Kathryn Zug: Is your practice tired of wrestling with insurance denials, deciphering EOBs ⁓ and watching your revenue slip through the cracks? ⁓ You are not alone. ⁓ Welcome to The Claim Game, the podcast designed to cut through the confusion ⁓ and provide you with the best practices for revenue cycle management success. ⁓ We are Jeremy and Kathryn Zug and we've been with people just like you in the trenches. Each week, we'll break down complex billing processes, ⁓ share real-world solutions from practices like yours, ⁓ and ask questions of the game makers and changers of healthcare so you can take control of your revenue. ⁓ Let's turn those claim denials into deposits and help you return to focusing on patient care. ⁓ It's time to win The Claim Game.
Jeremy: Some of you know what I'm talking about when I say this, but you didn't build a practice or a business. You built an administrative job where you act as full-time admin, biller, scheduler, trash taker outer, coffee maker, etc. You essentially boxed yourself in when you built your practice to a J-O-B. and maybe you got big enough where you got a biller, and your biller or billers messages you about a denial and your office manager, or maybe that's you, stops in the hallway with an eligibility question, somebody needs a portal password again, et cetera. This is the claim game and let's dive into today's episode. I'm Jeremy Zug. I'm the CEO of Practice Solutions where we handle billing, billing training, revenue cycle management for solo and group practices across the country. Today's episode is about the most expensive employee in your practice and how to deal with the most expensive employee in your practice. And it's not your highest paid clinician, it's you. It's you every time you stop real work to answer a billing question, an admin question, that your team should already know the answer to, or they should have a document that they can reference, or they should have a learning module or they should have a notebook that they reference like Gemini notebook or something like that. Here's the plan for this episode. First, we're gonna talk about the hidden cost of being your team's knowledge base and help desk. Next we're gonna talk about why everything breaks when one key person leaves and third how to turn general admin staff into expert billers in 30 days. So first let's talk about the admin tax or the help desk tax. And I'm gonna give you some math here, but I want you to pick a normal Tuesday on your calendar. Right? Somebody asks how to post a split payment. That's 20 minutes. Somebody else asks whether a denial needs an appeal or a corrected claim. Another 15 minutes. Your office manager needs you to look at an aging report before she'll touch it. 30 minutes, right? Say that happens six times a day, 15 minutes apiece. That's an hour and a half of your day, seven and a half hours a week. And that's nearly a full workday every week spent answering questions that have the same answers as last Tuesday, three Tuesdays ago, six months ago, right? 30 hours a month from the person who's supposed to be running the business. And here's the part that nobody really prices into this conversation every time we have it. Every interruption breaks the work you were doing, the contract you were reviewing, the clinician you were recruiting, the decision that was supposed to move your practice forward. You know, that work doesn't get a second shift, right? And you didn't hire an internal biller. You really hired and paid for a subscription to interruptions. And that's no way to function. I promise it can be a lot better than that. So here's what happens when knowledge walks out the door. So imagine you find a 10 out of 10 biller, right? Somebody who has worked in the industry, around the industry, maybe they did a different kind of billing, and you were somehow able to recruit them into the practice and then they leave. Biller turnover sits around 25%. And let's say you're Biller left. Not a dramatic exit, but maybe just a better offer. Maybe they left to be a mom, maybe they moved. A hundred different scenarios. Do you know how your claims need to leave? Do you know the systems around billing? Who the keeper of the knowledge around how your claims get scrubbed? Who knows which payer needs the auth number in a specific field? Who has the portal logins, the workarounds, the unwritten rules that keep your practices cash flowing? If the answer is, well, this person is the keeper of the kingdom, and they're gone, and you don't have a system, you have a single point of failure that can negatively impact or reverse your cash flow in the life of your practice. This is what we call brain drain. One person holds all the knowledge. There's no checklist, there's no documented steps, there's no backup, there's no insurance policy. The day that she leaves, your revenue cycle doesn't just slow down. It stops. And it stops until you get a new hire in. And that new hire starts guessing and starts making moves. And then that slows you down even further. And we talked about this on the previous episode, but every denied claim, every issue is going to cost you $52 to rework. And you know, the Availity abrasion index was a Really well done study. And that number goes into labor, research, phone calls, resubmission. A new hire guessing through your payer rules manufactures denials at a speed that should frighten you and should cause you to think about what are we going to do if our biller leaves? Can this, or maybe even a better question, not a negative question, but a positive question. Can this role or these tasks be done no matter who's in the seat? That gives you the practice owner a ton more leverage and makes your business a lot more valuable. Standardized workflows survive turnover and tribal knowledge doesn't walk out the door, it just sticks around.
