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(K)notes

​Why is it so Hard to Build Effective Billing Teams?

Even with smart, experienced employees, building effective medical billing teams is hard.  No one knows everything, and even if they did today, it would all change tomorrow.  On top of that, building the collective expertise required of a truly successful team is really tough.  But why?

1. You don’t know what you don’t know.

Medical billing is a craft, and like any craft, it requires constant learning.  Many suppliers are understaffed. Meeting immediate demands consumes all day, every day. The result is that billing departments are relying on obsolete knowledge because they simply have not had the time to think about it. 

Sound familiar?

• “I didn’t know the CMN I got back was not compliant.”
• “The prior authorization requirements changed … and we didn’t.”
• “We got killed on an audit because we didn’t know the detailed written order elements changed.”
•  “We kept billing for PAP supplies because we didn’t know Medicare does not pay for replacements during a failed trial.”
• “We didn’t know the advantage plan required us to use Medicare modifiers.  They always paid in the past.”
• “We didn’t know there are two ways to score sleep studies and Medicare doesn’t recognize the scores we used.”

Unfortunately, you don’t know what you don’t know.

2. Asking questions is intimidating.

Consider this common scenario. An employee spends three hours researching a billing problem.  It is not a particularly complicated billing problem, but it is an ambiguous one in which she has to determine why a particular payer is unprofitable.

After hours of research and phone calls, she figures it out and devises a pretty slick workaround to improve the collection rate.  As soon as she declares her solution, a co-worker across the hall pipes up “I had the same problem last month and figured out the same thing.  If only you had asked, I could have saved you a ton of time!”

Wasting that much time on an already-solved problem is very painful in this line of work. Why didn’t a clearly capable person with good co-worker relationships ask around before she dove in and wasted three hours?

Medical billers operate in a figure-it-out-as-we-go culture. Can-do attitude is expected, or perhaps it never occurred to our protagonist to ask around first. More often, though, expertise is concentrated in a single manager or peer. When that person is very busy or subconsciously signaling an unwillingness to help, asking questions is intimidating.

3. Time is a precious commodity and getting answers takes time.

Duh? Right?  Who has an overabundance of free time during their work day?  Time to go to lunch?  Time for a legitimate sick day? Stay ahead of current events? Please! It is hard enough just getting through the day.  Yes, time is scarce, but bewilderment is expensive!

(K)notes Can Help

At MiraVista, our team spends a lot of time researching DME reimbursement policy.  We schmooze with authorities, suppliers, and industry insiders so we can better navigate the medical billing landscape. We want to maximize cash flows and reduce recoupment risk with as small a billing team as possible.  Increase revenue and reduce expenses, as it were.

(K)notes, pronounced notes because the K is silent (like in knowledge), is how we share our work so other billing teams can concentrate on getting the best collection rates with the least amount of effort.

The basic (K)notes subscription is designed to solve that first problem above: knowing what you don’t know.  We break down the complex rules and curate important developments.  We deliver those insights in plain-English for the whole DME staff.

Take the 2020 End Stage Renal Disease/Durable Medical Equipment Rule for example.  We dissected that 162-page beast as you can see in the excerpted page below:

You can do that, too … assuming time is plentiful (see problem three above)!  Or, you can attend a (K)notes webinar and get the relevant insights in about an hour.  Have specific questions? Ask us during the live Q&A that is part of every (K)notes event.

An annual (K)notes subscription includes:

• Attendance to six bi-monthly webinars, each with a live Q&A session.
• Digital recording of each bi-monthly webinar to review or share with co-workers that couldn’t attend the live event.
• Six issues of the (K)notes publication.

If you want to know what you don’t know, subscribe here.

Try (K)notes

If you want to try us out, consider attending our next event.  You can register for a single event here.