How finding the right medical company can be the difference between a successful and unsuccessful practice.
“She couldn’t even buy a hairbrush. So, we took her on and we did her billing and caught up all that back billing. A few months later, I went back and I said, ‘I don’t see your minivan outside.’ She had this broken down little minivan that she was driving around. And she looked at me and she said, ‘Girl, I just bought a brand new crossover SUV!’” -Jam Fleming of Accurate Medical Billing
In this episode, Dr. Jen Barna talks with expert medical biller Jam Fleming of Accurate Medical Billing. Finding the right medical billing company can be the difference between a successful and unsuccessful practice. Jam shares some fascinating stories with us about practices that her company has been able to save from closing their doors and even embezzlement. She also shares some important tips on what you should look for when hiring a medical billing company. For instance, did you know that you should find a medical biller who works on a percentage basis instead of a claim basis? Tune in to hear what you should know about medical billing and why it matters.
Check out some of the success stories from Accurate Medical Billing HERE
As a Better Business Bureau of South Central Louisiana Accredited Business, Accurate Medical Billing upholds a higher standard of service for all of their clients. They place value on their relationships with the people with whom they do business. From their healthcare professionals, and insurance carriers, to their staff and all the way down to the driver who delivers their claim forms. They appreciate the people who help them keep their doors open.
Accurate Medical Billing is committed to offering their healthcare professionals a cost effective alternative to maintaining an in-house billing office by providing the same benefits and services without the overhead and time constraints associated with housing, managing, pay rolling and insuring a full time staff.
Their goal is to collect every penny owed to their providers from all sources including insurance companies and patients alike. They work with their providers to ensure that they are fully compensated for the services they provide.
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Podcast produced by: Amanda Taran
Please enjoy the full transcript below
Jam: She couldn’t even buy a hairbrush. So, we took her on, and we did her billing, and caught up all that back billing. A few months later, I went back and I said, “I don’t see your minivan outside.” She had this broken-down little minivan that she was driving around, and she looked at me, and she said, “Girl, I just bought a brand-new crossover SUV.”
Jen: Welcome to DocWorking: The Whole Physician Podcast. I’m Dr. Jen Barna and I’m excited to be here today, because we’re going to talk about a topic that we have not ever talked about on the podcast and that is a topic that in the past I’ve always dreaded and refused to learn anything about, but I think as a physician, it is important for us to at least know our options about medical billing. If we choose to know nothing about it, which I still do, it is also good to know how to choose a medical billing company that can help you to reach your goals, whether those are to hand it off completely or to be involved to various extents depending on your interest and your personal needs with your practice.
I have a guest with me here today, Jam Fleming, of Accurate Medical Billing in Baton Rouge, Louisiana. Jam and her organization are Trusted Resources on the DocWorking site. We have developed this section on the DocWorking website of Trusted Resources. These are businesses that we have gotten to know and trust that we would use personally. I wanted to invite you, Jam, to DocWorking: The Whole Physician Podcast, because I really want to hear your expertise about how someone goes about choosing a medical billing company, and then some of the stories that you’ve seen with some of your clients over the years. So, Jam Fleming, thank you so much for joining me today on DocWorking: The Whole Physician Podcast.
Jam: Thanks so much for inviting me and including me in DocWorking.
Jen: With your experience, you’ve been in medical billing since 2009. Is that right?
Jam: We’ve been a BBB Accredited Business since 2009. But we’ve actually been in business since 2005.
Jen: And you work across multiple states with multiple practices in multiple types of clinics and practices. So, physicians, and psychologists, and what other specialists do you work with?
Jam: We have a lot of behavioral health clients, we also have a couple of surgeons and a couple of PCPs, we have urgent care, OT, PT, and ST, the rehabilitative services, we do that as well. So, we have a whole spectrum.
Jen: And you have a phenomenal rate of collection. I’m interested in hearing about that. But I guess, what I’m wondering is, if I were to come to you as either private practice, maybe just on my own or a small group private practice and say, “Okay, we’re opening a small group private practice. So, we need some medical billing help.” What would be the questions that I should be asking when I start to look for a medical billing company?
Jam: We could actually even look at it, like, we are having a conversation about that right now. The first thing that I would ask you is, where are you in your credentialing process? Because when you’re starting up, you have to get on board with all the insurance companies to be in network. So, that would be my first question: “Where are you? Are you just starting that process and do you need guidance in that? Or, are you already established in that work and are just really needing someone to do your billing?”
