• Practice Solutions

This Is When You Need a Billing Consultant



Main Points


  • You need a billing consultant when you start in private practice so you don't make simple mistakes

  • You need a billing consultant when you are looking to grow and don't know how your systems and processes will work

  • You need a billing consultant when you are in a situation that has gotten out of hand and you need complex issues resolved


There was a book by Calvin Miller entitled The Book of Seven Truths. This book is no longer in print, but it is a triple narrative and beautifully written. One of the truths states that you should only take advice from people that have gone down the path that you want to go down yourself.


That is the foundation for consulting.


Consulting exists you to get to a location quickly and without the pitfalls that you might experience if you did it yourself. When you go into private practice, you may be tempted to "bootstrap" everything and in a lot of ways that makes sense. However, when it comes to billing and managing your revenue cycle, you can't afford to make big mistakes, have bad processes, or let complex claims problems linger.


You need a billing consultant when you start in private practice so you don't make simple mistakes. The US healthcare system of privatized health insurance and medical billing is particularly difficult to navigate.


The system we currently exist in for healthcare is not exactly user-friendly for the patient or the healthcare provider. There are endless amounts of documents that you will encounter, rules for handling protected health information, electronic health records, etc.


Not only that, but you will be faced with regulatory changes that might impede or halt billing and revenue from third-party payers. You will be faced with navigating all of these factors.


Finding a mental health billing specialist and that can come alongside you, root for you, and help you not make some of those simple, but costly mistakes is an invaluable investment in your practice.


How is hiring a consultant an investment? I am just paying money to talk to someone...


That is a good point but look at the numbers. If you spend 50 hours setting up your billing systems and processes by bootstrapping, you will have spent $6,000.00 worth of time (if your fee is $120.00) setting up your billing systems and processes.


However, if you hire a consultant to talk you through the processes, you could spend 15 hours setting up your processes and procedures.


Remember, time is the one commodity that you can't get back and always run out of. Value your time above all else in the business.


You need a billing consultant when you are looking to grow and don't know how your systems and processes will work. Let's say you are the owner of a successful practice, but that practice is just you for the time being. You are looking to add other clinicians and grow your practice.


Up until now, you haven't had to worry about payroll or how billing will work with other clinicians. Likely you are coming from a community center where billing and payroll was handled separately and you didn't have to think about those variables.


But now you do!


Your billing consultant should be able to tell you the different models of operating a billing system. The benefit that any consultant brings to their clients is the ability to tell you how you are doing things compared to the rest of the practices in the country.


They will be able to offer you insight into how practices are operating and whether you are setting your billing processes to succeed or if you are setting up processes that aren't scalable in the long-run.


Before you grow your practice, ask your billing consultant some of the following questions:


  • How do you other practices do billing?

  • How do the economics of billing work when adding more clinicians?

  • How do other practice do payroll?

  • What are the issues that practices run into when they are scaling?

  • How do practice owners incentivize their clinicians to get their notes done on time?

Answers to these questions and more help you to grow in a way that will enable long term sustainable business practices.


You need a billing consultant when you are in a situation that has gotten out of hand and you need complex issues resolved. Let's say you have scaled up and things are chugging along.


Your systems are dialed in.


Your clinicians submit their notes on time day in and day out


You are getting paid regularly and in handsome amounts


Then everything goes wrong!


Out of nowhere, you have a claim situation that is complex and is causing cash flow problems. You aren't sure which way is up or down and you are not sure how to proceed with the project or what the path out of the wilderness is that will lead to reimbursement.


You need someone who is going to cut through the ambiguity quickly and resolve the claims issues for you. This is where a consultant is going to lead you through the path of least resistance and get you answers that you didn't have before.


It is important to know when to ask for help, even though you have likely done everything yourself up to this point. A billing consultant will help you with your claim denials and complex claims issues so that you can have the peace of mind necessary to run your business.


The bottom line is that you have options when it comes to starting, growing, or maintaining a practice!


Smart and successful business owners know when to rely on vendors or experts to help them with their problems.


If you read this blog and felt that any of those situations applied to you. Reach out to us and schedule a time to talk with one of our consultants! We want your practice to succeed and do well in the long-term!

© 2017 PRACTICE SOLUTIONS, LLC