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[Music] [Laughter] hello good to have you hi good evening good evening it's me berger are you here with us right now my dear welcome welcome we're gonna um allow a couple of books to come in got a little echo or something do you hear me echoey yeah yeah i hear enough strain hello does it sound clear though are you there yeah yeah let me make sure it's the right microphone maybe okay testing testing now it's better now it's more clear yes that's my fancy microphone hey y'all as you're coming in drop in the comments what is your day like in one emoji how do you feel today one emoji to tell us how you're feeling today i'm gonna close this door and request someone to turn on the air because i'm hot up in here and she's super hyper fyi thank you yeah and i'm drinking um stress relief tea oh really i thought you were gonna share like uh wine or something that you're i like how you have your name on it just in case we forget it that happens sometimes yeah are you drinking enough yeah i'm just gonna bring this glass there's one glass which it's out there she's like i'm just gonna keep this at your office and i'm like no that's gonna like hang out outside thermos like when i need to keep my cold wine in it like you can't bring that to the office i want to make tea in it you're gonna have to get a teacup mom hey guys as you're coming in i see you folks are here drunk in the comments one emoji to represent what you feel like today what was your day like i don't know why it sounds echoey for some reason hi good evening nc worker we gotta get your name one day are you in the facebook group nc worker so i can know what your name is just for my own all right we have some folks here you guys met tiffany last time welcome back tiffany we got her back again you didn't scare her away exactly yeah thank you guys for being kind to her and making her feel at home um and then we have christina hi guys super exciting this is my first time so bear with me [Music] i told you guys last time it's a really big deal to be on live like there are a ton of like people who are avid youtubers and you know making content all the time but you put them in a you request them to be live and they're like yeah you mean there's no opportunity for edits or anything no oh amy's got the the er like is that nervous like the ones with the i don't know what it's like a zipper yeah that one amy yeah and lee virtual head virtual hug welcome guys so um if you're just joining us drop in the comments if you're on facebook drop in the comments and make sure you approve so i can see your name otherwise it just shows us facebook user and i won't be able to address you um so what i was saying is that yeah it's a little nerve-wracking coming on live and so high five to both of you we're making it and it's an evening they've been working all day i know that because they've been working in the office with me all day so um yeah they've been putting up with me for almost 24 hours right i'm at 24. i guess more like that like 12. yes i'm so happy that you're here so let me let me share so oh man amy sorry to hear that yeah hugs healing hugs my love yeah hopefully he's feeling okay get lots of rest i know from experience my my scratchy voice that keeps coming in and out these last few weeks this is a result still of my situation with the vid so yeah so um it's just like weird stuff i just my allergies i'm blaming it my actually the doctor said that it's because of of my heightened inflammation inflammatory response because it killed it's those i've never had allergies like this where it lasts me for weeks and that's so severe so it's just weird stuff and i've got girlfriend still that she's got the swelling of the hands and feet like every time she eats anything with sugar oh my god yeah so it's bad amy oh is he going to school in person that's a good question lee i'm curious i don't know all right so um so yeah so christina's here christina has been how long have you been around with me again how many it's gonna be 12 years i keep playing 13. i've skipped over 12. i'm like it's been 13 years that's fine yeah pretty much right so 12 is i mean after 10 right it's like over a decade right exactly it's funny after chatting yeah so we've she's watched me grow up have i grown up though i don't know she's watching what do you mean well you've been always been very um what's the word um oh i can't even say the word uh very mature oh okay i was gonna say is it a word that we're allowed to say here you've always been super mature and especially the fact that i'm older than you and you are already super mature so only by like six months right wink wink that would make me a little younger i love it yeah so we've been working together for a long time so tonight's conversation i wanted to talk about is you're a senior yes a senior in college we're gonna say i'm only a sophomore she's a senior so um so yeah so what we're talking about today is essentially our lives going from entry level to medical billing management right really overseeing the revenue cycle so we've all actually started in healthcare like the bottom of the food chain we'll call it totally yeah um and so it's just a fun i think topic and a fun discussion so as you guys are joining us let us know what questions what do you want to know what do you want to know what details do you want um and um and yeah so we are today just going to have a good casual conversation i don't necessarily want to go too far into anything specific because i want to give you guys an opportunity to ask questions um and i i had on my mind to talk about some management level certifications because i've had that question and i was working on a video for one of our um subscribers on the channel and um and it just kind of like brought it to my mind that it would be a great thing for us to to chat about so um yeah so with that said christina you want to tell your story girl tell us how you got into healthcare how detailed you want to get with us okay no names how did you get into health care okay the billing side all right so i'll try to do the very short version it's very hard for me to do short version um so i got into the medical field um i was married before um well let me start with i was totally not in the medical field at all i used to work at kinko's i worked there for almost 10 years and then i got married and my husband at the time was a doctor so i ended up quitting my job at kinko's and then i started working at his office um and that's when i got thrust into medical billing that