Jeremy Zug: We'll get right back to the podcast episode. But first let me ask you a question. Who is the highest paid insurance biller in your practice? If you're the one doing your billing, the answer is you. If you're the practice owner, and you're a clinician, you know the drill. You do the hard work, you deliver great services. And then there's this waiting game. There's billing after hours and on weekends and during birthday parties, or you go to the office for a quote unquote quick visit and then you look up at your clock and all of a sudden you've been there for three or four hours doing billing. Following up on claims is tedious and it creates a massive bottleneck for your cash flow. And that's exactly why Practice Solutions does billing for practices that take insurance. We take your practices billing completely off your plate. Our our team handles everything from Eligibility and benefits to charging cards, to posting payments, following up on denials. And we deal with insurance companies every single day so that you can focus on growing the practice. It's time to stop stressing over the billing and getting back to what you do best, which is running your business as best as you can. Head over to practicesol.com today to schedule your free consultation to see if our done for you billing services are right for you. All right, let's get back to today's episode.
Jeremy: So let's talk about how to turn your admin. Let's say you you don't have a biller, let's say you have a clinician or you have a friend who is an A plus, 10 out of 10, great competency. great chemistry, great character, but maybe struggles with billing competency. Here's what changes this equation. Your front desk already knows your clients and your providers and your payers, and maybe even knows somebody at the payer by name. Right. This is a person who is much closer to being a great biller than any resume on a job board, any stranger who's gonna walk in. What that person needs is a system. They need the six stages of billing in order from credentialing to patient registration, eligibility and benefits, payment posting, aging follow-up, and claim submission. If we were to give that person the diagnostic questions for each stage, give that person a step-by-step audit that she can run without you, give her a cadence, weekly coaching, real claims from your own AR, give you KPI dashboards that show you that billing is moving. Week one. Is that the six stages in your own denial math would be the first thing we would want to train her on. The second week is front-end stages from credentialing to patient registration and eligibility checks. And this is where denials are born. This is where you manufacture the bad stuff. So if we get whatever color dye we pour at the beginning of your revenue cycle is the color we get at the end when we go to follow up on claims. Week three, we would look at back end stages, payment posting, aging, where money is Found and collected. And then week four, submitting claims. 30 days, we would take a general admin and turn them into an expert biller. And when training ends, you need that person, regardless of if you do our internal biller training or if you do your own, that person needs support. If you do biller training with us, they get a year of support guaranteed. We would never let your billing fail. For the full year after training, your team can bring us complicated billing questions, weird denials, the payer edge cases, and the ones that used to land on your desk at 445 on a Friday, and they would go to us instead. You would stop being the help desk for good. And what is that really worth to you? Is that worth a full workday a week for a year? One more thing, because planning week, means looking at the full picture, right? Trained people run the system and data tells the system where the money is. We recently worked with a 45 provider practice that wanted a better look at its reimbursement under a Blue Cross Blue Shield plan in their market. We compared their rates with other practices and found that another practice nearby was getting $35 more per session than the same payer. Across their volume, it meant roughly a million dollars a year that they were missing out on. That's not a billing problem necessarily. That's a contract problem. And you can't negotiate a rate you don't know exists. Our rate reports through rate vantage show you what comparable practices in your city are getting for $250 for a single report and $750 for three reports. But that report only pays off if your team can run the revenue cycle management behind it. And that's the order this works. You train the people and then you measure the market. If you start with the people, I've put the whole training framework into our free guide, the Biller Training Blueprint. This is a 30-day path. It's six stages and one year support guarantee. You can also sign up for our internal billing training on our website at practicesol.com. You can get all that in the show notes below, or book a call with our team, and we would love to walk you through how to get the right person in your office the right training. I'm Jeremy Zug. We'll see you next time.
Jeremy Zug: If you enjoyed today's episode of The Claim Game, please take a moment to leave us a rating and review wherever you listen to your podcasts. It really helps new listeners to find us. Make sure you never miss an episode by subscribing to The Claim Game on your favorite podcast app. Your feedback means so much to us. We want to provide valuable education about revenue cycle management. So if there's something we didn't cover in our topic that was a burning question for you, Please let us know so we can try to get you the information you desire. You can find the links to all resources we mentioned in this episode in the show notes. And if you want to dive deeper into our resources, we have two places you can do that. First, you can go to our blog at practicesol.com forward slash blog where we have eight years of educational blogs. If you want to learn more about what practice solutions does, reach out. We'd love to hear from you. Just go to practicesol.com to learn more and to connect with one of our awesome people on our team. Thanks for listening. ⁓ We are Jeremy and Kathryn Zug and this is the Claim Game. ⁓ See you at the game table next time.
