Medical Billing Forum

General Category => General Questions => : tallmanusa January 16, 2013, 09:44:07 AM

: Telemarketing and Appointment Setting
: tallmanusa January 16, 2013, 09:44:07 AM
We plan to use offshore telemarketing companies to set appointments for $30 per appointment. Our rep would then visit the doctor. We plan to use the telephone script from Michele's ebook.
Has anyone tried this?
: Re: Telemarketing and Appointment Setting
: PMRNC January 16, 2013, 06:37:57 PM
Seriously?   You are just going to find you'll piss off people more. Offshore telemarketing?? I'm sorry I can't add anything productive to that except "Good Luck with that"
: Re: Telemarketing and Appointment Setting
: tallmanusa January 16, 2013, 09:15:46 PM
Telemarketing is something that Michele recommends in her ebook (not necessarily off shore); I guess you never read her book. I am also using her script.
: Re: Telemarketing and Appointment Setting
: RichardP January 17, 2013, 01:43:17 AM
tallmanusa - am I correct in remembering that you said in an earlier post that you used to be a doctor?  If yes, are you an M.D., or PhD.?

I've spent quite a bit of time in the offices of my clients.  At 35 to 45 patients per day, they work their butts off.  Their staff act as gatekeepers.  Only the most serious matters get past the gatekeepers to the doctors.  And then, only the really serious matters get the doctors on the phone at that moment.  All the rest remain until the end of the day, when the doctor returns the phone calls.  If you have been in private practice, I assume you already know this.

Here are several questions (out of many more) for you to consider in your attempt to schedule appointments:

1.  If the staff is currently doing the doctor's billing and getting paid extra for it, do you think they will pass your billing company info along to the doctor?  You are their competition.

2.  When the harried doctor is returning phone calls at the end of the day, do you think he will return a phone call to some stranger that wants to talk about his finances?

3.  If by some chance the doctor does return the phone call to your offshore call center, how will his phone call be handled?  Will he be immediately connected to the original person who contacted his office?  If not, will the person taking the doctor's call-back know what the original caller said to the doctor's staff to get the doctor to call back (speaks to your company's credibility in the doctor's eyes)?  Do you plan to have your offshore phones manned 25/7 in order to be available for the doctors' return phone calls - given the difference in time zones?

4.  You will not be receiving many (if any) appointments from your off-shore calling efforts.  If you pay your callers by the appointment, how will you handle the turnover that is bound to occur as your staff discover that they never get paid because no doctor ever makes an appointment?

5.  Why do you think anybody here wants to help you in your efforts to take work away from Americans and give it to foreigners - just so you can make more money?
: Re: Telemarketing and Appointment Setting
: tallmanusa January 17, 2013, 09:42:47 AM
Richard, telemarketing is one of the methods Michele recommends in her ebook, this was not something I dreamed of. I am willing to try that. There are other methods she recommends as well, which I would be trying.
All your points are well taken. I am just as skeptical as you are.
The telephone calls whether made off shore or made from someplace in USA do not matter much, they all are reading from a script which Michele provides in her book. Simple enough.

There are companies off shore who do this on a regular basis for other companies in USA; they have gone through all the problems that you mention and still are in business and taking new clients. They are paid for performance; and one reason for hiring them is that they don't suffer from the turnover that we have in this country.
Nobody is reinventing the wheel here.
: Re: Telemarketing and Appointment Setting
: PMRNC January 17, 2013, 12:21:58 PM
The telephone calls whether made off shore or made from someplace in USA do not matter much, they all are reading from a script which Michele provides in her book. Simple enough.

You would have to show me a doctor who signed on with a biller from a telemarketer offshore. And yes it does matter. The language barrier is one point and the ethical and practical resentments are another. I'm stating a fact. I know office managers who call some carriers and get offshore phone bank and let's just say they are NONE too happy.  One of my clients gets so flipping mad having to call Dell Tech support that they got rid of ALL their computers and replaced them for that reason alone. In today's times, I don't see any effectiveness or business ethics in using an offshore company, if anything it would stand to represent your business and that would not be too glowing for you.

In regards to the effectiveness overall of telemarketers or "appointment settings" isn't my cup of tea. In my opinion no one can represent me or speak for me better than me. I've also seen some dirty telemarketing tricks that didn't turn out so well. Physicians talk to each other, and a telemarketer has LESS of a chance getting past the gatekeeper than you do.  J M H O
: Re: Telemarketing and Appointment Setting
: PMRNC January 17, 2013, 12:24:42 PM
The telephone calls whether made off shore or made from someplace in USA do not matter much, they all are reading from a script which Michele provides in her book. Simple enough.