i was not doing anywhere near what the real building is i was just sending the claims i had no idea how to do anything aside from that i kind of just peeked my little head over the the current billing lady that he was using she would come into the office to do his billing and i just was spying a little bit i'm like i could totally do this let's just get rid of her and you can let me do it so we ended up doing that and then flash forward um that was like almost five years that i was there maybe a little less and then i got a job i got divorced i got a job at a chiropractic office and that's where i met jasmine and that's where jesus made beautiness happen so that would be literally the worst job of my entire life i'm gonna just say that um but i only i'm happy about it because i met jasmine there i mean she had just um taken over the building for the chiropractor that i was working at um i think you had you were just going in that day right i was like it was my second day on the job and jasmine comes in super professional with her little briefcase and everything and you know i was dying behind the front desk i had never been working you know front desk before at at a doctor's office um you know when i was working at my husband's office at the time i didn't really do too much with the patient so so yeah so i met her and um i lasted a month at the job i ended up he fired me which was totally insane but blessing in disguise um he fired me and i uh went on to craigslist and i applied for a job my only thing anymore i don't know it wasn't back then so i looked on craigslist and the only one that i sent my resume to just coincidentally was to jasmine she didn't put her company name or anything i saw that it was medical building i'm like okay i'm gonna i'm gonna send it and see what happens and my god what a small world that it was her i mean just crazy so it was totally meant to be um i gotta say from my perspective how that happened pause that part of the story because it's so fun because literally i so interestingly enough i had been putting random ads or things out and craigslist was like a place that i would be responding to people's ads they were putting out like oh we're looking for a biller we're looking for this so i would put out you know hey like i'm i'm in the area keep in mind i had just moved to florida i don't know a month before or something it was not even it was very very short time that had been in florida and they responded that practice responded to one of my messages and then we corresponded and then they said come into the office and um keep in mind the very first practice that i had been like to at all in florida the very first time that i had ever worked with anybody in florida actually any medical practice so i just moved from out of state far away california to be exact so i'm very far away from florida yeah and um and so then i could get back to this like practice and i meet this amazing trick at the front i'm like oh my god she's so great we're having a great like interaction she's super inviting super engaging i go back to meet with the doctor totally fine it wasn't until like our second or third meeting that he mentions oh she's brand new he was a little bit different we're just gonna say that and so she she starts talking about oh she's you know she's she doesn't know what she's doing and this and that and i'm like how long has she been here she'd only been there for a couple of weeks and i was like what i thought she was like i want you doing for about that couple of days yeah oh my gosh i thought you ran the practice yeah that's right at that point i think this is like our third meeting so i i this but i had no idea like i had just met her that time that i met you was just a couple of days in i think your connection's getting bad or something you're chopping up a little bit the storm's out there it's important she's still in florida guys that's no so yeah so that was my from my perspective i'm like i had no idea that she was brand new that was the first thing and i was just impressed like from day one so i've had an ad out that i'd put out for a billing a billing assistant actually at the time because i just moved down there and i needed somebody to come you know to my home office to help out with with stuff which is like a weird thing but it was a thing and so um because it wasn't really like doing a lot remotely per se especially in a place that was like brand new so um so literally i get the resume i still had no idea that it was you because she had a name like her maiden name i think on the resume and i knew you're married neighbors i like i knew her name from the practice so it was a very funny serendipitous thing when we finally came together and i met like i realized that it was you like i'm talking to him like did you used to work at like a sport but i kind of know your voice and i mean you guys we're talking about miami we're not talking about like some small town where there's like 10 people like this is there's like millions of people in miami so it was absolutely totally all god so yeah yeah it's craigslist the trusting site no lee i would say because i don't know anything about craigslist uh no the answer is no i um i would say stick to indeed or zip recruiter don't go on craigslist looking for a job okay a long time ago i would not go on there now for that yeah so okay continue your story christina okay so then um so i went and i interviewed officially um at jasmine's apartment um and we hit it off she's like listen i'm giving you the job or just come so we can do the interview i'm like okay cool i'm gonna go so nothing she offered me the job and you know i i literally i had i'm not even gonna count the experience that i had at my ex-husband's office because i really didn't do much except just literally send the claim that's it and you know put in demographic information so i learned everything she showed me um i started just with doing answering the phone doing eob posting which i loved for such a long time um i never thought that i would get tired of doing the eob posting until you know a few years in when i started to you know learn a lot more um but it was great i mean she did such a nice job teaching me it was it was really good it just worked very smoothly i was able to pick onto stuff very quickly um and then you know i got thrust into doing the ar stuff which i really enjoyed as well you know every time you got a clean paint it's like yeah yes um so so yeah i mean it was great i've learned everything from her so she has she got me like a little infant