Author Topic: Attrition  (Read 2868 times)

williamportor

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Attrition
« on: May 08, 2016, 09:41:07 AM »
Since starting my medical billing business 2 1/2 years ago, I've signed up 11 medical professionals, it's been a lot of hard work. Thousands of telephone prospecting contacts, many hundreds of door to door contacts, and over 3,000 mailers. I have a grand total of 4 clients that are still with me (the lowest paying one's naturally!)   2 providers retired, 1 only wanted me to clean up their billing mess, than took it back in house to do themselves, 2 office managers were very happy with my work, but were later overruled by their provider bosses, who insisted the billing be brought back in house so they could "keep an eye on things"1 closed his office to pursue other business ventures, and  only 1 was dissatisfied with my work (not wanting to admit their cash flow problem was due to credentialing, not billing) I love medical billing, but don't seen much future in it at this rate of attrition. Is it normal to lose over 60% of one's clients every year?? If it is, I may need to consider another line of work.  :-\
« Last Edit: May 08, 2016, 10:11:15 AM by williamportor »

PMRNC

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Re: Attrition
« Reply #1 on: May 08, 2016, 10:39:54 AM »
I don't think you can say it's normal or not.. in 2 1/2 years that's pretty decent!! Instead of looking at the client base you lost as a whole 60%.. maybe look at it with a change in some things you can do within your business. For example the ones bringing it back in-house, that was one thing I noticed too even 5-10 years ago. With that my business model of working in THEIR systems was born and it was the best change I made. Not only were there no more overhead costs for me, but my clients still had the very same control and could keep a watch on things making it a win-win for everyone. The clients having trouble with credentialing, maybe offer to review contracts and expand services to include credentialing and contract review/negotiations?

The great thing about this business is that unlike having a store or selling products, you sell services which you can continue to develop and market more diversely. Your services will always save the client money, so while losing 60% you may in fact gain 80%. Just take a look at what you are doing, add to, change and market :)
Linda Walker
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williamportor

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Re: Attrition
« Reply #2 on: May 08, 2016, 01:38:33 PM »
I don't think you can say it's normal or not.. in 2 1/2 years that's pretty decent!! Instead of looking at the client base you lost as a whole 60%.. maybe look at it with a change in some things you can do within your business. For example the ones bringing it back in-house, that was one thing I noticed too even 5-10 years ago. With that my business model of working in THEIR systems was born and it was the best change I made. Not only were there no more overhead costs for me, but my clients still had the very same control and could keep a watch on things making it a win-win for everyone. The clients having trouble with credentialing, maybe offer to review contracts and expand services to include credentialing and contract review/negotiations?

 The great thing about this business is that unlike having a store or selling products, you sell services which you can continue to develop and market more diversely. Your services will always save the client money, so while losing 60% you may in fact gain 80%. Just take a look at what you are doing, add to, change and market :)

PMRNC - Thank You for your response. Pardon my ignorance, but I'm having a hard time understanding how losing 60+% of my clients and over 80% my income every year is "pretty decent" The 2 clients that brought back their billing operation in house at the behest of their provider bosses were providers that I was already using their own software to do their billing, yet they insisted in doing so anyway, even though it cost them twice as much to do so. Also...the 11 providers I signed up represented $5,000 in monthly income to my business, since I lost about $4000.00 of it when the providers left....how is this an 80% gain for me?? :-\
« Last Edit: May 08, 2016, 01:40:11 PM by williamportor »

PMRNC

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Re: Attrition
« Reply #3 on: May 08, 2016, 03:28:44 PM »
I was speaking to the future.. replacing the 60% with 80%. I was pointing out you might be missing the big picture. I think every billing company goes through these kind of growth stunts.. as I mentioned, it could be time for a change. Add some services, change of business model, etc. Was trying to show you that the glass is not half empty, but half full. :)

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kristin

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Re: Attrition
« Reply #4 on: May 08, 2016, 07:52:00 PM »
One thing to consider...supplemental work as a biller for another company. If I am reading what you have said here correctly, you are making $1000 a month on four clients? If I am wrong, pardon my misunderstanding.