You would have to show me a doctor who signed on with a biller from a telemarketer offshore. And yes it does matter. The language barrier is one point and the ethical and practical resentments are another. I'm stating a fact. I know office managers who call some carriers and get offshore phone bank and let's just say they are NONE too happy.  One of my clients gets so flipping mad having to call Dell Tech support that they got rid of ALL their computers and replaced them for that reason alone. In today's times, I don't see any effectiveness or business ethics in using an offshore company, if anything it would stand to represent your business and that would not be too glowing for you.

They are paid for performance; and one reason for hiring them is that they don't suffer from the turnover that we have in this country.
Nobody is reinventing the wheel here.

Let's be honest here because I don't buy that excuse made by Physicians and billing companies in the US.. it's the COST factor so let's not make it something it's not. THE "SAVE a BUCK" mentality of using offshore companies is .. IN MY OPINION  irresponsible.   "turnover we have in this country".. not understanding that at all.

In regards to the effectiveness overall of telemarketers or "appointment settings" isn't my cup of tea. In my opinion no one can represent me or speak for me better than me. I've also seen some dirty telemarketing tricks that didn't turn out so well. Physicians talk to each other, and a telemarketer has LESS of a chance getting past the gatekeeper than you do.  J M H O
: Re: Telemarketing and Appointment Setting
: RichardP January 17, 2013, 06:59:03 PM
I am just as skeptical as you are.

This may be splitting hairs here over semantics, but I was not meaning to be skeptical.  I was being practical - based on my experience with doctors and their staffs (staves?)  I'm not trying to discourage you.  I'm trying to provide information that will help you develop more realistic expectations about likely results from that type of telemarketing.
: Re: Telemarketing and Appointment Setting
: PMRNC January 18, 2013, 01:54:37 PM
I just happen to be having a conversation with the OM of one of my larger pediatric groups and I casually asked her if she gets calls from Offshore companies, she laughed and said, yes but I hang up immediately and proceeded to tell me how she felt which was similar to how I felt.   
: Re: Telemarketing and Appointment Setting
: tallmanusa January 18, 2013, 02:39:57 PM
From what I am told, the appointment is made in 1% of the calls made; however the close ratio of the appointments is 85%.
Apparently $30 is enough money for off shore companies to  filter the 99%; I am happy to work with a company in US that would do it for that price.
: Re: Telemarketing and Appointment Setting
: QueenAlicia January 18, 2013, 03:07:56 PM
I really wonder why the 2 of you keep entertaining this foolishness, LOL! I really don't take this person seriously because if you notice how you guys ask questions they are always avoided. 
: Re: Telemarketing and Appointment Setting
: RichardP January 18, 2013, 03:29:47 PM
I really wonder why the 2 of you keep entertaining this foolishness
... if you notice how you guys ask questions they are always avoided.

I assume the purpose of this site is to educate people.  Future readers can read what you've read and come to the same conclusion that you have come to.  That would have been more difficult to do without seeing the answers given (or not given) in response to our legitimate questions / comments.

At a minimum, folks reading our questions/responses will come to understand the issues that need to be taken into account when setting up a billing service.  Hopefully, this larger discussion (it spans several different thread/topics) will help answer questions and generate new ones for the folks who are serious about setting up legitimate billing services.  Knowing the right questions to ask is often key to succeeding at an endeavor.
: Re: Telemarketing and Appointment Setting
: PMRNC January 18, 2013, 03:36:10 PM
Alicia, your absolutely right.

From what I am told, the appointment is made in 1% of the calls made; however the close ratio of the appointments is 85%.
Apparently $30 is enough money for off shore companies to  filter the 99%; I am happy to work with a company in US that would do it for that price.

Do you know how OLD that statistic is?  It also mirrors the OLD statistic of 1% return rate on mailings. <sigh>   You sound sold and you sound like you are choosing cost over things I would consider too important to oversee. COST savings means nothing if I'm going to leave a bad taste in the mouths of my potential client.    Again, you sound like it's a go so I'm not sure why the back and forth.  PERSONALLY the savings wouldn't be enough for me to choose offshore over giving someone in the US a job. J M H O  again.
: Re: Telemarketing and Appointment Setting
: QueenAlicia January 18, 2013, 03:41:30 PM
I really wonder why the 2 of you keep entertaining this foolishness
... if you notice how you guys ask questions they are always avoided.

