Lead, Follow, or Turn Out the Lights By Dave Jakielo, CHBME was rereading a booklet written in 1988 by Pritchett and Pound entitled “Business as Unusual.” Its premise is how to survive in an ever-changing environment similar to our current medical billing marketplace. It is hard to believe that it was published over a quarter century ago, but could not be more relevant in light of what we are facing today. let’s take a look at the past, present, and future of our industry. in the past, billing companies enjoyed a high profit margin even if they weren’t very efficient. some of the characteristics of a typical company of days gone by were: • a stable, long-term client base • not much pressure to reduce management fees • low employee turnover and the flexibility to employ some slackers • claims that were paid upon their first submission • paper, paper, and more paper passed from workstation to workstation, date stamped, alphabetized, filed, and stored forever companies made money because there was so much fat in the system that even poorly run companies turned profits. Presently, billing companies are noticing that profits may be shrinking and margins are being squeezed due to lower reimbursements and higher operating costs. We face many issues today. • an ever-changing client base as acquisitions and mergers are prevalent in many medical practices • management fee pressures are prevailing as rates drop due to some companies’ increasing efficiencies • companies face moderate to high employee turnover depending on the economy in particular geographic regions • still putting up with people who don’t give 100 percent • a substantial increase in third party rejections, denials, and patient co-pays and deductibles • there is too much paper handling, which increases costs and hinders productivity companies are finding it more challenging to maintain the margins and profits they enjoyed only a decade ago. because of FROM THE road the ever-changing rules and regulations, we are also learning that it is unlikely to find someone who knows everything in the industry. so what lies ahead in the future? the billing industry won’t go away – there will always be a need for our services – but it will cease to be as we know it today. companies will be larger and there will be fewer of them. • you will need to prepare to work with larger clients. • the pressure to reduce fees has become the norm. • We will always need to find ways to do more with less. • your employees will expect job diversity. Plus, everyone will have to be highly productive. • the following will need to become second nature in your company: 270–271, 276–277, and patient portals. if you don’t know what i’m referring to, just do a google search. • you will need to adopt a totally paperless environment. only deal with the exceptions and allow technology to handle the bulk of the work. conservatively speaking, i predict that about 30 percent of the companies in business today will disappear. your company may be one of the fatalities unless you are always on the path of continuous improvement. this isn’t a prediction; rather, it is a calculated estimate based on what is going on around us. the key is to constantly examine each and every process in your firm and ask yourself the questions: • how can i eliminate this function, policy, or procedure? • how can do this function faster and cheaper? • What other revenue generating services should i be offering to my clients? in summary, we need to lead, meaning continually growing your businesses revenue 10 to 15 percent per year, or follow by merging with a company that has similar goals and objectives by becoming an employee. if you don’t do one or the other, then you will need to turn out the lights when your last client leaves. Dave Jakielo, CHBME, is an international speaker, consultant, executive coach, and author, and is the president of Seminars & Consulting. Sign up for his free weekly success tips at www.Davespeaks.com. Dave can be reached at Dave@Davespeaks.com or (412) 921-0976. I 54 hbma billing • may. june.2013
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