How to approach the office manager

[Bill the Biller]

Hello all. This is my first post. I recently opened my own corporation and am looking for a client.

I know this topic has been discussed here a million times, but I'm looking for an answer to one specific part.

Many on this forum have advised not to try and skip the office managers by going directly to the doctor. My question is what do you tell an office manager? Why would he agree that a billing company does a better job than the staff he overlooks? Why wouldn't he feel that some current office jobs are threatened if I come and offer so many practice management and billing solutions which the in-house team have been fulfilling until now?

I do this all day now, and I really need to find a client, so some good words of advice for my situation can be extremely helpful.

Thanks in advance

Bill

[williamportor]

Hello all. This is my first post. I recently opened my own corporation and am looking for a client.

I know this topic has been discussed here a million times, but I'm looking for an answer to one specific part.

Many on this forum have advised not to try and skip the office managers by going directly to the doctor. My question is what do you tell an office manager? Why would he agree that a billing company does a better job than the staff he overlooks? Why wouldn't he feel that some current office jobs are threatened if I come and offer so many practice management and billing solutions which the in-house team have been fulfilling until now?

I do this all day now, and I really need to find a client, so some good words of advice for my situation can be extremely helpful.

Thanks in advance

Bill

Hello Bill -

I'll try to give my answers to your questions:

Q: My question is what do you tell an office manager? A: Normally I say something like: Hello, This is Bill with ----Medical Billing Co. We do (fill in your services) Is this something you could use for your clinic? Most of the time you'll get a flat "No" If I'm speaking with them in person, I'll leave my card and say something like "If you get tired of hassling with Insurance companies one day, please give me a call" Then go to the next clinic.

Q: Why would he agree that a billing company does a better job than the staff he overlooks? A: That depends if their present staff is doing a good job or not. If they have a good running operation, and claims are getting paid, they'll have little incentive to hire an outside biller, but if their staff is stretched too thin and doesn't have time to do a good job, it may be an opportunity for you.

Q: Why wouldn't he feel that some current office jobs are threatened if I come and offer so many practice management and billing solutions which the in-house team have been fulfilling until now? A: He may indeed feel that way, but if claims are not getting paid, he may feel a change in staff may be in order.

I fully understand your need to find a client. There are far more billers than there are providers looking for one. A few ideas for you:

* Going door to door and handing out your business cards to office managers and staff is a smart idea. Have a short intro. ready and be prepared to answer questions.

* Don't overlook telephone cold calls. I've acquired 75% of my clients this way. This is not very stylish, but it allows you to market your services nationwide. (And in case you're interested, the national do not call list does not apply to business to business marketing calls.)

* If you don't have a client, then you're a full time salesman. Sales is a numbers game. The more contacts you make, the more providers you'll sign up.

* Don't worry about having a perfect marketing plan. As I've said before here: An imperfect marketing plan done consistently is far better than a perfect marketing plan done inconsistently. So, set up a daily schedule and go to work.

Good Luck     

[Michele]

I added some additional comments to Williamsporter's advice:

Q: My question is what do you tell an office manager? A: Normally I say something like: Hello, This is Bill with ----Medical Billing Co. We do (fill in your services) Is this something you could use for your clinic? Most of the time you'll get a flat "No" If I'm speaking with them in person, I'll leave my card and say something like "If you get tired of hassling with Insurance companies one day, please give me a call" Then go to the next clinic.

We will ask the office manager something like "are you currently having any issues with your billing or accounts receivables"  We ask this because if they are truly not having any issues then they don't need us.  If they are, it opens up a conversation.  Also, if you can find an 'in' you might be able to help them out with an issue and build a relationship.  It also gives you a chance to show your stuff.  We have had office managers let us help them out with just an area of their billing, like workers comp, or BCBS.  Then after clearing up the issue they hired us to do the entire account.  We've also had some say "Thanks!" and then walk away.  It's a gamble but that experience always helped us when we were just starting out.

Q: Why would he agree that a billing company does a better job than the staff he overlooks? A: That depends if their present staff is doing a good job or not. If they have a good running operation, and claims are getting paid, they'll have little incentive to hire an outside biller, but if their staff is stretched too thin and doesn't have time to do a good job, it may be an opportunity for you.

We find that most offices who bill inhouse are losing money. Not all, but a lot.  Most do not work the aging report regularly and that is a huge mistake.  We will ask, are you able to get to the aging report monthly?  Usually that is the task that always gets bumped to the bottom of the pile, often never getting touched.

Q: Why wouldn't he feel that some current office jobs are threatened if I come and offer so many practice management and billing solutions which the in-house team have been fulfilling until now? A: He may indeed feel that way, but if claims are not getting paid, he may feel a change in staff may be in order.

I fully understand your need to find a client. There are far more billers than there are providers looking for one. A few ideas for you:

* Going door to door and handing out your business cards to office managers and staff is a smart idea. Have a short intro. ready and be prepared to answer questions.

* Don't overlook telephone cold calls. I've acquired 75% of my clients this way. This is not very stylish, but it allows you to market your services nationwide. (And in case you're interested, the national do not call list does not apply to business to business marketing calls.)