I assume the purpose of this site is to educate people.  Future readers can read what you've read and come to the same conclusion that you have come to.  That would have been more difficult to do without seeing the answers given (or not given) in response to our legitimate questions / comments.

At a minimum, folks reading our questions/responses will come to understand the issues that need to be taken into account when setting up a billing service.  Hopefully, this larger discussion (it spans several different thread/topics) will help answer questions and generate new ones for the folks who are serious about setting up legitimate billing services.  Knowing the right questions to ask is often key to succeeding at an endeavor.

Obviously this is a board for educating others.  I have been a member of this board for several years and have seen these types of characters come and go.  I am skeptical of this person and the tone I was using was sarcastic. 
: Re: Telemarketing and Appointment Setting
: tallmanusa January 18, 2013, 03:46:57 PM
This person does not need a response from me. If there was an ignore button, I would use it.
: Re: Telemarketing and Appointment Setting
: PMRNC January 18, 2013, 04:22:08 PM
This person does not need a response from me. If there was an ignore button, I would use it.

That is your loss of course. Ignoring myself or others who frequent here, truly is up to you.  I know if I ask for an opinion, I would want a straight up answer from the people who have experience such as ours.  I've been in the health insurance industry for over 25 years from BOTH sides, I don't apologize for my straight up responses. I'm not here to sell anything. Take it or leave it. A few days ago I made my stand. I'm not going to help anyone who participates in offshore outsourcing in any way, shape or form. Good luck.
: Re: Telemarketing and Appointment Setting
: tallmanusa January 18, 2013, 04:32:12 PM
Marketing is the most difficult part of this business, not billing or coding; if you have less than 25 clients, you have a 50% chance of being out of business in five years. (I have a reference for that article). The most important question almost any reader asks, " how do I market ? ".  Telemarketing is a well recognized way of marketing; Michele has written a book on marketing, in which she devotes about five pages to telephone marketing.
This business is not easy, unless one takes a proactive stance, one is likely to go into oblivion.  I am not here to have a few clients, I am here to build a major nationwide presence. That obviously is a tall order, and I don't take it lightly.

" Adapt or Die "; you can download the survey https://www.zepherella.com/survey

It is interesting to note, that out of about 600 medical billing companies listed, 243 had their telephones disconnected or out of business, that is in one year, mostly small companies.
: Re: Telemarketing and Appointment Setting
: tallmanusa January 18, 2013, 04:36:32 PM
Linda, you are all right; we have difference of opinions, but I respect your opinions, you certainly know a lot more than me about this business. I am used to different opinions; what I am not used to is some ignorant person making snide personal remarks.
It is difference of opinions that makes this world, one has to know how to express it, some do some don't.
: Re: Telemarketing and Appointment Setting
: PMRNC January 18, 2013, 05:09:04 PM
Marketing is the most difficult part of this business, not billing or coding; if you have less than 25 clients, you have a 50% chance of being out of business in five years. (I have a reference for that article). The most important question almost any reader asks, " how do I market ? ".  Telemarketing is a well recognized way of marketing; Michele has written a book on marketing, in which she devotes about five pages to telephone marketing.
This business is not easy, unless one takes a proactive stance, one is likely to go into oblivion.  I am not here to have a few clients, I am here to build a major nationwide presence. That obviously is a tall order, and I don't take it lightly.

" Adapt or Die "; you can download the survey https://www.zepherella.com/survey

It is interesting to note, that out of about 600 medical billing companies listed, 243 had their telephones disconnected or out of business, that is in one year, mostly small companies.

I think you get way too hung up on statistics, don't be so easily fooled by what you read.   I can get you stats on how many people stand on their head for 30 min a day and work those stats to say whatever I want them to say AND do it honestly. :)    YOUR stats actually BLOW 85% of my own members right out the door.   My network has over 7000 active members. More than 45% are billing companies, doing QUITE well. Some are large, some are small. Your number of 25 clients means nothing and I will tell you why.   I know a billing company with 5 clients doing JUST as well as another with 15 clients.  Those stats are based on HOW many interviews? (I admit I don't read such foolishness, I deal in real life, and see what I see)   

I can't change your mind. You will just find another article, more stats and ignore those who defy those stats.  I have nothing more to add.
: Re: Telemarketing and Appointment Setting
: RichardP January 19, 2013, 03:33:48 AM
tallmanusa - you said:  It is interesting to note, that out of about 600 medical billing companies listed, 243 had their telephones disconnected or out of business, that is in one year, mostly small companies.

