Are You Ready for the Coming Healthcare Changes in 2015?

healthcare changes

Change Is Coming to Healthcare! Are You Ready?

(Article Originally Published by – Dec/Jan issue)

The healthcare industry is facing a tidal wave of change: Obamacare, the implementation of ICD-10, Electronic Health Records, merges and acquisitions of physician practices, new HIPAA rules and regulations, and much more. This can be a challenging time for medical billing companies. Or, you can go with the flow and stand out in your market as the company of choice.

By staying on top of all the Healthcare Changes in 2015, you can bring hope and financial stability to struggling practices and salvage some practices that would otherwise fail and go out of business (or get acquired by a hospital or other large entity). What can you do to stay on top?

You must become a full-service revenue cycle management company. In today’s fluctuating market, billing companies that do not keep up with the changes that are coming will be left behind by companies that do. Start contacting and partnering with other companies that can provide services to your clients that help them solve their revenue cycle challenges. Go beyond just providing billing services. Offering a variety of services will position you as “the expert” in your area and experts always have business that can solve the revenue challenges of your clients.

Look through this magazine and you will find a number of vendors that can be valuable to you in assisting your clients with medical coding questions, HIPAA compliance, EHR meaningful use attestation, online document management, patient portals, integrated payment channels, patient collections and other revenue cycle issues.

Find a billing system that is fully integrated with an EHR system. Many outdated, server-based billing systems are trying to patch together a practice management system with one of the new Electronic Health Record systems designed by a different company or on a different platform. The company who developed the PM system patches together an interface with an EHR system developed by another company. This is just asking for trouble, trust me. My company tried that a few years back and it was a disaster for all our clients.

If this is the case with your PM system, you are only asking for headaches and a possible loss of clientele. EHR companies are going out of business every day. Some of them are also still server-based (software loads onto your local hard drive) and trying to get them to work together with billing software is a nightmare and will only lead to ongoing issues in your company. Two different companies, with two groups of programmers, trying to keep all the different parts of both systems running smoothly is almost impossible and will lead to chaos and confusion in your company and with your clients.

As painful as it may seem now, you must begin to look for a billing system that is totally integrated with an EHR system. That means that it was designed from the ground up by the same programmers in the same company. There are such systems available, and most of them are cloud-based (accessed securely 24/7 through a browser via the Internet).

Anything less than total integration of the two systems is a disaster waiting to happen. Start your research now and find a system that will take you into the future, at least with any new clients you bring on. And, as part of your due diligence, make sure there is a way to import the data from your current system into the new system (at least the patient demographics). Then, begin to educate your current clients on why they need to start using an EHR, if they are not already, and why they need to use a system that is fully integrated with your billing system.

Look for a system that has a way to tie in with insurance company databases. One that not only checks for eligibility but that automatically imports the patient data directly from the insurance company’s database and creates a new patient chart. This will save you hours of data input and will help you keep employee costs under control.

It will also keep you from submitting claims that are sure to be rejected because the patient was not eligible for the service. And, it will keep the practice from spending time seeing patients that they will never collect from their insurance company. This will increase your revenue for that practice and will eliminate a large number of claims rejections as well.

Stay on top of changes in the industry. Don’t get bogged down in the day-to-day details of your billing business and overlook what is happening in the industry. You need to set aside time, not only to attend industry conferences (at least once a year) but you need to subscribe to and read industry magazines, newsletters, and books. The person who does not read is no better off than the person who can’t read.

I can predict the success you are going to have in your business (and in life in general) if you will tell me just two things: the people you associate with and the books (magazines, newsletters, blogs) that you read. Set aside time each week to read about our industry and keep up with the changes that are coming almost weekly. Change is what life itself is based on, and if you are willing to change along with the industry, you will prosper and so will your clients.

You should not assume you will have your current clients forever. You won’t. Things change in medical practice: staff turnover, new policies and procedures, new government rules and regulations, competition, new technology, and the marketplace itself. All these things can cause you to lose a clients from time-to-time and you must always be tuned in to the latest marketing ideas.

Whether you realize it or not, your competition in this industry is not just other medical billing companies. The practice itself is your biggest competition. All it would take is for a new office manager to come into one of your practices and decide that they would rather not outsource their billing; she thinks they can do it themselves more efficiently and more economically. You must keep reselling your clients on your efficiency and on your cost savings and show them the advantages of using you rather than doing the billing themselves internally.

Provide them with revenue reports that show what percentage of billed dollars (expected) are actually being collected.

Show them you are the expert in this industry by producing and providing them a professional newsletter with articles that show that you keep up with the changes in the industry. You can find a ton of content for your newsletters at and other medical sites. Just be sure to link back to articles and most websites will thank you for sharing their information with your clients.

Take the practice administrator (or the doctor) to lunch on a regular basis and show them printed reports that illustrate the revenue collections you have helped them with from both insurance providers and patients.

Hold “Lunch ‘n Learns” on a regular basis with your clients to bring them up to date on what is happening in the medical industry and position you as the expert.

People want to do business with “the expert” in any field. When you buy a home, you don’t want the brand new real estate agent who’s just completed training; you want the guy or gal that has sold 100+ homes. When you look for a CPA, you don’t want one that just hung out his or her shingle. You want one that pays less than double digits in their own taxes and that has a number of clients they service.

The same is true of a doctor’s office. They want to feel that they are dealing with the company that can bring in every last dime that is due to the practice.

Continue to network with other business people in the community, join your local BNI group or Chamber of Commerce, and get out once a week and let people know you can solve the cash crunch for doctors and that you can help them build their business through your contacts.

Set up an automated way of keeping in touch with everyone you come in contact with that is a prospective client. Let them know that you are the only company/person they should do business with and when it comes time for them to decide to outsource their billing, you are the only choice that makes sense. People don’t buy when you are ready to sell. They buy when they are feeling the pain. Be at the top of their mind when they decide it is time for change.

Remind your current doctors and office administrators that you are looking to build your business. Assuming you have done a good job for them, ask them for a referral. You would be surprised as to how many billing company owners never ask their clients for a referral. And not just for the name of someone. Ask them to pick up the phone and call the other doctor or office administrator and tell them how pleased they are with your billing service and that they think it would be in their interest to meet with you.

You can shrivel up and die in this ever-changing industry. Or you can make the choice to grow and prosper, starting right now!

Patrick Phillips is the Founder and CEO of American Business Systems, the nation’s largest network of independent medical billing companies, and author of “Cash Crunch to Cash Flow: How to Get More Money Faster Into Your Professional Practice … And Plug the Hidden Leaks that Are Draining Profits,” available on

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