Medical billing and revenue cycle management
Hiring a biller is the obvious move when volume grows. It is sometimes the right one. Here is the arithmetic most practices do not finish before they decide.
Twenty minutes. If the numbers say hire, we will tell you that.
Add up the real cost of the hire: salary, payroll taxes and benefits, PTO coverage, software seats, training time in the first ninety days, and what it costs you the month they give notice. Then take your monthly collections and multiply by the percentage you have been quoted. Compare annual to annual.
The basics, since you will check anyway
Each one leaves your reports looking healthy.
The visit happened and the note exists. The charge was never built, so nothing was submitted and nothing came back denied.
The claim went out correctly and came back paid, at a level below what the documentation supports.
The payer's own fee schedule says one number and the remittance says another. Nobody reconciles the two.
A client kept running long on follow-up visits. The schedule said one thing, the claim numbers said another, and the two never lined up. Our team asked about the gap.
The practice had been providing a service they did not know was covered. It was documented in the notes every time. It had never been submitted. We filed retroactively and it kept paying going forward. The level of care they wanted to provide stopped being a time cost, and growth became an option.
Step one
You check it yourself. The self-check above takes one report and about ten minutes. You do not need us for that part and you do not have to tell us what you found.
Step two
Twenty minutes on the phone. You tell us what you found and what you run on. We tell you what we would expect to find underneath it and what it takes to fix.
Step three
If you move, payer contract renegotiation is part of onboarding, at no separate fee. Rates set back when the practice was smaller are usually the second thing we find.
The comparison most practices run is salary against percentage, and it is wrong in both directions. It leaves out the true cost of a hire and it leaves out what the percentage buys.
What does the hire cost with payroll taxes, benefits, PTO coverage and software seats included?
What do the first ninety days cost you while they learn your payers?
What happens to collections the month they give notice?
What are your monthly collections multiplied by the rate you have been quoted?
Who reviews the biller's work, and when did they last do it?
Do you have the volume to justify two billers and a supervisor?
Finish all six before you decide. If the numbers say hire, hire, and hire when you have the volume for two billers and a supervisor. Below that, one person is a single point of failure, a capacity ceiling, and nobody checking their work, all at once.