Jeremy: Some of you know what I'm talking about when I say this, but you didn't build a practice or a business. You built an administrative job where you act as full-time admin, biller, scheduler, trash taker outer, coffee maker, etc. You essentially boxed yourself in when you built your practice to a J-O-B. and maybe you got big enough where you got a biller, and your biller or billers messages you about a denial and your office manager, or maybe that's you, stops in the hallway with an eligibility question, somebody needs a portal password again, et cetera. This is the claim game and let's dive into today's episode. I'm Jeremy Zug. I'm the CEO of Practice Solutions where we handle billing, billing training, revenue cycle management for solo and group practices across the country. Today's episode is about the most expensive employee in your practice and how to deal with the most expensive employee in your practice. And it's not your highest paid clinician, it's you. It's you every time you stop real work to answer a billing question, an admin question, that your team should already know the answer to, or they should have a document that they can reference, or they should have a learning module or they should have a notebook that they reference like Gemini notebook or something like that. Here's the plan for this episode. First, we're gonna talk about the hidden cost of being your team's knowledge base and help desk. Next we're gonna talk about why everything breaks when one key person leaves and third how to turn general admin staff into expert billers in 30 days. So first let's talk about the admin tax or the help desk tax. And I'm gonna give you some math here, but I want you to pick a normal Tuesday on your calendar. Right? Somebody asks how to post a split payment. That's 20 minutes. Somebody else asks whether a denial needs an appeal or a corrected claim. Another 15 minutes. Your office manager needs you to look at an aging report before she'll touch it. 30 minutes, right? Say that happens six times a day, 15 minutes apiece. That's an hour and a half of your day, seven and a half hours a week. And that's nearly a full workday every week spent answering questions that have the same answers as last Tuesday, three Tuesdays ago, six months ago, right? 30 hours a month from the person who's supposed to be running the business. And here's the part that nobody really prices into this conversation every time we have it. Every interruption breaks the work you were doing, the contract you were reviewing, the clinician you were recruiting, the decision that was supposed to move your practice forward. You know, that work doesn't get a second shift, right? And you didn't hire an internal biller. You really hired and paid for a subscription to interruptions. And that's no way to function. I promise it can be a lot better than that. So here's what happens when knowledge walks out the door. So imagine you find a 10 out of 10 biller, right? Somebody who has worked in the industry, around the industry, maybe they did a different kind of billing, and you were somehow able to recruit them into the practice and then they leave. Biller turnover sits around 25%. And let's say you're Biller left. Not a dramatic exit, but maybe just a better offer. Maybe they left to be a mom, maybe they moved. A hundred different scenarios. Do you know how your claims need to leave? Do you know the systems around billing? Who the keeper of the knowledge around how your claims get scrubbed? Who knows which payer needs the auth number in a specific field? Who has the portal logins, the workarounds, the unwritten rules that keep your practices cash flowing? If the answer is, well, this person is the keeper of the kingdom, and they're gone, and you don't have a system, you have a single point of failure that can negatively impact or reverse your cash flow in the life of your practice. This is what we call brain drain. One person holds all the knowledge. There's no checklist, there's no documented steps, there's no backup, there's no insurance policy. The day that she leaves, your revenue cycle doesn't just slow down. It stops. And it stops until you get a new hire in. And that new hire starts guessing and starts making moves. And then that slows you down even further. And we talked about this on the previous episode, but every denied claim, every issue is going to cost you $52 to rework. And you know, the Availity abrasion index was a Really well done study. And that number goes into labor, research, phone calls, resubmission. A new hire guessing through your payer rules manufactures denials at a speed that should frighten you and should cause you to think about what are we going to do if our biller leaves? Can this, or maybe even a better question, not a negative question, but a positive question. Can this role or these tasks be done no matter who's in the seat? That gives you the practice owner a ton more leverage and makes your business a lot more valuable. Standardized workflows survive turnover and tribal knowledge doesn't walk out the door, it just sticks around.