and uh spoon fed me and baby fed me the whole time but i think it went pretty quick in my opinion considering i didn't know anything about anything yeah um and i've learned at all i know how to do the eft enrollments edi enrollments like i've learned even computer stuff i learned how to do it stuff because i didn't know how to do that he's the backup i.t person like person needs some other help or like to break it down for it like an issue let me get on and let me log on to your computer remotely and figure it out yeah exactly i can do the basics it's like your computer doesn't work restart it boom exactly i love it no i mean truthfully like from day one i've been i've been super blessed because these two ladies that you guys are meeting here like from day one they they've impressed me so which is why they're here and like i mean not to say that i mean our other team members are amazing but i feel you know like when you feel like somebody fits you know it's like the puzzle pieces they're like okay like you're the piece you're the missing piece like i lost it i found it and so yeah christina like when we first got together like i didn't you know you really were the easiest person to train like we've had issues with people over the years and we're like why is it so hard like it's like christina gets it like yeah i don't know i don't want to use myself as the example like if you're able to show me not that i'm not a stupid person it's just i i knew nothing and she was able to teach me a couple of months and you just slowly start to get better and better at what you're doing you just have to have the drive to want to grow and learn more that's very important in this industry um you don't want you don't want to stay like a stagnant and stay in the same spot because you're you know you're just holding yourself back to be able to learn more and grow more so yeah i love that that's a great tip right listen be open to change because i know change is really hard for everybody it's hard for me and i've grown leaps and bounds for sure because jasmine it pushes me and squeezes me to do better so like tonight this is the thing for like people yeah i've seen it like comfortable i mean i never i was a very shy person when i was younger so this is like a huge step for me i started going to like let's talk about okay well let's answer some questions there's a couple of questions okay so um so okay please comment christina you now need to make so much money in india and md billing that you don't need a man an empty marriage yes we're staying away from that is it true that insurance companies will only accept clan claims via a particular billing software such as blue cross or availity okay so clockwork you sent that comment to me on one of the other videos and i asked for you i want to know more about you said blue cross and availity and there are companies that have preferred um clearinghouses right that they receive from every company has a representative clearinghouse but the companies talk to each other so we can we can talk about that more specifically at a later date but basically we as providers organizations have our clearinghouse the insurance companies also have their clearing house and so if they only have a clearinghouse that like is available for example or what's the main one like payspan or um what's the other kind of thing of another change health care change health care yes which was in beyond a little while yeah yeah and so change health care is a big one too so that that company is the company that represents the insurance but i if i have a totally different company my insurance company sends claims to change health care and they process the claims my my did i say insurance company my clearing house sends claims i don't have an insurance company yet wink wink no i only open one of those um no my my clearing house would send it to the um clearinghouse of the insurance company which would be in this case where we said change healthcare or availity right so it's not it's not a restrictive thing at least at this point in time so and if it were i i just don't think that there's any insurance companies that would i'll be allowed to do that the open market for um for clearing houses it's so big now like there's just so much competition there isn't like one company that owns the market share or anything like that i mean from the insurance perspective change health care is a really big one pay spend exactly ten that one has a ton of um insurances under it so yeah i hope that answers the question clockwork i say okay yeah i understand i think i understand so you're clearing how to building software communicate with each other yes yes exactly yep they work with each other you got it you got it clockwork and let me know if you have more questions about that because i'd love to expand on it if we need to in another um video too um oh okay lee tiffany tiffany lee wants to know how long you've been with the company also we have mostly employees but we do have we do have an offshore counterpart that we partner with they are not contractors or employees it's essentially we pay a vendor for the services and then we have two people that are contractors here in the states i think so most of our people are our employees though just him hopefully that answers your question okay tiffany and i would have been the jasmine for over five years so it'll be six years in september oh i love that you know the anniversary day christina knows hers i always have to look back i'm like what is the date again well i mean i listen what helps me cheat is because that's when i started going out with leo at that time so that helps me and then i know it's december yeah exactly it's true i i do that all the time now too like especially with the business like i forget i lose track of time so i do it off of ronnie's age you know it's insane so crazy she's like an adult almost like two years from adulthood it's crazy yeah insane um there seems to be a fine line between billing software and the clearinghouse yeah so a lot of software have their own built-in clearinghouse now they're most of the companies function independently and it's really just protecting their brand so they have their own software and then they have a clearinghouse brand or company that even they might own but it's not necessarily like one company for example the only ones that are like that are more like office ally they but they still kind of treat it like a separate product thumbs down i didn't say that i was kidding just don't come after me okay obviously yeah practice