Welcome to a brand new year. It looks like it is stacking up to be very interesting— and possibly one of the most challenging for the medical billing industry. There is an overabundance of issues facing us in 2010 and beyond and we need to develop a strategy to ensure we continue on the pathway of success.

Find Quality Staff
When I talk with managers across the nation, one of the biggest issues they convey to me is the challenge of recruiting and retaining quality staff members. You would think with a national unemployment rate in excess of 10 percent that it would not be hard to find excellent employees. But not everyone out there is qualified. It is imperative to make sure you invest time in the recruiting and interview process.

While there is no foolproof way to ensure you have made a smart hiring decision, here are two tools that can help your odds:

• Administer a profile assessment (available on the web) to see if the person will fit into your companies culture.
• If you are hiring for an accounts receivable position, test the applicant to determine his or her level of knowledge and if additional training will be required. Ten years of experience doesn’t ensure that someone knows what he or she is doing.

Catch the Insurance Curve Ball
Every company must also be prepared for what the insurance companies are throwing at us to try to hinder the claims adjudication process. Some examples are:

• Additional services requiring pre-authorization
• The growth in non covered services
• Possibility of bundling payments back in with the hospital’s payment
• "Non Negotiable" insurance payments
• The never ending quest for additional documentation

Given these trends it’s important to make sure you have a sound self-pay collection policy and professionals working in your accounts receivable department. Keep in mind that today we must work with the insurers rather than against them because they are the ones controlling our clients’ reimbursement.

Beware the Recovery Audit Contractors
If Paul Revere were still here, he’d probably saddle up his horse and gallop through the street shouting the “RACs are coming! The RACs are coming!” Yes, the recovery audit contractors are revving up for an all-out attack on the “evil practitioners” that are miscoding, over utilizing, and just down right abusing the Medicare system. Be warned.

Take Positive Steps
If the above has totally depressed you, don’t fret; all is not lost. As we’ve said before, challenges create a plethora of opportunities. We know that the healthcare delivery system will not become less complex— just different— so don’t put you head in the sand and hope that this too shall pass. Force yourself to maintain a positive mental attitude. Positive people live in the future and are solution oriented; pessimistic people live in the past and make excuses.

Here are some hints that can help you acquire and maintain a positive attitude:

• Become a continuous learner. Load you IPod with educational materials and listen while driving or exercising. Annually you should invest about three percent of your net income into your personal development. It’s amazing how acquiring knowledge in relation to a subject reduces your apprehension about it.
• Block you calendar for “Thinking Time.” Yes, make an appointment to spend time just thinking. Write a problem on the top of a blank sheet of paper and as solutions come to mind write them down. To make this exercise effective you should spend your thinking time in one of your favorite places. Mine is on a Saturday morning with a pot of coffee before anyone else in the house is out of bed.
• Lastly, avoid “Crackberry” disease. There is no written rule that states that we have to be connected to one another 24 hours a day 7 days a week. It’s OK to turn off your phone, portable email, and texting device and spend time on other priorities, such as your family.

We know that the healthcare environment will be ever evolving; it must because the Medicare rolls will increase by nearly 50 percent in the next 15 years and things can’t remain status quo. So you have three choices regarding your future: 1) you can make things happen, 2) you can watch things happen, or 3) you can sit back and wonder what happened.

The choice is yours.

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 www.Davespeaks.com. Dave can be reached via email Dave@Davespeaks.com; phone 412-921-0976.