jakielo, CHBME re you ready for the most interesting year in the medical billing industry history? The rapidly changing environment and the challenges you will be facing mean that you will have to devote more time to strategic planning than ever before. Otherwise it will be difficult to remain in business. going with the flow and hoping that things will “just work out” is as bad a strategy as engaging any new potential client that comes along because you are in panic mode. Without a combination of thoughtful planning and adopting a proactive approach to the future, your chances for continued success will definitely become grim. Here are some areas that will definitely affect your ability to grow and prosper in 2014. ICD-10 has the potential to be the biggest event that has ever impacted our industry. some issues related to this change are: • Potential disruption in your clients’ cash flows if third party payors are not prepared to accept and adjudicate claims containing the new ICD-10 codes. as we know, if your clients’ cash flows are slowed, yours will be too. Inform your clients that this may occur and instruct them to put aside enough cash to cover three months of expenses or make sure they have a line of credit in place to keep them solvent. Do this for your company's expenses as well. • The amount of time required to code each claim is obviously going to increase due to inexperience and the additional time needed to review supporting documentation. Test early and time how long it takes to code 50 charts using ICD-9 and recode them using ICD-10 guidelines. This will give you an idea of how the workload may increase and determine which resources you will need to ensure prevent massive backlogs. another change we have seen in the industry is impacted by the implementation of eHR systems. Practices are now asking billing companies to take over their billing and requesting that you continue to use their systems rather than convert them to your current billing software. This could be an opportunity or a nightmare, and before you consider using a client’s system that you do not have any experience with, consider the following: FROM THE ROaD • How many other potential clients in your geographic marketing area are using the same software? ask the salesperson who your potential client bought the software from. That salesperson will be able to tell you what the market penetration is, which will help you to determine your growth potential. never waste time learning a foreign software product if it is only used by a few prospects. Investing time in the additional training and the added expense to work on multiple systems only makes sense if you have the potential to recover your investment because the system is utilized by other potential clients. • Do you have flexible team members who have the ability and willingness to learn a new system? lastly, given how many new insurance policies that went in place this year have increased deductibles and coinsurance percentages, you may see your clients’ self-pay receivables growing based on their particular payor mixes. Keep in mind that we are in the billing business, not in the collection business. Here are some things you need to remember: • Based on the state law where your client is located, you may or may not be able to make collection calls to patients without a collection agency license. Your local collection agency will be able to inform you about the laws that would apply to you, so you can remain compliant. • If you do the math, the cost of a collection call is more than $8.00 per successful connect. Hypothetically, if you are charging a six percent management fee, each call would have to yield a payment of at least $135 to break even for you. Yes, there are challenges ahead, but the great news is that there will continue to be a need for efficient, effective, and compliant medical billing companies. Here’s hoping you are one of them. Dave Jakielo, CHBME, is an international speaker, consultant, executive coach, author, and is president of Seminars & Consulting. Dave has been helping companies grow and improve their profitability for more than four decades. Sign up for his free weekly success tips at www.davespeaks.com. Dave can be reached via email at dave@davespeaks.com or phone at 412-921-0976. A 42 HBma BIllIng • maRCH.aPRIl.2014
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