Nobody Asked Me, But … ou may think that in this day and age the process of collecting money for medical services would be simpler, but in reality, it is getting more complex. This is good news, because the need for the services of professional billing companies is greater than ever. Here are some thoughts I have gathered about what we are facing in the medical billing industry today and in the future. ■ Without interoperability, the ability of Electronic Medical Record (EMR) systems to communicate with one another, Meaningful Use, is really Meaningless Use. Regardless of how excellent the information is that has been captured by my physician in his EMR system, if my data can’t be accessed by every other healthcare professional, what good is it? Could the billions of dollars the government invested in this projected be misguided? ■ ICD-10 is either going to be the most disruptive event to hit the medical billing industry or it could turn out to be like the Y2K scare of 2000. Success or failure will be based on three things: documentation, documentation, and more documentation. ■ The average deductible for the new high-deductible policies sold on the Federal Exchange is about $6,000. This means that for office-based physicians, approximately 40 percent of their income will have to be collected from their patients. This will require practices to implement strict polices for collecting co-pays and deductibles at the time of service because the probability that a physician will be paid the self-pay portion drops dramatically once the patient leaves the office. I recommend using a vendor that offers the ability to keep credit card information on file, so the practice can automatically charge the patient any outstanding self-pay balance remaining after their third-party claim is adjudicated. ■ As medical practices continue to merge or be acquired, some billing companies will face the challenge of staying in business. So to ensure your company remains viable, here are a few “must dos”: • Make sure no one client represents more than 10 percent of your total annual revenue. If you lose them to 38 HBMA BILLING • MARCH.APRIL.2015 FROM THE ROAD a merger or an acquisition, it won’t be a major disruption to your firm. • Develop and implement a strategic marketing plan. Remember, prospects may still call you, but they need to know how to find you, so a robust website is imperative in today’s marketplace. • If you don’t want to dedicate time, money, and energy to sales and marketing, you could examine the possibility of selling or merging your billing company. If sales and marketing aren’t a priority, you will find yourself slowly going out of business. ■ An additional tool that is starting to have an impact on our clients’ practices is the availability of what is known as “business intelligence” software. These programs usually run as a bolt onto your current medical billing software and allow you to slice and dice data and turn it into more meaningful information. Some examples of what can be tracked and monitored are expected charge and collection volumes on a daily basis versus waiting to review end-of-month reports. You can set the program to track increases or decreases in visit levels, warn about payor mix shifts, and send alerts if there is a change in modality utilization. At this time, business intelligence software is in the infancy stage, and I think it will be a powerful tool to help you help your clients to be more efficient, effective, and profitable. Yes, the industry is continually changing, but it has been this way for decades and thankfully so because, as I mentioned earlier, the need for professional billing companies is greater than ever. However, you can’t continue doing business the way you have done it in the past. You must continue to grow and constantly strive to improve your company on all levels if you plan on being a player in the future. ■ Dave Jakielo is an international speaker, consultant, executive coach, and author and is president of Seminars & Consulting. Sign up for his free weekly success tips at www.Davespeaks.com or text “Davespeaks” to 22828. Dave can be reached via email, Dave@Davespeaks.com, or phone, 412-921-0976. By Dave Jakielo Y
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