practice nate is their brand but i must i don't know if they i don't i've not looked into any of their legal structure or anything but their business structure i should say they um but they've got a different brand for their clearinghouse his office ally the software for billing is practice mate and i think their ehr has a different name too i don't remember what if you guys know you can tell us in the comments um yeah but most companies like have a most companies are trying to have a built-in software if they're keeping up with the times and they are a cloud-based or web-based system it's just the thing it's the thing that you have to do like if you're not doing it you're pretty much behind you should have something that's integrated because nobody wants to have the extra steps to move out of the software and send your claim somewhere else so um yeah there you go what are we talking about okay so back to what we were saying so christina what is it that you so you started out talking about payment posting and things like that so what is your day tip okay well let's talk about what you're what's your role right now who are you who are you with ibs so um i'm revenue cycle manager uh so i'm pretty much overseeing the entire revenue cycle for all the clients i do um the client meetings um i should have done a list but i mean i'm in the day to day as well so i still kind of dabble a little bit helping out with ar when you do filtering and stuff and i like doing that because then you kind of lose your touch on that kind of stuff so i do enjoy that um i also oversee the offshore company that we work with you know and help them i do trainings i'm an expert now doing uh training videos i haven't gotten tired of my annoying voice yet um archived just so you'll have my voice around forever uh what else i do um i do the client invoicing uh i answer questions if they have um questions on the invoice thank god that's very minimal because i'm the one doing them so there should be no questions because i'm doing it correct um what else uh reporting reporting obviously yes reporting okay yes i do um the reporting as well we have a cost analysis report that i fill out every week um also our combined weekly performance just showing um where we're at for each of the clients how many claims they submitted the value for the claims uh paper claims how money we send as well because we're tracking that obviously we want to try to keep that as minimal as possible unfortunately there are still companies incredibly that still want paper i don't know why the banging of my husband is like the bane of my existence insurance paper billing i know for sure we're going to get to a point at some point that they'll have clearinghouses that will allow us to send um medical notes with the the claims for personal injury and stuff so but yeah so we're tracking all of that we like to see holistically how we're doing um as a company and then you know how each other clients are doing as well um is that everything i don't know yeah well team you didn't talk about team stuff i guess management okay so team so we do uh exactly connecting with our team um where even though all of us are all in different states i'm in miami jasmine's in north carolina tiffany's in virginia we have people all over the place we are able to which is my favorite part of everything i love sending messages we're very communicative throughout the day um so we're you know i it feels like we're together even though we're not um so we do we do a little banter here and there um but we do do um oh this is best all the time but just on the day you see it in writing like in texas i mean i'm a professional at sending get gifts i don't even know how to say the thing okay i think that's right i don't know what it stands for gift i don't know i'm sure that the letter is important but i don't know so i love sending that but i just like having you know a good relationship with the team you know you want to make everybody feel like we're together even though we're not you know what i mean it's you have to do that you don't want people to feel like they're on their own island um so we do a weekly ar meeting um with our ar team tiffany's the manager for the ar so i'm on the call as well and we kind of will make a list of topics to talk about we answer questions in those meetings um and then just kind of you know together come up with solutions for the stupid little problems that we you know all encounter when we're doing this medical billing stuff um and just working together as a team to figure out the stuff and then bringing stuff to the table as well like air you know issues that one person may be having might not be affecting someone but at some point it will so we kind of talk that out and we do it together as a team um and then we have our manager meeting as well and then i update jasmine how things are going well me and tiffany do as well um so all the managers come together and we update jazz on where everything is at and so yeah so we're pretty much meeting a weekly basis um and then we have a monthly meeting with our entire team which is also fun too we try to to do what we call them icebreakers so i look up the icebreaker questions thank god for google because i would not be able to think of those questions on the fly um so yeah we should we should leave this session with icebreaker question that we can put on the bottom or something see we should write that down in the back on the back of the page you should write that down for us to do that or um icebreaker things are hilarious because that kind of you know helps you to get to know people and get people talking which me and jasmine are professionals at that i can probably talk non-stop here it's funny you think she said she said she was shy at the beginning but you would never guess it i think no i'm gonna tell you that yeah and it's funny because i know i was gonna say i remember when you first started doing the the management i mean the management the uh client meetings they were like oh my god i'm ready i'm sweating i'm so hot like like oh my god i'm turning red i see they're gonna be able now we do videos with a lot of a lot of people um some of our clients still just do by phone but a lot of you know a lot of people were doing video meetings that's kind of our knee jerk is like and that's not just kovid by the way like we've been this has been our structure for a long time so thank the lord we actually didn't have much impact really for anybody like our team at all i mean you know people obviously have their kids around