Jen: Oh, so, that’s a great question, because I didn’t even realize that you provide help with credentialing for insurance providers.
Jam: We do. I don’t know if it’s standard in the industry, but for us, the more successful our client is, then, of course, the more successful we are. So, we want to set them up for success from the beginning.
Jen: Great, okay. If we’re wanting to find a medical billing company to help us run a successful practice and we really want to outsource that, if we were to go out and contract with someone, they might just do this one subset of billing, whereas another company may be able to do a much broader and thorough job depending on how they function. If I’m wanting to sort out which is the best medical billing company to work with, what would I need to know or what would I need to ask?
Jam: Okay, so, I think that the most important thing is compatibility, relationship. You can tell by talking to someone on the phone whether or not you are compatible, because it’s more of a relationship than just a company out there doing something for you. Even though the billing company should hover in the background and really never be seen, you still have to work with the providers to reach their goals. If a medical billing company is not interested really in what you need to do to have a successful practice, what you need to collect monthly and offer different solutions for that, then that is just going to be the type of company that a provider– they don’t need help with that and they’re fine with someone just filing their claims. Does that make sense?
Jen: Yeah, I love that. If you’re someone who is really going to truly outsource the medical billing, you need a company that is going to know you, know your practice, and really understand what is needed and what needs to be done to get the collections accomplished. Then you need that report, so that you understand what’s going on at different times.
Jam: Exactly, because some people will want suggestions and some will not. When we’re looking at a provider and their codes that they’re using, if they’re not using a specific code in their practice that they could, and I see that other providers in their same specialty are using it and they’re not using it, we’ll look at that, we will catch it and we’ll say, “Why are you not using this particular code?” They may not even know that they should be using it.
Jen: That is a great point and that would be exactly the kind of thing that I would think would bring huge value from the physician standpoint, especially if it is someone who has not learned about medical coding, which I think a lot of us don’t have the time or desire to take on. But we also want to be confident, of course, that it is being done correctly. How would we judge other than experience, and time, and other clients, who have been with someone for a long time, which to me is an indicator that someone is doing a good job? So, that’s one thing. Is there any kind of licensing or something like that, that we should be looking for specifically to know that someone is adequately trained?
Jam: In Louisiana, there’s not a license required. There are a lot of courses out there, a lot of training colleges that teach the medical billing modules. But you don’t have to have a license. They give you a certificate that you passed the course. So, I think the best way would be to check references and to find out what types of providers the billing company currently builds for.
Jen: Perfect. I completely agree. That makes great sense. Working with the providers that you’ve worked with over the years, I would love to hear some stories of just, what have people brought to you, what has surprised you about working with different providers? Do any stories come to mind for you?
Jam: Well, I tell you, providers usually come to us in a frenzy. They know that their billing is not working, but they’re afraid to make the change. Rather than accepting that and interviewing medical billing companies, they just stick with what they have and hope for the best, until their cash flow is so behind that now they’re in a panic. I’ll tell you, probably 80% of the people who come to us are about to close their doors, because they have waited way past the period that they should have to start looking for a solution to their medical billing.
Jen: Wow. I love that you said that, because what we do at DocWorking, of course, as you know is help physicians to prevent burnout ideally and/or deal with burnout. Of course, that is a situation that contributes in a huge way to physician burnout. So, if you can help people turn their practice around, that must be really rewarding.
Jam: It is and it happens pretty quickly, because once we have the information, it really only takes about 14 to 21 days to get money in the bank. You should be able to hand over your information to your medical biller for the past year, because you have a year to file a claim with almost all of the insurance companies. What we like to do is get that information, and then we just all dive in, and bill that entire year within the first week of receiving the information, so that in two weeks’ time the payment floor, they call it that because years ago you would send in claims and they would literally stack them on the floor because they were paper claims, and then they would go to the piles. So, that was called the payment floor.
The payment floor is 30 days by law, they have to process the claim within 30 days. But the payment floor for most insurance companies is 14 days. That’s why I say 21 days. Your biller should be able to input your information and then after that first week of doing that within 21 days, you should get a huge check for everything that you thought you lost over the past year. If it’s a year, you can get your money.
Jen: Is it common to find that there are filings that either weren’t made or that were filed incorrectly?
Jam: Extremely common, just about all of our providers have that situation. If they’re not starting up new, then they probably are in that situation.