If I am not misunderstanding, you should consider supplemental work as a biller for someone else, stat. There is good money to be made.

williamportor

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Re: Attrition
« Reply #5 on: May 09, 2016, 03:31:55 AM »
I was speaking to the future.. replacing the 60% with 80%. I was pointing out you might be missing the big picture. I think every billing company goes through these kind of growth stunts.. as I mentioned, it could be time for a change. Add some services, change of business model, etc. Was trying to show you that the glass is not half empty, but half full. :)

OK...that makes sense. I already offer insurance verification and am learning credentialing. Are there any other services that I might offer?

williamportor

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Re: Attrition
« Reply #6 on: May 09, 2016, 03:33:16 AM »
One thing to consider...supplemental work as a biller for another company. If I am reading what you have said here correctly, you are making $1000 a month on four clients? If I am wrong, pardon my misunderstanding.

If I am not misunderstanding, you should consider supplemental work as a biller for someone else, stat. There is good money to be made.

Sounds good. Any suggestions on what other supplemental work I could offer?

PMRNC

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Re: Attrition
« Reply #7 on: May 09, 2016, 08:56:22 AM »
You can offer other things that go along with credentialing that entail analyzing contracts and plan payments and adjustments. Offer to review the practices adjustments so you can find the carriers with the higher adjustables which could help in re-negotiations of fee schedules for some carriers. Other services you can offer would be review and update of office financial policies, P&P, compliance plans, HIPAA compliance etc.

I know you mentioned insurance verifications, are you offering appeals as well?

As I gained more experience I picked up quite a few consulting only jobs where I was able to do a lot of the above services on a consulting basis and many times I made more money doing that than billing plus it's great way to make new contacts. After I finished a job I would offer a discount and give them my card for referrals. Marketing the consulting services was not only lucrative but it also helped gain contacts and even secure clients who would later use my practice management services.
Linda Walker
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Michele

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Re: Attrition
« Reply #8 on: May 09, 2016, 01:02:20 PM »
Since starting my medical billing business 2 1/2 years ago, I've signed up 11 medical professionals, it's been a lot of hard work. Thousands of telephone prospecting contacts, many hundreds of door to door contacts, and over 3,000 mailers. I have a grand total of 4 clients that are still with me (the lowest paying one's naturally!)   2 providers retired, 1 only wanted me to clean up their billing mess, than took it back in house to do themselves, 2 office managers were very happy with my work, but were later overruled by their provider bosses, who insisted the billing be brought back in house so they could "keep an eye on things"1 closed his office to pursue other business ventures, and  only 1 was dissatisfied with my work (not wanting to admit their cash flow problem was due to credentialing, not billing) I love medical billing, but don't seen much future in it at this rate of attrition. Is it normal to lose over 60% of one's clients every year?? If it is, I may need to consider another line of work.  :-\

Although "normal" is hard to define, personally I think that 60% is high.  It sounds like a fluke though.  What are the chances that one billing service would have that many clients leave.  We have attrition but I would say it's closer to 5%.  I personally believe the billing business is still very much alive and well.  I think that providers need outside services even more than ever with the way things are.  They must collect everything they are entitled to.  Many providers think that bringing the billing in house gives them more control but it really doesn't.  I see much more go wrong right under the doctor's noses.  Being in the office doesn't mean they know what's going on.  You said that your remaining four accounts were only bringing in about $1000.  Maybe try to market to accounts that would be a little more income.  For example, a provider who visits a nursing home and doesn't have an office might work out well for you.  We bill for several of those.  They don't even have offices or they are moonlighting.  Try contacting local nursing homes to see if they can provide you with the names of providers that visit patients there in the facility. 