and stuff like that during the time including me but most most people you know it's like life was pretty much like the same because we were always relaxing that was a huge blessing for us people have asked me i'm like no for me it was nothing happened but work-wise like it was yeah totally smooth thank goodness yes it's a huge blessing and i think the coolest thing is that i feel like like you were mentioning or describing describing like company culture like we've been great about trying to maintain like really great connections with our team and maintaining a great company culture where people feel included and involved and that's really important because that's why most of these companies who were used to brick and mortar and being in one office they've struggled over the last year because it's a huge difference when you hardly had a company culture that was like echoing when people were in the building and then now like remove them from the building and they don't have to see you every day and you don't have to say anything to them like or whatever there's no requirement of like communicating it's hard to retrain people in that kind of way so yeah yeah we have some questions let's see do we use a vendor for patient collections yeah we don't um so you tell me are you thinking like soft collections or like collections like hard you have not bill collections like impact your credit thanks let me know if you're asking which one because i can i can talk talk about both um how did you learn the different specialties guidelines and et cetera [Laughter] yeah yeah amy it's a lot um it's a lot let's just say that so and you know the issue as you all are aware is that every specialty has lots of guidelines from not just the the coding guidelines you know the procedure codes and things like that icds whatnot right we're not just talking about like if it if it were just like cms just tracking the the lcds and ncds the local coverage and the national coverage determinations that would be awesome but every single insurance company um has their own rules and guidelines and specialty so it takes time to learn that stuff like to build on that knowledge so it's you know yes as long as possible try to stay with with a comfortable specialty like i know your specialty if you know your specialty well stick with it he's ortho so yeah tiffany knows ortho too so i think it's ortho right right amy um yeah so i would say and you have a good variety if you're in something that has like overlapping for example ortho typically has like physical therapy in it they might have surgery things like that too so you know there's some there's some expansion there where you don't you won't feel like you are um completely getting out of the specialty like if it's pt codes and you had physical therapy at your ortho you probably feel comfortable with it so let's see okay um how did you oh stick with that yes both okay so lisa's asking the question so soft collections soft collections lee for patients we do as a billing company we don't do hard collections at all we actually allow our clients to tell us what they want to do so we've always done what we call a delicate patient billing process which means that we're very mindful yeah exactly we're very mindful of like we want them to preserve the patient relationship right there are some practices that could care less about the patient relationship they're probably not our practices like we don't i mean we want return patients for sure we want clients that care about the patient and the patient experience and so you know typically our clients want to know that the patients are going to get their information um communicated to them in a in a nice way so to speak in a way that is not going to make them hate the practice and run the other direction um and so when we do that i'm still getting like feedback and i don't know what that it went away and then it came back i don't know i don't hear it i hear you're fine oh okay it's like muffled okay okay all right so um what i was gonna say was what was i saying unless you were talking about the delicate collection patient building sorry guys it's late um so basically after the patient hasn't paid and they get to graduated status the client chooses where where that goes basically if they choose to not have it go anywhere and it just sits in bad debt in their software we do that and then we also can add it to a separate collection agency we do have some that we recommend but we don't have that one that we love like i'm not gonna say i'm not gonna say names here because it's not like any of them do anything different it's if you can if you have a practice that has a lot of patient liability and issues with collections and you have a local collections attorney i would honestly recommend working with the local collections attorney because it's a bit more successful if they do like letters from the attorney so but let's talk about the real deal here how do you prevent patients from getting bills that's like trying to amplify some of the stuff that happens at the beginning like getting getting a little bit better with the eligibility making sure people collect deductibles up front at least a portion towards it like getting estimations as well as tight and as well as you can so preventing billing is important because medical bills are like the last thing on anybody's mind and like nobody wants to pay medical bills so um i mean it's not you know it's it's not like a population specific thing it's like pretty much anybody and every um area and that pretty much every um level are not really that interested i was trying to make sure i answered the other oh so our company that we use for patient collections so we've we've recently switched to a company for to manage the cl it's essentially the clearinghouse process for us so years ago we used to mail statements i did it [Laughter] don't stop the whole thing not have to do that anymore do not mail patient statements there's a lot of reasons why you don't want to do it i learned the hard way that there's legal reasons why you have to like be careful about mailing patient statements you know i we we study this and we talk about this in the courses and stuff too that um the fair debt collection practices you have to just specific language every state has its own language nationally or federally there are laws around what you can and can't say it is very consumer protected right so they don't want you like harassing the patients and old school like form letters for billing and like i don't know if you guys remember this