Jen: Now, I know why your references are so good. So, what’s the most interesting situation you’ve come across where something came in and you guys were able to sort it out, but it was just the most interesting thing?
Jam: Well, as far as the claims go, I had a provider, where their the billing company was not billing the claims to the correct insurance company. This provider dealt with Medicare a lot. Medicare pays 80% and then either the patient or the supplemental policy pays the other 20%. This provider handed me an EOB (explanation of benefits) for about $20,000, and he got paid $1,500, and all of the claims that were denied were submitted to the supplemental insurance company instead of Medicare. Does that make sense?
Jen: Yeah, so, you were able to just submit it to the correct entity, which would have been Medicare to turn that around.
Jam: Yeah, turn that around, so he was able to make his payroll. I had a company, who actually– Their billing company stopped billing for that. They just said, “No, we’re not billing for you anymore,” which is very rare. That rarely happens. Usually, a provider leaves the billing company. They asked us, “If we could just help them make their payroll,” which we do. After a month of us doing the billing, they were able to figure out that the head guy in charge was actually embezzling their money. But they weren’t getting that from their previous biller reports, monthly reports that showed how much money came in and what patients it attached to and all of that. Our reports are very detailed. When we gave them the report showing how much money we collected and they saw how much money actually went into the bank, they started making inquiries, and they were able to find that out, and save their business in that way, because now they’re getting all of their money without someone siphoning it off the top.
Jen: Wow, that’s an interesting story. Fantastic. Yeah, of course, staying on top of it with the monthly reports is critical.
Jam: If your billing company is not providing you with reports, then you should be skeptical.
Jen: Absolutely. Yeah, that makes sense.
Jam: One thing that I always ask my providers is, “What do you want?” I had a provider that shocked me, because when I asked her that, she said, “I want to be able to buy a hairbrush.” She had a successful practice. She had people coming in and out of the door. She had employees, she had everything. But when it came time for her to get her paycheck, she wasn’t getting a paycheck and she couldn’t even buy a hairbrush. So, we took her on, and we did her billing, and we caught up all that back billing. A few months later, I went back and I said, “I don’t see your minivan outside.” She had this broken-down little minivan that she was driving around and she looked at me and she said, “Girl, I just bought a brand-new crossover SUV.” That I feel is the type of difference a medical billing company can make in a provider’s life rather than just in their practice. So, I like to always tell that little story.
Jen: I love that story, Jam, because it really gets to the point of how you as a medical biller are impacting the lives of the providers that you serve, and what you do is so important and makes such a difference. So, what is the message that you would most like to get out to the DocWorking community?
Jam: Don’t be afraid, knowledge is power, ask questions, and just feel out different opportunities with different types of billing companies until you find what you feel is comfortable.
Jen: Yeah, absolutely. Find the team that you are most compatible with that you really feel you can build a relationship with.
Jam: Right. I think that another important thing for choosing a billing company is that you choose one that works on a percentage basis rather than on a claim basis. Because if someone is working on a claim basis, they’re getting paid for filing that claim, regardless of whether that plan gets paid or denied. They’re still getting the same money. But most billing companies that bill on a percentage basis, they only get paid if you get paid. So, it gives them that extra incentive to actually make sure that you’re getting your money rather than just filing your claims.
Jen: Fantastic. That’s critical. Well, thank you, Jam Fleming of Accurate Medical Billing. It is terrific to speak with you. I look forward to talking with you and having ongoing conversations. We really appreciate having you as a trusted resource, because we value you, and your business, and everything that you’re doing for your clients, who are members of our physician and healthcare community. Thanks for joining me today on DocWorking: The Whole Physician Podcast.
Jam: Thanks, again, for having me.
Jen: And if you’re interested in learning more about Jam Fleming and her medical billing company, Accurate Medical Billing, you can find a link in the show notes. You can also find her on the DocWorking Trusted Resources section about medical billing and Jam tell us other ways to reach you, if someone is interested in learning more.
Jam: Well, we have a website claimsgetpaid.com and you can also reach us through the South Central Louisiana Better Business Bureau website. There’s a link to our company there, too.
Jen: I look forward to speaking with you, again, soon.
Jam: Thank you. Have a great day.
Amanda: I’m Amanda Taran, producer of DocWorking: The Whole Physician Podcast. Thank you so much for listening. Please don’t forget to like and subscribe and head over to docworking.com to see all we have to offer.