Published - October 2001

By Dave Jakielo


Today, as I was having a telephone conversation with an investment banker who monitors the billing industry, he called to ask me the question, "What has changed in the Billing Industry over the past few years?"

Before I responded, I asked him what his thoughts were relating to the industry based upon his research. At first I found his responses humorous, then it dawned on me that he has the same perceptions that I hear echoed by many of our clients and prospects and it isn't funny. Below, I've listed a few of his observations.

He stated that due to all the advances in technology billing cost must be dropping dramatically and our cost of doing business must be less today than yesterday.

Given the slow down in the economy, it is easier to find qualified employees.

Due to mergers in the insurance industry, claims are easier to file and are usually paid on a timely basis.

Physicians realize the value of a quality billing service and are willing to pay a higher fee for that quality.

Most physicians understand that due to the complexity of billing they realize they cannot do it themselves and require the expertise of a billing company.

Well my fellow "Billers" I'm sure that you have found all of the above to be true. I'm sure most are finding billing so easy you probably sit around trying to come up with ideas of how to fill your time and how to spend all that extra money.

Seriously, my intention isn't to take a shot at the investor I spoke to. My intent is to bring to light that the industry be it investors, physicians or hospitals, just doesn't get it. Billing is more complex today than it was yesterday.

However, we must be aware of the perception many have relating to our industry, because "Perception is Everything."

After the conversation I started reflecting on what I have encountered since accepting a new assignment as Chief Operating Officer for a billing company that specializes in Practice Management and Billing Services for Emergency Physicians. They are as follows:

Technology is making great strides in many industries but not the billing industry. Many of us are scrambling to find the "least worst" alternative in billing software. National software vendors are not doing anything to develop or enhance their products to assist with the challenges of the billing industry. Their systems are develop for either large academic institutions, zillions of dollars, or individual "small to medium" sized practices.

Even though the economy may be floundering in certain pockets of the country, the trickle down effect hasn't freed up personnel that are experienced in the billing industry. Recruitment is still a challenge.

Insurance Companies may have encountered merger mania but did anything improve? My findings in 2001 have been that more claims are being denied incorrectly, claims are paid at the wrong reimbursement rates or worse yet we never hear anything on approximately 15 percent of the claims we file. The number one payer category today seems to be "We never received your claim."

Certain clients do not realize that billing companies revenues are declining while expense are continuing to rise, or if they do realize, they consider the rising cost and shrinking margins to be our problem not a problem they need to help address. Sometimes it boils down to the fact that they understand you may have challenges as a billing company and that they "feel your pain," however they respond as follows: I WON'T ACCEPT A RATE INSCREASE AND BY THE WAY DON'T LET MY MONTHLY DEPOSIT AMOUNT DECLINE.

We know that the complexity of this business grows exponentially every day but some physicians fail to comprehend the complexities. Their expenses maybe rising as fast or faster than ours e.g. malpractice, so they are looking for way to reduce their cost and we are probably their largest expense after their payroll. This leads them to ponder the question, "can I do it less expensively by taking my billing in house?" What many of them soon find out if they take that drastic step is "Net dollars" in the bank, immediately decline and very rarely recover to the previous levels. Why that occurs is a topic for a future article.

What it all boils down to is that "Perception is Reality," and after all these decades in the billing industry, people just don't get it. Please don't get discourage and never give up the fight. Continue to strive to provide the best quality and professional service possible. And someday we'll all overcome the obstacle of "your just another billing service."

Keep in mind I'll be happy to address any issue of importance to you. So keep your questions and suggestions coming. Send inquires to any of the following. David Jakielo, Seminars, Training & Consulting, 86 Hall Ave. Pittsburgh PA 15205., 412-921-0976 or visit my web page at

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