* If you don't have a client, then you're a full time salesman. Sales is a numbers game. The more contacts you make, the more providers you'll sign up.

* Don't worry about having a perfect marketing plan. As I've said before here: An imperfect marketing plan done consistently is far better than a perfect marketing plan done inconsistently. So, set up a daily schedule and go to work.

Good Luck     

We really try to push that we work with your staff, helping to collect all that you should be collecting.  We stress that there is still plenty for the staff to be doing as well.  Unless they have a person who is solely devoted to billing, has not a single other job, there is stuff for them to do.  We explain that they will now be able to get to all those jobs that keep getting pushed aside and can focus on patient care.  If they are having issues with the billing we also tell them that their receivables will most likely increase more than the cost of your services.

[PMRNC]

I never put much thought into this, I check my ego at the door. An office manager I'm speaking with gets to keep all the kudo's..they get all the credit, what do I care?  When I approach them that way I find it so much easier to get on board. I create a strong emphasis on why I need THEM. In fact I tell them flat out i don't take a client without a point person.

I'll also add that I have spoken with and worked with clients who really did not need an outsourced service. With that in mind i stay honest and I might even get some consulting out of it by helping them improve upon procedures they have noe.

[Bill the Biller]

Thanks all for your replies.

I'm preparing to meet an Internist whom I met already and he sounded interested in my services. I asked to speak to the office manager and I was gladly seen by the doctor himself who told me he does his own billing...

I will write down what we spoke, and please advise how to proceed further as your advice is crucial.

He is primarily interested in the billing itself and not in the EHR or similar practice management services that I offer. and I offered to start at 4.5% of the gross collected amount. Now I know this is low, especially that he is only seeing patients 4 hours of the day. Here I need advice what to write in the contract. Should I do a short contract of 6 months or so and then go up slightly with the fee if necessary?

He also wants me to enter about 2000 patients in the system (btw is 2000 patients a large base or a small base?) to which I said I will make a one time $500 - $750 charge depending on how time consuming it ends up being.

Then, I explained to him how we will send each other information. And here I wasn't sure, does the doctor need to provide me with the diagnosis and procedure code? I know I can look it up and suggest better codes if necessary, but usually who initiates the coding info, doctor or billco?

Also I left after we agreed that he'll follow up, he took my info and all notes that we've gone over.

I think I made some mistakes like not asking him his patient volume, not making a clear follow up plan before I left, etc, or rather let's call it some things could have been done better. I would really appreciate if any or all of you can tell me a. what mistakes I've made to correct for the future with him and with others. b. how to proceed on following up and on closing the deal.

Thanks a Bill

[Michele]

He is primarily interested in the billing itself and not in the EHR or similar practice management services that I offer. and I offered to start at 4.5% of the gross collected amount. Now I know this is low, especially that he is only seeing patients 4 hours of the day. Here I need advice what to write in the contract. Should I do a short contract of 6 months or so and then go up slightly with the fee if necessary?

Hopefully you are not in a fee splitting state.  4.5% is definitely low but we started out low to get our foot in the door when we first started out.  Definitely do a shorter term contract so that you can raise.

He also wants me to enter about 2000 patients in the system (btw is 2000 patients a large base or a small base?) to which I said I will make a one time $500 - $750 charge depending on how time consuming it ends up being.

2000 is a lot of patients.  In a good PMS that you are familiar with you can enter about a patient a minute (that's a fast pace to keep up) so it will take over 30 hours.

Then, I explained to him how we will send each other information. And here I wasn't sure, does the doctor need to provide me with the diagnosis and procedure code? I know I can look it up and suggest better codes if necessary, but usually who initiates the coding info, doctor or billco?

Provider absolutely must provider CPT & ICD codes.  Unless you are a certified coder with access to the patient chart you can't possibly code.  Also, be careful not to get into a position where the provider is expecting you to alter his coding to maximize his reimbursement, that could be fraudulent.  The claims should be coded to represent the services performed.  It is illegal to change coding to increase reimbursement.  Sometimes providers expect billers to do things like that.  It is ok to notice a possible mistake and go back to the provider to ask if they need to correct something.  But not ok to simply change.

Also I left after we agreed that he'll follow up, he took my info and all notes that we've gone over.

I would follow up in a week if you don't hear from him.

I think I made some mistakes like not asking him his patient volume, not making a clear follow up plan before I left, etc, or rather let's call it some things could have been done better. I would really appreciate if any or all of you can tell me a. what mistakes I've made to correct for the future with him and with others. b. how to proceed on following up and on closing the deal.

Thanks a Bill

The best way to learn is thru mistakes.  Just make sure you remember them the next time.  They weren't deal breaking mistakes so you should be fine.

[PMRNC]

Agree with everything Michele said, especially 4% being too low. I'm not a fan at all of % based billing as every billing company loses money (time=money) on the deal.

Thoughts on the entering of the patients..check to see if the PM system you will be using has a conversion, find out and if so how much and pass cost on to the provider. Of course if they had no PM system then I think that setup fee is very low also.

We do learn from mistakes like Michele said.

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