Having been in practice since 1993 I have seen my share up ups and downs. Although I enjoy the different components of practice management, I must admit that most of my professional satisfaction falls within the realm of patient care. Having started out as an associate doctor developing my practice within another group practice, I had the opportunity to learn from others mistakes. That does not mean that I did not have the opportunity to make my own. I started my own practice in the ground floor of the Folger Building located in downtown San Francisco in 1995. I finally did it, my own practice. My first task, focus on patient care. I must admit that this quickly became a challenge. While hiring and training new staff, building my new practice, etc, watching my bottom line was a challenge. I thought I would hire someone friendly to manage the front office, and do billing during downtime. This was among the first of many mistakes I made. The personality traits require of a scheduling/front desk C.A., and the organizational management and experience of a back office/billing C.A. were almost impossible to find in one person. During the next year, I had found several employees who were great in one area, while lacking in the other. This biggest problem in losing my employee was that my billing was affected. I could always find a replacement to handle the scheduling and routing of my patients, however, I had to stay late for weeks on end till I found the correct replacement for the front-desk/billing C.A.. Having to do my reports, billing, and collections after hours quickly took its toll on my personal life. I was unable to spend the quality time with my friends and family that I had learned to enjoy as the owner of my own practice. By the time I had lost my third employee, I realized that the late nights, and minimal rest began to effect my patient care. While counseling a patient on nutrition and rest, I actually had been told I looked tired. Could it be? I had become a hypocrite to my own patients. I realized at that point, that I would have to make some changes. I had fallen victim to poor business decisions.
Although stressed, I was still fortunate to have a busy practice. Because of poor focus on my one employee, my accounts receivable had gotten out of control. I decided to hire a dedicated Billing C.A.. I took an ad out in the local paper, and was amazed at how many responses I got from experienced people. I was fired up! Now I could have the opportunity to have someone watching my aging and accounts receivable for me full time. The first few months were great. The money was really rolling in. I believe it was a Wednesday. I came into the office at 9 am to see patients, when my super C.A. gave me the great news… she was moving. It seems that her husband had been transferred to Houston, and they were moving in a month. I tried not to frown, and was genuinely happy for my parting employee. She was kind enough to give me 30 days. I immediately took an ad out in the paper. Once again, was pleasantly surprised with the resumes that came in. I had decided on one specific candidate who had been working down the street in another practice. I asked her when she could start; she responded that she would be able to in two weeks. Although I was stressed about the additional work that I had taken on (again), and needed someone right away, I felt bad about asking her to leave without notice. I would not want to damage the practice of another colleague, nor would I want this to happen to me. She gave her two weeks. I actually got a nasty message from the doctor where she worked. He told me that she left because I was paying her way more than the market average. I really never considered what others were paying, merely wanted to offer a fair exchange to may new staff member.
Okay, she started. Things went very well. I enjoyed having this person on my team. She was able to keep revenues flowing. I did lose ground during sick time and vacation periods though. Then there were occasional punctuality issues. Overall this was a good hire. I had worked with this person for a couple of years. Once she completed her night school she too moved on. At this point I went through a string of unreliable hires. Each interviewed well and for the first couple of months was great... but then became full of personal conflicts. The details are irrelevant but I got so behind in my billing, I almost lost myself again. I talked to a friend who had suffered years before. He told me about how happy he was with the billing service he hired. I could not believe that he was just trusting someone blindly. I told him no way. He gave me the number of the company, and told me to call. I thought before this call, I would ask around to other colleagues. I was truly surprised. I called several different D.C.’s, and over one-third of them were using billing services. Two of them were even using the same one.
I made the call. Since then I have been using the same company for nearly three years. What a relief. I have since gotten married and had a child. My patients see how happy I am, and the referrals reflect how happy this makes them. My billing is current and I don’t need to worry about turnover. The cost is less than one half of what I paid the other billing staff, not to mention payroll taxes, and all the associated conflicts. I never train anyone for billing, and enjoy life much more overall.
I wrote this article to reflect my own personal case study. It is intended as my testimonial to the benefits of hiring a billing service.
Best wishes to all,
Dr. Marshall P. Luck D.C.
Rincon Chiropractic
www.rinconchiro.com
