Published - May 2009

By Dave Jakielo

Business as Unusual
If You're Not Moving Forward, You're Definitely Falling Behind

One thing is apparent: healthcare is about to undergo some of the biggest changes we have seen in decades. The new administration in Washington is making healthcare one of its top priorities and it’s more than just lip service.

The White House has signed an executive order formally creating the Office of Health Reform. The goal is to expand and improve health coverage in America. Responsibilities of the new office include:

  • Coordinating with all relevant executive branch agencies
  • Reaching out to state and local officials
  • Working with Congress to enact health reform legislation
  • Overseeing implementation of any eventual policy changes

Although we have heard for years that healthcare reform is a top priority, little real change has occurred on a national level. However, the perfect storm is now brewing—and it may lead to a multitude of changes affecting the entire healthcare delivery system.

Impact on the Billing Industry
The coming changes make it imperative that billing companies embrace a mind shift in how we run our day-to-day businesses. Here are a few issues that billing companies will face and will continue to face in the future:

  • Lower reimbursements and increased denials from third parties
  • Higher business operating costs
  • Major investments in technology relating to electronic health records
  • Employee retraining relating to coding, whether it be ICD-10 or 11
  • Management fee pressures from current and future clients

Our industry is in for more changes than we have seen in decades. While we can’t predict with any certainty exactly what will happen, we know that change is inevitable and that we must be prepared. As always, challenges bring not only problems to solve, but numerous opportunities. However, if you continue to operate your business in the same old fashion, you will probably see an erosion of your effectiveness and profitability in the new healthcare environment.

Proactive Strategies for Success
To remain successful your strategy must move from reactive to proactive. No longer can a billing company wait to see how the competition retools its businesses; sitting on the sidelines with a wait-and-see attitude and making plans to mirror what your competitors are doing is probably going to leave you in the dust.

Here are some proactive strategies you should institute immediately:

  • Research the marketplace and see what your clients and prospects are contemplating relating to the monies that will be made available from the stimulus package relating to electronic health records and electronic medical records.
  • Review your current account receivable follow-up policies that pertain to denials and rejections. Utilize denial management software to detect and stop any systematic rejections.
  • Automate everything possible.
  • Pay attention to current market rates that are being offered in new proposals. Some companies have leveraged offshore and automation to substantially reduce their operating cost and improve their efficiencies. These internal operational improvements are allowing firms to offer lower prices while delivering a quality service.

Lastly, an important tool that should be utilized to measure your success relating to client satisfaction is a survey. I recommend that you conduct a client satisfaction survey at least every six months. The survey can be conducted by phone, email, or snail mail based on your client’s preferences. Keep in mind the following guidelines when conducting any survey:

  • Make it short and concise. Limit it to five questions.
  • Make the rating scale 1-10. Everyone is familiar with that format.
  • Include the following after each question: “If you answer is less than a 10, what changes should we make to become a 10?”
  • Complacency is a word that should be stricken from every billing company’s vocabulary and mind set. Today if you do not embrace a proactive approach when it comes to improving your company, you may find yourself looking for a new career. Don’t fall into the trap of still doing day-to-day tasks that should be delegated to others in your firm. In times of change and uncertainty, company leaders have a special obligation. Their job is to work “on their business,” not “in their business.” Put on your leadership hat and take hold of the big picture. It’s time to move forward.

    Dave Jakielo, CHBME, is an international speaker, consultant, executive coach, and author and is president of Seminars & Consulting. Dave is past president of Healthcare Billing and Management Association and the National Speakers Association Pittsburgh Chapter. Sign up for his FREE weekly Success Tips at Dave can be reached via email; phone 412/921-0976.

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