It's late and I'm not going to go looking for it.  But we had an exchange on a different thread about the number of doctors who adopt EMRs / EHRs.  You provided a link that I followed, and then followed links within that link.  I ended up on a web-site that provided a statistic something on the order of 10 years ago, about 80 percent of all doctors in the U.S. were solo practitioners.  Today, only about 30 percent of all doctors are solo practitioners.  The exact statistic here may be off, but the order of magnitude is not.

Small billing companies populated by a few billers mainly have solo practitioners or small doctor's groups for clients.  If the population of solo pratitioners went from around 80% to around 30%, one would expect that a lot of small billing companies would disappear.

I assume your target market is not the solo practitioner.
: Re: Telemarketing and Appointment Setting
: tallmanusa January 19, 2013, 11:50:09 AM
You are correct our target market is not the solo practitioner.

There appears to be tremendous unemployment for medical billers. We get 1 to 2 unsolicited applications per day from our on line portal. Most of them have tons of billing experience. It is my impression that most of the medical billers have introverted personalities, and either they are unable or unwilling to market their crafts.
My challenge is to hire billers who can also market our business.
: Re: Telemarketing and Appointment Setting
: PMRNC January 19, 2013, 02:47:15 PM
My challenge is to hire billers who can also market our business.

That's always of course a good idea. How will you build this into their pay-scale, I noticed on your pricing page you advertise 5% and I know that can be peanuts for some type of clients or a crazy amount for other types. How would you build a pay scale for employees?  You could do an internal affiliate style compensation that will allow employee's to receive regular compensation for work and then affiliate style/commission style payout for addition of a new client?  Just thinking out loud.
: Re: Telemarketing and Appointment Setting
: RichardP January 19, 2013, 03:09:11 PM
You are correct our target market is not the solo practitioner.

We plan to use offshore telemarketing companies to set appointments for $30 per appointment. Our rep would then visit the doctor.

If you are targeting other than the solo practitioner, the purchasing decision may be made by a business manager rather than a doctor.  In a setting which contains more than one doctor, and where the doctors are working for salary, is it likely that each doctor has the power (or desire) to hire his own biller or buy/rent his own EMR / EHR?  It is more likely that the organization has standardized on one EMR / EHR that all doctors use and one billing organization that all doctors use.  Your telemarketing effort needs to target the person within the organization that has the power to hire and purchase.  Doing cold calls to random doctors doesn't seem to be an efficient way to do this.  Just a thought.
: Re: Telemarketing and Appointment Setting
: RichardP January 19, 2013, 03:51:38 PM
My challenge is to hire billers who can also market our business.

Our setup is such that a designated person acts as the go-between between us and a particular client.  This gives the client and his staff the opportunity to get to know our contact person with them really well, and the contact person to know them really well.  If any of our billers have a need to convey information to, or request information from, a given client, they go through the designated contact person rather than do it themselves (this also keeps the billers focused on their work rather than talking on the phone to doctor staff folks).  But note that this contact is between our staff and someone who is already our client.

You used the phrase billers who can also market.  Perhaps you meant to say staff who can also market??  If you have so many actual billers that some or all have time to talk to people other than your clients, you have too many billers.  You are overstaffed.  They are underworked.
: Re: Telemarketing and Appointment Setting
: tallmanusa January 20, 2013, 11:27:51 AM
Richard, the practice of a designated person for customer support is an excellent one, most successful companies follow that. It insulates the billing people from customer support. I certainly plan to do that.
I have some questions;
1. Is the communication between the clients and the designated person (and the billers and the designated person ) by emails or phone?
2. Generally how much communication occurs? How many clients can one designated person handle? I know it depends, but some idea.
3. Does the designated person need to know much about medical billing?
4. What should be the pay for the designated person?

Thanks
: Re: Telemarketing and Appointment Setting
: PMRNC January 20, 2013, 12:07:05 PM
the practice of a designated person for customer support is an excellent one, most successful companies follow that. It insulates the billing people from customer support

I can't speak from experience on this, as my goal was always to work SOLO.   When I worked as a claims specialist at 3 of the top 5 carriers only ONE utilized this where they had customer support services separate from the claims specialists. They tried this for about a year and it was a disaster, I know, myself, if I need to call somewhere I don't want to be "handled" I want to talk to who I need to talk to and that's why it didn't work out. 