the stamps that would go on patient statements do you remember that last year yeah like the angry stamps there's a bunch of like of those forum stamps that people used to sell that most of that language you can't use so it was one of those things that like you know i was like you are used to that stamp or buying the stickers they used to have stickers that you would put at the top that stuff doesn't fly right um and so you know um we learned the hard way that you um when i say the hard way yeah we had a legal um situation costs us money a lot of money a lot of a lot of money we're just going to say that owning a business is not for the faint of heart those of you who wish to get into it so um got to be prepared for uh having a really good attorney in your pocket or a couple of them in different states if that's necessary yeah so if we do patient collections we use inbox health right now actually i have the box here on my desk because yeah and it has a t-shirt in it christina would you like it oh my gosh give it to me so this is actually the cutest right here you guys that right there that's super cute look at that oh doctor once wrote i don't know what it says there oh that's hilarious a rise doctor once wrote you can't read it because that's what he wrote yeah i didn't read i haven't finished uh unboxing but i'm gonna do an unboxing video but they i've had it for a while we've been working with them for a while now um but i um so far i really like their um everything about their process and if you guys haven't um heard anything about inbox health look into it because it's something that i think is going to completely revolutionize what we do in the area of patient billing it just totally changes the relationship and it's like it actually supports what we were just saying like the patient pro the patient communication process like having people feel good about the way that you're letting them know about balances they have a two-way communication i don't want to bore you with all the deals but so far i like the product you know there's things that we're working through yeah yeah well and just real quick they also have their own collection agency so you can literally send the patient to collections with their company with the click of a button you don't have to fill out anything i haven't done it yet but i didn't know that well there you go i gotta make sure i have that my list of pleasant i recommend because that's the thing is whenever we've worked with other companies too like every company is a little different about what they want and what they need for um for sending patients to collections so you have to like generate reports that can produce that information and sometimes it's a pain and sometimes it's a manual process right where you're not generating a report you're like typing something into another portal so yeah who sends the patient's statements so um it's a mixed bag on our team but it just depends so like our software's we're up we're we're producing statements from the software most of them and sending them somewhere else but we do have a couple of systems that we work with that have the clearinghouse function built in even for the patient statements which is helpful um there's not a pretty process like it's almost like i think about like the revenue cycle process you know it like runs out of steam at the back end of it like by the time it gets to patients like everybody's depleted and like nobody which is why patient billing is has always been a forgotten thing like in most companies there is they just are just sending hundreds of thousands to collections because nobody is really actively doing anything besides letting the bill go like i'm always amazed and i actually really i'm a little annoying you have to know this if i'm a patient at your practice i like to test your setup like i'm like what happens if i don't respond to your bill like oh so a month later you send me another one oh sorry and then six months later i'm still getting a bill like you just spent like 25 on me sending me a bill my bill was 20 bucks like that's strange so those are the kinds of things that i do when you are in billing you just get annoying like that yeah let's see what else is out there because they most companies don't have um they don't send you to collections for a certain balance because it's so little like you know if it's if it's under you know 500 bucks or something like that it really just depends on their policy um because some will send you for 50 bucks but it depends on their policy but um but yeah so let me give up i think we missed yeah i know soft is easy to do basically sending non-aggressive warning letters yeah i mean even warning letter you gotta be you would be amazed to know some of the things lee that are in the protections for fdcpa law which is why i recommend using a clear clearinghouse i should have said that from day one the reason why you want to use a clearinghouse is because they have to know that law because likely they are doing form letters they're creating the statement like formats and all of that so they want to protect themselves to hold themselves harmless they don't you know want to be a part of like some issues with fdcpa lawsuits so um so yeah i see what happens if the patients don't totally pay the doctor yeah some of them deal with it some of them don't lee [Laughter] i mean tiffany tiffany has some clients that like they just they just what do you think tiffany how do i explain that they just don't feel it's just like yeah they're very generous and don't go after the patient they just kind of allow it to sit there and you know they don't want to write it off for bad debt or get rid of it [Music] but they'll leave it on the ar the patient ar for six years to do nothing it's quite irritating for us as billers because like we want to generate reports and have clean reports that tell us stuff that we need to be billing like not just have stuff sitting out there for like years that we have no control over let me see forget about owning a billing business okay so we've told you this guys already that we're going to be doing the coaching program for the billing companies soon when we get to that you will get i guarantee you that you will absolutely number one on your list is going to be find an so attorney have somebody's number in your pocket that you can reach out to locally because your state is what matters right and you can even have something like a legal um shield legal shield is the um yeah legal shield where you can pay a membership fee and then you can talk