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Great Customer Service Is About Processes and People


HBMA Billing

Read more from the latest issue of Billing.

Every business owner wants to be successful and grow. And when it comes to building up your business, your customers are one of your most valuable assets. Keeping them satisfied is critical to your bottom line. It is also critical to recruiting new customers. Word of mouth is how many practices find new vendors, whether that is a personal recommendation from a friend, through online reviews of your business, or by asking for recommendations from members of a professional organization.

In addition to being the foundation of your financial success, happy customers are more likely to support you by testing or providing feedback on new products or services so you can fine-tune your offerings. They are also more likely to purchase those new services from you, helping your business to thrive.

Your billing company can't really afford to have customers leaving because they are unhappy. And you certainly can't afford to have customers generating bad online reviews, which they are more likely to do today than ever before. One unhappy customer can do long-term damage in today's digital world.

So how can you ensure that your customers have the best possible experience at every stage of their relationship with you? And how can you turn those happy customers into your very best advocates?

It really all comes down to processes and attitudes. And processes are the lynchpin. It is a lot easier to be warm, friendly, patient, and responsive when there are clear processes for everything and everyone knows what is expected of them.

Certainly, look to hire people with the right attitude and personality to fit with your organization and support your customers. Look for candidates with great customer service and billing skills. Provide support for them when a customer is being difficult and let them know when it is ok to move that customer up to the next level of command. But ultimately, the best thing you can do is back them up with a solid plan and process for every interaction they have with your customers from the first sales call to the everyday phone call with a question. Here are some suggestions on how to do that.

Sales and Onboarding

It is true that first impressions matter. There is some research out there on selling that suggests that today most people are already about 70 percent of the way through their buying process by the time they actually reach out to you. This means that they have already done a lot of research on you. They have likely narrowed their search down to their top two or three choices at this point. By now they are looking for fit and experience. How you interact with them in that first one or two phone calls is critical.

Think about this as your opportunity to shine. Be prepared. Gather as much background as you can so it's clear you know who you are talking to. For example, check out their website and online listings. Get to know something about the area and who the biggest payors and employers are. Show that you took some time to prepare and you aren't going into the first call cold. If someone gets you by phone on the fly, let them know you are eager to talk to them but can't speak at length right now and offer them a call back to discuss. Make sure it is within a day or two, but better to be prepared than to flail because it is a specialty you aren't as familiar with.

Be prepared for questions. You should have some kind of playbook that has answers to all the questions potential customers have asked. It might also include testimonials from customers or even a list of customers who offered to provide references for you. It might include key points about different specialties or aspects of billing and how you handle them with some key data about your success. For example, if you commonly have your customer's A/R over 90 days at 10 percent or less, be sure to highlight that. Or if you have a paperless process for workers' compensation claims, mention that. You should have all these things and more at the ready.

Once someone chooses your company, you should also have a very solid process for how you bring them on board. In the case of medical billing, since so much depends on the practice, consider having a checklist that your team and the customer work from that clearly lays out what each is responsible for. Have regular calls to check on the status of those items. Make sure the customer knows what is expected of them, both in writing and in early phone calls. This can help provide a smoother onboarding experience and reduce potential conflict down the road if there is a problem.

Other things to consider are offering some value-added services when new customers come on. This could be services provided at no or a discounted cost. These options might help get the customer to sign on with you, but they also can benefit both you and the customers in the long run by improving the onboarding experience and possibly the billing process.

For example, Greg Morrice, vice president at Advanced Medical Solutions (AMS), says that they often offer low-cost credentialing to potential customers. According to him, it is worth the work even at the low return because "it has such a big impact on the billing process." It is one way they can be sure the practice and AMS get paid correctly. "We really think of it more as part of our onboarding," he adds.

Morrice also sees offering consulting on IT and electronic health records (EHR) in much the same way. "We help them figure out what technology they need and how to set it up," he explains. "We train them and support them through that process." He believes it impacts the billing process and getting paid correctly so it is worth it to offer services like this for little or no cost.

