• Practice Solutions

3 Things To Do When Your Biller Leaves



Main Points


  • Keep calm

  • Take over the billing and credentialing until you can find a replacement or a stand-in option

  • Make a plan and execute the plan

Mental and behavioral billing can be difficult enough, but it is nerve-racking when your biller or billing service leaves abruptly. Thinking about this scenario in terms of any other staff turnover can be helpful, but the event is still just as scary.


There are very actionable steps that you can take to make sure that your revenue doesn't stop flowing and there are steps that you can take that can ease the nerves throughout this process.


It is very important, especially if you are the owner of a group practice, to make sure that you are steady and show good leadership throughout this process. No, you may not know billing, but you have started a business which means that you are smart and capable to handle a variety of bumps in the road.


Keep calm!


You receive that email or phone call that makes your stomach churn. Your biller is leaving, your billing service is shutting down, or your billing service is terminating your contract.


The terror that you might feel can hardly be overstated!


It is perfectly normal to feel those feelings. However, you are going to have to bring yourself back into your brain and start to work. The first step in making sure that your billing goes through is to keep calm.


Once you know that you are without a biller or billing service, take a moment to panic! Go for a walk around the block, get coffee, scream, go for a run, and do whatever you have to to make sure that the next part is handled well!


Once you are in a good headspace, you are going to want to sit down and critically think through billing and what is involved. Here is a list of domains of billing and questions you should be asking yourself:


Payment Posting

How was my biller posting payments?


Was there an insurance payer that has an online portal?


Do I have all the logins to insurance that I need?


How do I get access to payment records?


How are payment records stored?


Claim Follow-Up

When we receive a denial, how is that documented?


Can I see where our follow-up activities have taken place?


How do track rejections and patient information?


Eligibility and Benefits

When we get a new patient, how are benefits checked?


How do we make sure that deductibles are updated?


Do we collect patient cards or not?


Claim Submission

How are claims submitted?


Do I have everything I need to make sure that claims are submitted?


Can I track where claims are in the process of paying?


By sitting down and making a list, starting with these questions, you are able to create a much better environment for succeeding through this exciting time.


Take over the billing and credentialing until you can find a replacement or a stand-in option. You may or may not know how to do billing, but to make sure that it is getting done it may be necessary that you take over the billing in the meantime if you don't have a stop-gap measure.


If you know how to do the billing, then this piece won't be as challenging, but for those of you that don't know how to do billing follow these steps to make sure you are ready to take over the billing.


  1. Don't panic! You can do this.

  2. Make time in your schedule and don't no-show on yourself

  3. Document everything and make sure you have access to everything

  4. Allow twice as much time as you think it will take you to make sure you have ample room to do the billing well

  5. Write down the process of how you are doing everything. You can use those notes later to create a billing manual for if this situation ever comes up again

  6. While you aren't doing the billing start creating a plan for how you are going to get out of the billing!


Once you are familiar with the billing piece of the pie, then it is time to start looking at other solutions for the billing long-term. This process is called vendor selection.


Usually, in the vendor selection process you will look at a broad cross-section of options to make sure you have the right solution for your practice.


Typically, this involves looking at the following options:


  • Price

  • Service frequency

  • What you get out of the service

  • What your patients get out of the service

  • Accessibility to your service provider


Among other variables, these are the most important. At this point, you may be a little gun-shy to give up control of one of the most important facets of the business. However, you can ask colleagues and other trusted professionals who they would recommend doing this side of the business.


It is important as the owner of a business to be working on your business and not necessarily in your business.


Make a plan and execute the plan. With any jarring change, you will need to make a plan and execute the plan.


Remember, bumps in business happen, but there is nothing that you will go through in a business that someone else hasn't gone through themselves.


There are plenty of strategies for risk mitigation that you will want to look at to make sure you are covering the most vulnerable parts of your business and develop plans in case the worst happens.


In this scenario, the worst has already occurred and you need to focus on containment.


Make sure that if patients are impacted that you start with their experience. You don't want your patients to even know that something has happened. You will succeed through this process if they don't feel any sort of change.


If your patients know this has happened, you are doing something wrong.


Then you will want to make sure that you are coving the day to day work AND working on a plan for the long term.


In conclusion, don't worry or panic about a big change, even if you didn't see it coming.


It is important that you keep your head through this time, and if you think about this kind of personnel turnover, if this person didn't give you reasonable notice then you wouldn't want them on your staff anyway.


Remember, when you hire a company or person looking for the three "C"s:


Character


Competency


Chemistry


If you are in this situation and want to talk to a consultant about how to handle this well, reach out to us via email at info@practicesol.com.

© 2017 PRACTICE SOLUTIONS, LLC