to local attorneys you can get consult consults and things like that for pretty inexpensive so even something like that is better than like flying solo and thinking no big deal i know that doctor he's my buddy he's only your buddy until he's not your buddy and you're in court pretty much all right let's get back to talking about um tips let me see if clearinghouse sends a statement the statement is not is the statement is set coming from the doctor's address it yes usually um it comes everything is is addressed to the doctor's office there are like what i would call old school style formatted like billing companies that they process everything for the doctors so they even receive the payments and then they pay the doctors strange setup like i would if i were a provider and owned my practice i would never agree to that i would not want anybody else managing my money like because then your two your roots are too like intertwined like what if you want to leave that part they like manage all of your money that's i mean i understand it if it's like a full hospital setting and they've helped you like i mean they essentially are the management company for your organization but it's not the right thing if it's just a provider practice and you've got cash management happening outside of your business you're just like relinquishing too much power it's not okay so huh all right i'm gonna we're gonna pause the questions for a second because i want to know from tiffany what would be your recommendation for somebody who's like starting from entry level that is interested in developing themselves to like what is your one little tip that you would say what's like the number one for you that you should do to go from like management entry level to management yeah i mean i definitely think starting on entry level is the way to go because you just get everything from understanding the importance of demographics being correct um you know just everything for that and then moving on to billing and then you know why demographics is really important and just always be really like learn because it is everything is forever changing there's always room for improvement room for growth and just you know learning everything yeah and doing the entry level too um just the fact of you'll be posting understanding how to read an eob it's like mind-blowing how much that helps you when you start to do ar because you're able to like quickly look at the thing and be like okay i already know what this is for i have to do this and that's to correct it right so just learning the basics you have to do that piece first there's i don't think there's a way for you to skip that because you won't be functional if you want to be a manager do ar i personally like to be hands-on so for me the training and learning that stuff um really helped um put me where i am right now right i mean i would agree i think people management like from the perspective of trying to direct and instruct somebody like if you haven't really done it yourself like how would how can you be effective and and even be able to communicate well with them right like to say this is what's happened or this is what i've noticed you're doing wrong or here's how you can get better um so yeah i i would say that i've had people that you know have said they want to get into billing and they just want to like you know run the show kind of thing like you really have to be willing to learn um everything you have to have you have to be able to bring something to the table and how are you going to manage a person when you don't know how to do that are you going to direct them right i mean you can own something if you want to just walk in and like buy but you've got to hire somebody who knows the job that can do the real management stuff because you you will not be a great leader if you if you can't speak on their level like you won't be able to you know communicate with people like they have to understand that you they have to know that you understand their plight you know their world um so i mean i just i do think that what you guys are talking about with the ar follow-up part like it's the most important part for ar follow-up like if you don't understand how to read eobs you won't understand a patient account what that's supposed to look like um you won't understand how to communicate to a patient like why they own a bat oh a balance so many things so many things um i was just checking to see who sent you oh okay let me let me let me jump back into amy's question because i i didn't see it to understand what it says have employees in different areas how do you separate practices by roles or does one permit yeah okay no you want to share since you're here today we find that it's really good to not have one person doing everything for one client why do you ask it's better to have more hands in the pot and people tr not really tracking all other people's work but you're going into the same accounts that other people coming into and then it's crazy that you'll find oh well look this person didn't see this didn't see this so we definitely don't recommend having one person doing it all it's better to have a couple of sets of eyes in accounts like we'll have one person that does the patient billing um so that person's reviewing the account we have the ar rep that's reviewing the account as well it's just very helpful because nobody's perfect i'm not perfect neither is tiffany one of us will catch something that you know somebody else didn't catch it's just good time yeah it's doing everything stuff will get missed there's no doubt about it yeah yeah so absolutely yeah and i'm a big believer of and you know christina's learned this for me over the years too the departmentalization like because of that to protect the client you know um there are so many companies that function like the person the team the um client gets onboarded and then one team member gets handed the full account um and that's a that's problematic because if that person leaves you're left high and dry you've got to have somebody come to the rescue to try to you know manage those and some people own you know four or five accounts that they leave that one person leaves and everything's done you know and it's all fallen apart and and um not only that you know we've talked about this before but the concept of area of strength is super important like if somebody is really really good and enjoys like christina was mentioning that she loved him at posting at the beginning like if that's your jam you're just like yeah you know and you again