1. Is the communication between the clients and the designated person (and the billers and the designated person ) by emails or phone?

I would always have to put myself in the shoes of my clients. If they need me they should be able to contact me via ALL methods in a given time frame (business hours).

2. Generally how much communication occurs? How many clients can one designated person handle? I know it depends, but some idea.
NO way to answer this at all because there are variables on the volume and type of work PER client as well as variables on the experience level of each biller/staff member.  I've seen billers be able to handle 5-6 accounts comfortably and I've seen those who could only handle one or two very large clients. (DME comes to mind)

3. Does the designated person need to know much about medical billing?

I would have to say YES.. and this is where I would probably cancel out the idea of just a separate person/staff, many things will need to be passed on to an experienced biller anyway, I can't see hiring anyone w/out experience in medical billing. There's also the VERY VERY important factor of HIPAA, even if they are just merely answering the phone you willl need to make sure their access to systems are within their scope of experience, that they are INDEED properly trained on their HIPAA responsibilities.

4. What should be the pay for the designated person?

For what you are doing I would have to say this is right along the lines of "receptionists"  They answer phone and pass on to where it needs to go. I can't see anything more than $7 or $8 an hour. (depending on going pay scale in a particular area) Maybe a great job for a high school student?

How many clients do you have now? What does your business plan entail for the time frame of growth? What type of facility will you be working in? Is there space available for the type and volume of staff you have planned for? Examining those might give you a better idea of expanding staff and duties of each staff member.
: Re: Telemarketing and Appointment Setting
: RichardP January 20, 2013, 02:37:26 PM
Our setup is such that a designated person acts as the go-between between us and a particular client.

I made this statement to set the stage for the point of my next paragraph in that post - which is, we are staffed only to handle the billing we have, and our communication is only with clients we already have.  If we needed to engage in marketing, we would not use our current staff to do that.  We would subcontract out to experts.  But the truth is, our expertise is our marketing tool.  We know how to bill for many different specialties, and most of our clients have Physician Office Labs.  We know how to do complicated billing.  Our current clients speak highly of us to other doctors and we turn down most of those who then ask us to take on their billing.  We are interested more in making money (which we do) and less in building an empire.  (There is a size beyond which the extra headache of dealing with so many clients is not worth the extra money they would bring in.)  I realize that our geographic location brings us into face-to-face contact with more doctors than someone in a different location might encounter face-to-face.  So I am aware that most billers face different circumstances than we do.

Our setup is such that a designated person acts as the go-between between us and a particular client.

Based on your feedback, I now see that this statement could be misleading.  I only meant to say that we don't all pester the client with questions as they arise.  And likewise, a given client is not interrupting the work of our billers randomly.  We generally communicate with our clients through our designated person for our sake as well as for our clients' sake.  However, a.) if necessary, any one of our staff knows they are free to contact any one of our clients' staffs if they need to.  We just encourage them to go through our designated persons as much as possible, and our staff understands the logic of this; b.) acting as the designated contact is not the only work these people do, so to think of them as being at the receptionist level is misleading.  They actually need to know a great deal about billing in order to answer the questions coming from our clients staffs (often with the patient standing in front of the staff person who is calling), and so they tend to be among our higher-paid folks (that $30 per hour thing mentioned in another thread), and c.) we communicate by fax, e-mail, and phone - depending on the need of the moment.

Consider this:  if you hire a goup of low-knowledge, low-paid receptionists to be the go-between between your organization and your clients, your receptionists are going to get asked questions they don't know how to answer.  Who in your organization would these receptionists turn to in order to get their questions answered, and how would the receptionsist communicate with these "experts"?  The "experts" who accept and respond to the questions from the receptionists would be your designated people, just like I have mine.
: Re: Telemarketing and Appointment Setting
: PMRNC January 20, 2013, 02:55:49 PM
But the truth is, our expertise is our marketing tool.  We know how to bill for many different specialties,

SAME HERE.. Love this.    My experience and education is my biggest marketing tool.  Can't imagine any outside service selling it better than myself.
: Re: Telemarketing and Appointment Setting
: RichardP January 20, 2013, 03:04:33 PM
 8) :)