Just an idea.  Sounds like you are diverse and trying very hard.  I hate to see you give up.
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PMRNC

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Re: Attrition
« Reply #9 on: May 09, 2016, 07:07:02 PM »
Those clients that are pulling out to go "in-house" do so because 9 out of 10 times they want control and most billing companies are utilizing their OWN software solutions. Those leaving an outsourced solution for an -in-house solution are doing so because they want MORE control or they are looking to manage things "in house". This happens to billing companies mostly utilizing their own software and which is why the better solution billing companies have today is to utilize the practices system where they maintain and continue control thereby allowing you to perform your services at the same time as they maintain control. Those providers taking back billing in-house are unhappy with some of the services an outside company is providing and they seek to bring back in-house.. Billing companies today must remain diversified and allow the control to stay within the practice at the same time as providing those services. This has been happening for years and billing companies today don't know how to deal with it because they have positioned themselves with their OWN software, their own solutions/services and thereby taking away some of the practices control which inevitably breaks down. There is NO reason today a billing company with a great deal of experience and knowledge should have to obtain a client and put them totally on their systems. A good, experienced biller can carry out all the tasks and keep the billing on the practices existing system or system of THEIR choice and still save the practice money, time and promote their services with complete control for the client.

This has been happening for years.. billing companies today must stay diversified in their services and allow practices the total control they want at the same time as providing the services to them and saving them money.

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

kristin

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Re: Attrition
« Reply #10 on: May 10, 2016, 07:27:31 PM »
Quote
Sounds good. Any suggestions on what other supplemental work I could offer?

Sorry, I wasn't clear about what I said! I meant that maybe YOU could do supplemental work for another billing company(ies), to augment your income. In addition to my regular office job, I do remote billing for two billing companies, and make great money with them. So while you are trying to grow your own company, maybe you could be working for another company at the same time, for extra income.

Michele

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Re: Attrition
« Reply #11 on: May 11, 2016, 08:13:41 AM »
Of the providers that we have had leave to do it in house, most were being done in their system.  That is why they insisted we use their system, so that they could at any time take it back over.  I agree being diversified is important.  We always will do the work in the provider's system if that is what they want, but it doesn't prevent them from leaving.  In my opinion it actually makes it easier.  They are already set up, they just have to replace you.  With that being said, I don't turn them away for that reason.  Even if I know that they want to do it in house and I'm probably temporary.  I do it hoping they will be happy with my work and not consider replacing me.  Sometimes that works.  Sometimes no matter how good you are, they just want someone in their office.  I have an appointment this week to go in to an office that we previously worked for in their system and then they took it over.  They now want us back after 18 months because doing it themselves isn't working out. 
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williamportor

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Re: Attrition
« Reply #12 on: May 24, 2016, 03:29:26 AM »
Of the providers that we have had leave to do it in house, most were being done in their system.  That is why they insisted we use their system, so that they could at any time take it back over.

I'm not sure what the providers were thinking when they insisted on taking their billing back in house...(they were not interested in further dialogue.) The office managers who hired me said it would cost them 3 times as much to do the billing in house, but did so anyway. I was billing through their software, and had cleaned to a pretty big backlog of unpaid claims. Oh well, back to cold telephone calls. Hopefully this was a fluke like you folks said. 

Michele

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Re: Attrition
« Reply #13 on: May 24, 2016, 08:28:29 AM »
I hate when a provider appears to be upset about something but won't tell you what it is.  They don't give you an opportunity to either correct the issue or dispute it if they are incorrect.  We've had that happen once.  We knew the office manager didn't like us from the beginning because she was doing things that weren't right so we knew it was a bad situation.  After over a year (with great receivables!) they let us go with no reason or explanation.  I had a good relationship with the doctor who owned the practice and I asked him outright, what happened?  He wouldn't tell me.  Very frustrating.  BTW their income immediately dropped 40% after they fired us.

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kristin

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Re: Attrition
« Reply #14 on: May 24, 2016, 07:37:25 PM »
Michele, doesn't it just boggle your mind that the doctor would lose income like that after he let you go and not care, when the most likely reason he dropped you was because his office manager was pushing for him to do so? An office manager should be all about INCREASING revenue, not decreasing it. It almost makes me wonder if she wasn't embezzling from him, or something, and couldn't do that while you had the account.