Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => : TammyL December 02, 2011, 10:45:46 PM

: Let Go
: TammyL December 02, 2011, 10:45:46 PM
Hey guys it's been awhile because I had been so busy working with all the new clients I got but I have a bit of sad news and i'm still stunned . I signed up a Mental Health Practice of 3 on 9.13.11 I started the billing on 9.15.11  And let me tell you it was a mess beyond a mess a/r reports had not been ran and claims  not followed up on statements had not  went out in  2 months. So here i'm thinking im doing my thing cause they a/r was down and in oct i brought it up by 9800.00 plus when i sent statments out in oct i collected about 5000.00. Now a few weeks ago i had some words with the office office manager because she was trying to be controlling and tell me how to do the billing her way and i had a problem with that because she started out doing billing but some how starting running the front desk and doing the billing and it was a bit too much for her. So i talked to one of the docs about it and she  said yes she can be a bit a controlling when it comes to the office since she's been with them for over 10 years she likes to take control over everything so i told the doctor i am very capable of doing my job without her telling me what to do and how to do it. So i guess the receptionsit/ office manger didnt like me talking to the higher up so they let me go on 11.28.11 stating they need someone to do there billing fulltime and they felt i was to busy for there account  since i had other docs i billed for and they were going with another billing service. How about a patient called me about there bill on 11.29.11 and i informed the patient i could not help her because they let me go so she had to call the office the patient called me back and told me the that the receptionist / office manager was doing the billing and she didnt have time to answer her question about her bill she was  the only one in the office working for 3 docs and didnt know when she could help her. I was speechless and clueless. How do you get rid of the person who increased your a/r it was either the office managers way are no way so she made sure they canned me to hit the highway. I worked day in and day out on this account one doc a/r report was 47 pages and the other two were around 22 pages i completed all of them refiled alot of claims not on file and some had be w/o for no auth. I gues this is a lessoned learned from here on out just keep my mouth shut and don't say anything. I truly feel i was done wrong but it is what it is
: Re: Let Go
: PMRNC December 03, 2011, 11:56:43 AM
Well, certainly you have a right to be upset, however you can make this a learning experience. I see a few things wrong off the bat and hope you take it within the spirit in which it was intented.

The office manager is the "GOD" of the office. I'm not saying you take any abuse or anything but going over her head should be an absolute LAST resort. More often than not if you make them your friend and approach them with a "helping hand" rather than a "taking over attitude" you'll get more out of them, be respected. I always let my office managers be the "hero's" Why not? Keeps everyone happy.  The office manager is always going to win over you in any office about 99.9% because they are the most trusted within the practice.

Next, you really don't state what type of contract you had. You stated they let you go on 11/15, did they give you notice? What type of termination clause was in your contract? For example, if one of my clients had terminated our contract on 11/15 and a patient called 11/29, MOST likely it would be me, responsible for answering her questions because most likely I billed it and it's within the 30 days notice. Also with some clients there is a "cleanup" period to which that time frame would have been within.  THE only time I can think of that would cause for me to CEASE any follow up with patients or bills immediately and before the 30 days is fraud.   

Maybe you were just venting and that's ok, but I see every opportunity to learn from these things. Try not to take them personally as it may not be last time it happens to you, maybe next one will not pay you, who knows.. that's business.  Hopefully you had and have a contract to protect yourself and your business from things like this. 
: Re: Let Go
: TammyL December 04, 2011, 08:38:27 PM
To Linda thanks for your advice the contact I signed was if they were not happy with the services they give me a 14 day notice I first started out in the contract with a 30 day notice and they came back with a 14 day notice. And the patient that called me was a patient I was helping  get her sons bill straight back in Oct when she first got the bill when statements went out in Oct. But it is truly a lessoned learned it's like after I cleaned up all the old A/R and increased there revenue they let me go because they pretty much sided with the Office Manager who is the Office Manager, the receptionist and the biller for a practice of three and the same patient called her to discuss the bill since I was no longer doing the billing and she informed the patient she did not have time and did not know when she could get back with her to discuss her son's billing problem because she was just too busy and was the only one in the office.
: Re: Let Go
: billingandscanning December 05, 2011, 06:33:17 AM
TammyL, keep your head up! I understand your frustration, but I agree with Linda that going over the Office Manager's head should be a last resort. Maybe next time changing the way that you approach the Office Manager may make all the difference in the world. Let them know that you are there to help them and that not replace them. Maybe she felt threatened by the good job that you were doing. Did they say what the reason was that they wanted to change the amount of time that they needed to give you a notice from 30 to 14 days?

I know a doctor that would not keep any of her staff more then 3 months, if the staff was luck, the might stay 6 months. She had an Office Manager that stole $40,000 and after that she did not trust anyone.