Jeremy Zug: We'll get right back to the podcast episode. But first let me ask you a question. Who is the highest paid insurance biller in your practice? If you're the one doing your billing, the answer is you. If you're the practice owner, and you're a clinician, you know the drill. You do the hard work, you deliver great services. And then there's this waiting game. There's billing after hours and on weekends and during birthday parties, or you go to the office for a quote unquote quick visit and then you look up at your clock and all of a sudden you've been there for three or four hours doing billing. Following up on claims is tedious and it creates a massive bottleneck for your cash flow. And that's exactly why Practice Solutions does billing for practices that take insurance. We take your practices billing completely off your plate. Our our team handles everything from Eligibility and benefits to charging cards, to posting payments, following up on denials. And we deal with insurance companies every single day so that you can focus on growing the practice. It's time to stop stressing over the billing and getting back to what you do best, which is running your business as best as you can. Head over to practicesol.com today to schedule your free consultation to see if our done for you billing services are right for you. All right, let's get back to today's episode.
Jeremy: So let's talk about how to turn your admin. Let's say you you don't have a biller, let's say you have a clinician or you have a friend who is an A plus, 10 out of 10, great competency. great chemistry, great character, but maybe struggles with billing competency. Here's what changes this equation. Your front desk already knows your clients and your providers and your payers, and maybe even knows somebody at the payer by name. Right. This is a person who is much closer to being a great biller than any resume on a job board, any stranger who's gonna walk in. What that person needs is a system. They need the six stages of billing in order from credentialing to patient registration, eligibility and benefits, payment posting, aging follow-up, and claim submission. If we were to give that person the diagnostic questions for each stage, give that person a step-by-step audit that she can run without you, give her a cadence, weekly coaching, real claims from your own AR, give you KPI dashboards that show you that billing is moving. Week one. Is that the six stages in your own denial math would be the first thing we would want to train her on. The second week is front-end stages from credentialing to patient registration and eligibility checks. And this is where denials are born. This is where you manufacture the bad stuff. So if we get whatever color dye we pour at the beginning of your revenue cycle is the color we get at the end when we go to follow up on claims. Week three, we would look at back end stages, payment posting, aging, where money is Found and collected. And then week four, submitting claims. 30 days, we would take a general admin and turn them into an expert biller. And when training ends, you need that person, regardless of if you do our internal biller training or if you do your own, that person needs support. If you do biller training with us, they get a year of support guaranteed. We would never let your billing fail. For the full year after training, your team can bring us complicated billing questions, weird denials, the payer edge cases, and the ones that used to land on your desk at 445 on a Friday, and they would go to us instead. You would stop being the help desk for good. And what is that really worth to you? Is that worth a full workday a week for a year? One more thing, because planning week, means looking at the full picture, right? Trained people run the system and data tells the system where the money is. We recently worked with a 45 provider practice that wanted a better look at its reimbursement under a Blue Cross Blue Shield plan in their market. We compared their rates with other practices and found that another practice nearby was getting $35 more per session than the same payer. Across their volume, it meant roughly a million dollars a year that they were missing out on. That's not a billing problem necessarily. That's a contract problem. And you can't negotiate a rate you don't know exists. Our rate reports through rate vantage show you what comparable practices in your city are getting for $250 for a single report and $750 for three reports. But that report only pays off if your team can run the revenue cycle management behind it. And that's the order this works. You train the people and then you measure the market. If you start with the people, I've put the whole training framework into our free guide, the Biller Training Blueprint. This is a 30-day path. It's six stages and one year support guarantee. You can also sign up for our internal billing training on our website at practicesol.com. You can get all that in the show notes below, or book a call with our team, and we would love to walk you through how to get the right person in your office the right training. I'm Jeremy Zug. We'll see you next time.
Jeremy Zug: If you enjoyed today's episode of The Claim Game, please take a moment to leave us a rating and review wherever you listen to your podcasts. It really helps new listeners to find us. Make sure you never miss an episode by subscribing to The Claim Game on your favorite podcast app. Your feedback means so much to us. We want to provide valuable education about revenue cycle management. So if there's something we didn't cover in our topic that was a burning question for you, Please let us know so we can try to get you the information you desire. You can find the links to all resources we mentioned in this episode in the show notes. And if you want to dive deeper into our resources, we have two places you can do that. First, you can go to our blog at practicesol.com forward slash blog where we have eight years of educational blogs. If you want to learn more about what practice solutions does, reach out. We'd love to hear from you. Just go to practicesol.com to learn more and to connect with one of our awesome people on our team. Thanks for listening. ⁓ We are Jeremy and Kathryn Zug and this is the Claim Game. ⁓ See you at the game table next time.
