The Hungry Payer

If you give a pig a pancake... Everyone knowscompanies are created equal.
what happens in that children's book. The pigTraditional Billing
wants more, and more, and more. We don't haveThe term "billing company" describes precisely
to spell out the analogy. Insurance companieswhat traditional outsourced billing services do: they
have been taking pancakes from providers forbill. Their entire business model is wrapped around
years. Every year, they come back for more.entering charges into a billing system and filing the
Recently, Pacificare was found guilty of incorrectlyclaims on behalf of the provider. Fighting for claims
processing 30% of claims. Give an inch, take ais an afterthought. When the overworked billing
mile.company staff has time, they look through aging
Make no mistake, providers are locked in a powerreports and call on outstanding balances. Thus, a
struggle with insurance companies, who have thepractice that entrusts a traditional billing service
advantage in size, technology, people, andwith fighting for reimbursement very often
processes. It costs more today to fight forsuffers from lower collections than when they
proper reimbursement than ever before. And thewere fighting for reimbursement in-house.
payers are escalating the battle. Post-paymentFighting Services
audits, refund requests, underpayments, partialEnter the new breed of billing services: Claim
payments, late payments, and flat-out denialsFighting Services. Claim Fighting Services are built
proliferate and constantly knock practicesaround follow-up. Everything else supports that.
off-balance. They waste time, energy, and focus.Unlike billing services, fighting services are built
Recently, practices have asked: "Is it worth it?"from the ground-up to wage war for
"Why don't we just accept whatever they pay usreimbursement. First, they have dedicated staff
instead of fighting for what's ours?" On thefor follow-up. The follow-up staff has no other
surface, it seems plausible -- save a lot of money,job. They are the soldiers, and they are never
time, and energy on fighting a $10 "processingdistracted from their mission. They make up the
error". It costs more to fight for the $10. But thebulk of the fight services staff.
results can be disastrous. Giving up $10 today tellsNext, fighting services automate everything
the payer that we're content with the lowerpossible that distracts from the fight. Claim entry
reimbursement. The next step is to ask for more.is done at the provider's office. Errors are flagged
$10 turns into $15, $20, the entire payment.up-front and dealt with at the time of service.
Reimbursements drop lower and lower -- anClaim submission is fully automated.
endless spiral.Reimbursements are auto-posted where possible.
But that's not the worst part. Lack of action onNothing extra is added. Every feature is focused
certain denials may red-flag an office for a costlyon one thing: helping the fighting service fight for
audit. For example, if services are routinelyreimbursement.
submitted and denied pending medical records, andFighting services require accountability. Every biller
a practice refuses to send the records, the(read soldier) has a workbench -- a target list --
obvious conclusion is that the practice doesn'tthat tells them precisely which claims to work
have those records -- a nice juicy target for antoday. Managers oversee the process and make
audit.sure that workbenches are completed daily so
We know that appeasement is not a long-termclaims never wait more than necessary before
solution, especially when practiced with anbeing sent back to the payers. Accountability
adversary who is constantly looking for ways toworks both ways. A significant portion of claims
fatten the bottom line. The only solution is toneed provider input before the fight can continue.
fight. But how?Fighting services have a system to make
Outsourced Billingproviders accountable so that every claim is
Hiring staff to fight for claims and take action onworked, even if it needs provider input.
denials is not for everyone. Staff adds a fixedThe Long Road Ahead
overhead and needs constant management.Fighting services are not a panacea. They are only
Vacation days, sick days, health insurance -- allas effective as the providers that they represent.
take their toll on a small business. And thenThey form a partnership with the provider, in
there's the constant, nagging question: "Now that Iwhich the key ingredient on both sides is
have an effective biller, what happens if I losecommitment. Commitment to continually improve
them?"the process on both sides. Commitment to keep
Small practices often turn to outsourced billingopen the lines of communication between the
companies to fight for their money, entrusting theprovider and the service to prevent payers from
billing company to carry the fight for them,sowing the seeds of doubt. Most of all,
without distracting the practice from its primarycommitment to work together to surmount all
mission of serving patients. But not all billingobstacles and make the payers pay.