Good Luck!
: Re: Let Go
: PMRNC December 05, 2011, 09:42:55 AM
I run all "negotiations' of my contract by my attorney, 14 days is WAY too low, 30 days is standard and semi-safe. I also ensure the seriousness of the client with the payment of my setup fee.   

I know you said the terms were 14 days notice, but there should have been more in there such as what would take place once notice is given.. such as cleanup of accounts and responsibility to clean up any billing you have done. My out clause is about a page and a half long. You might want to take a look at your contract.
: Re: Let Go
: TammyL December 06, 2011, 01:05:00 AM
To Linda they did not want me to do any cleanup on any of the billing I did and there was not set-up fee because I was going remote billing into there computer.

And to billingandscanning yes you are definately right she was threatened by me for sure because I came in  and I did what was needed to be done to increase the doctor's revenue and cleaned up all the old A/R in the 2 moths I was with them
: Re: Let Go
: PMRNC December 06, 2011, 09:46:21 AM
To Linda they did not want me to do any cleanup on any of the billing I did and there was not set-up fee because I was going remote billing into there computer.

That's why I think a better and more detailed "out clause" would have been to your benefit.  The setup fee doesn't really have anything to do with whether you are billing remote. I've never NOT charged a setup fee. The setup fee is for your time and it also serves as a great "security" fee to show the seriousness of a client when they begin. It is a standard norm that most providers expect to pay when they begin. Certainly you can discount it as an incentive for faster signing of your contract, but you might want to re-evaluate not charging any setup fee.
: Re: Let Go
: billingandscanning December 06, 2011, 01:44:41 PM
I going to review my "Out Clause" and see if there are changes that I need to make to secure myself. The sad thing is that if the Office Manager is telling that patient that they do not have time to follow up on a bill, the Provider is going to end up right back in the situation they were in before you came in to do the clean-up Tammy. How sad!

We can learn from our experiences and use that to make the necessary changes so it does not happen again. Thank you Tammy for sharing this experience with us.

Linda, do you charge a setup fee for all your clients? How do you determine how much to charge? Do you go by the size of the practice?

Brenda
: Re: Let Go
: Michele December 06, 2011, 02:46:56 PM
We had a similar experience.  It's very frustrating.  You do everything you can and actually turn things around.  In our case we doubled this office's income in one month!  No back billing, no extra visits, just billing correctly!  Not only that the OM was STEALING!  She's still there, we are not, they dropped 40% immediately upon letting us go.  There is nothing you can do with a situation like that.  It's a no win.  If it wasn't 11/15 it would have been 12/10 or 1/21.  And the idiots that pay her...........well I've already called them idiots.

Keep your head high, you did your job right.
: Re: Let Go
: PMRNC December 07, 2011, 08:18:09 AM
Linda, do you charge a setup fee for all your clients? How do you determine how much to charge? Do you go by the size of the practice?
  I have always charged a setup of some amount from $100 to 2000 and yes the size of the practice is taken into account. When I have made my presentation or have spoken with a client that I'm confident enough to leave a contract with, I will tell them something like this: "My normal setup fee is $1000.00, however if you sign my contract by XX/XX  (usually give them 3-7 days) I will discount the setup to $700 (maybe even $500), it depends on my own instincts and again, the size of the practice, amount of work for setup, etc.
: Re: Let Go
: billingandscanning December 08, 2011, 03:55:02 AM
Thank you Linda for that info.
: Re: Let Go
: QueenAlicia December 13, 2011, 10:22:19 PM
Great advice.

Tammy those doctors may end up calling you back especially after you recovered revenue for them.  Only a fool would keep someone on who can't meet the needs of their patients.
: Re: Let Go
: Billergirlnyc December 14, 2011, 06:56:18 PM
Great advice, Linda!

Tammy, please try and keep your head-up. I think Linda hit every single point about what to do next time. I had a client who wanted to reduce my 30 day notice to 10 days and I wouldn't budge. Not only did he like that, he signed immediately.

I've also dealt w/a difficult Office Manager before, but what I do is what Linda said. I just agree with them and pretty much still do what I need to do to get the job done. He/She isn't in my office so as long as the end result nets the same I rarely get into a tiff with them. Sugar is better than vinegar, and trust me I know the ones that can test your nerves.

It's funny that my lowest paying clients are the ones I have the most difficulty with. Isn't that how it always works?

I wish you well and know this is a great lesson. Now you're packed with how to handle this type of situation going forward!
: Re: Let Go
: Michele December 15, 2011, 09:49:14 AM
Great advice.

Tammy those doctors may end up calling you back especially after you recovered revenue for them.  Only a fool would keep someone on who can't meet the needs of their patients.

The world is full of fools!  I am always amazed, although I don't know why, when a dr makes a decision that is so blatantly stupid for his practice.


It's funny that my lowest paying clients are the ones I have the most difficulty with. Isn't that how it always works?


Very Very Very Very Very TRUE!