Offering these add-on services at little or no cost helps improve everyone's bottom line while also improving the customer experience. The expense can be recouped in no time because of improved billing and hopefully customer referrals.


Ongoing Technology and Processes

As Morrice mentioned, technology can play an important role in billing success. Your billing company shouldn't be just a billing company to your clients. It should be a practice partner. The technology practices used can have a big impact on billing accuracy and getting paid. So it is important to talk about what solutions they already use and what you recommend.

It's up to you whether or not you require customers to use certain products, but there are certainly benefits to having them use an EHR or electronic charge capture. Some billing companies even offer incentives. In a recent interview during a webinar, Rick Kaufman, the owner of Billing Advantage, said that they do offer some incentives to get customers to use an EHR because the electronic superbill does save time and improve accuracy.

Whether customers use an EHR or not, you should have a well thought out process for how you handle each type of account. It should include things like when you expect to get the superbill and when you will submit it. You also need to have clear processes for things like how quickly you will address rejections and denials.

Many successful billing companies also have a set of key performance indicators that they work to. Ami Tucker, director of revenue cycle management at Healthcare Management Systems (HCMS), says, "We use MGMA standards as our benchmark, and we monitor how each account manager is doing in meeting those metrics." For example, if the MGMA best practice for average days in A/R for a specialty is 35, HCMS looks to exceed that. When a potential customer comes to them about their services, they walk through the metrics they achieve for their customers. They monitor each customer's account closely to ensure those metrics are being met.

The best customer service experience is the one that meets expectations. By setting clear goals with customers, and then meeting them, you can see the highest levels of satisfaction and generate referrals. "Almost all of our customers come to us through customer referrals," explains Kris Tucker, the CEO at HCMS. "When the potential customer reaches out to us we are able to show them how we compare to the MGMA benchmarks, and show them the quality of our service," adds Tucker.

The team at Billing Advantage has a similar approach. "To ensure a quality experience for our practices, we have some metrics we use to monitor and goal set for our staff," explains Kathi Crook, the chief operating officer. "These include: only 10 percent of A/R over 60 days, which we watch pretty closely to look for trends that signal a problem; all claims out within 48 hours; and denials worked within seven days from receiving the ERA/EOB."

These goals help ensure the same quality experience for every customer. In addition, they always respond to inquiries within two hours. "We get back to the customer quickly even if it is just to say, 'we have to call you back again later,'" says Crook. "We work hard to provide a positive experience, and it seems to be working. We don't lose customers because they are unhappy, and we get a lot of referrals from our current practices."

Going the Extra Mile

If you thought that what these successful billing companies are already doing seems like a lot, you'd be wrong. They see all of these processes as part of the great everyday experience they give their customers.

They do go above and beyond, however. Many offer additional consulting services to add more value and look for ways to increase revenue. AMS recently started offering some consulting around government incentive programs. "This is a newer area for us," says Morrice. "We are trying to help our practices understand and participate in programs like MU and PQRS that can impact their revenue."

According to Tucker, HCMS is always "actively looking at and evaluating customers' success and seeking out new revenue opportunities for them." They make recommendations to practices based on what they see.

Helping practices understand the complexities of medical billing along with programs that can improve their bottom line can only bolster their satisfaction. Taking this elevated approach to customer service is paying off for AMS, HCMS, and Billing Advantage. All three companies say that the majority of their new customers come from referrals from existing customers and that they rarely lose a customer because they are unhappy with their service and performance.

To achieve the same success, remember that it isn't enough to create processes or metrics to work toward. You have to follow through. If you say you will always respond within 24 hours or that you will work to keep denials under 4 percent, you have to deliver. Keeping a smile on your face also helps. But it's the end result delivered with a smile that really leads to referrals from your happy customers.


Paul Bernard, MBA, is director of strategy and analytics for Kareo. Bernard joined Kareo after selling his revenue cycle management firm, Broadleaf Health, to Kareo in 2014. Broadleaf, which grew two and half times in six years under Bernard's leadership, delivered industry leading revenue cycle performance to a wide range of specialties through the use of technology, workflow, and process improvements along with advanced payment and reimbursement analytics.

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