yeah exactly one hand rocking it out right with your 10k we were talking about 10k last week we're gonna finish that conversation on resources because it was a really good one um but yeah so like that remember that we were talking last week christina you would appreciate this about the the 10 keys on the keyboard oh my god you gotta have that little number pad on the side you can not do posting with the numbers across the top if you're doing that you are doing a very slow job totally totally i'm like how many times did we buy you remember i was thinking about like when we had to travel you buy like you had we bought those those little attachments there's no way that you can do posting without that you gotta have it it's necessary but yeah so you know i absolutely think that when you are um finding yourself in a space where you enjoy a particular function that's the right space for you you should be able to at least you know maybe you would be the manager of that department that area at some point like it's it's the right thing like tiffany's tiffany is a rock star at ar which is why she's the manager she's an absolute wrestler and he has the answer to the ar davinci code and this is no joke this is real life that we're talking about right now she is able to figure out an ar puzzle i mean in the snap of a finger blink of an eye she's able to just you know pull it apart in two seconds yeah and like i don't even know i don't even know she breaks it apart and like figures out things very quickly yeah it's a very very cool thing to to watch i just if you guys anybody who's listening out there if you find someone who is playing with the science of cloning i will be fine i will you whatever needs to be paid to even trial and error it i need a clone of tiffany and christina please and thank you all right i'm i'm done here okay i stepped down from my soapbox yeah no seriously um when you find that you're in like that magic space it's the thing that you feel the most happiest we've i think i've talked about this on lives before but like when you find yourself in that happy space it's probably where you should continue to lean into and don't push against it like you know i and i think it's you know sometimes you do what's necessary like we've all had to do that over the years where you're just like i don't love this part you got to do it it ain't going to be pretty but it's going to get done but at the same time once you're done with that like once you get a chance you get an opportunity to lean more into the things that you're like really more into because you're just gonna it's gonna feel better the work is gonna be better gonna be produced better like everybody's going to be happier with the results so yeah you feel accomplished when you're doing things that you like to do absolutely absolutely yeah there's nothing worse than being like all day or even part of your day and something that you hate and then you at the end of the day feel like it's like never ending because you took forever to do it that's the truth it's like it moved slowly and you couldn't get it done because you freaking hate it so i have things like that i mean for sure let me would you say to oh yeah like tiffany i think we tried at some point you'll be posting it like years ago right and we're like a long time ago um what was it then i don't really like research research coding yes that's not going to be yeah no oh yeah you know let me real fast on that i did the coding course to be a certified coder you could not pay me all the money in the world to do coding all day i would not enjoy that at all of course by the hair of my chinny chin chin so i'll pass and you pass she passed first first time guys cpc first time passer i mean i felt super awesome i don't want to do that all day i mean and that's the thing is when you're when you figured out that part it's important not to try to push it because like there's some people that get into it and then you just like hate your life for weeks on end i mean that's until you decide you're finally done freedom yeah no i knew for a long time that i was not gonna be a coder i mean i haven't actually i was just talking to someone about this the other day because i've got all the books here um you know i actually took a picture with them earlier today it's like my affectionate coding book oh my gosh that's crazy how many trees are killed for the coding totally um but i i was like man no no it's not my jam not my jam i can make it happen for like uh a second or two let me see um what is the minimum work possible maybe just for one doctor one practice yeah what's the minimum of work possible that you could do to help a doctor from their billing situation what's the minimum work that you could do payment posting to help them i mean i don't know i mean minimum i would say maybe payment posting if they haven't if they have a clearing house um yeah she's asking just to be able to do like part-time billing basically what's the very minimal thing that doesn't take as much time like if they haven't if they have a clearinghouse and a software that you can you know either interface with or you can process them electronically um it's a necessary function i don't know that it's helping them as much like meaning it's necessary it's got to get done but it's um not gonna be like collecting more money for them or anything so i hope that answers the question but so it is very minimum though in the sense like versus like doing charge entry or something like that if it's a manual process that'll take you forever um not forever but it'll probably take you a while and it'll involve a lot of manual work um so yeah let me see um amy with the ar i feel that you wouldn't have to do to know every specialty because the eob posting yes they maybe some some things that you need to know guideline wise but you can still work with it yes possibly however so you have to understand a lot and this is i'll answer this question and then tiffany christina if you guys have anything to add to it um like if you don't know the specialty well enough or at least are familiar enough you really won't know when there's a potential problem you build on that knowledge it's not like you know we don't take a magic pill you're like okay optometry right tiffany yeah that would be great if somebody produces that you could reach out to me as well i will pay you whatever whatever's ready exactly along with the cloning give me a magic pill that will teach us new specialties um but you build on that knowledge so like you know for example fqhc like we've talked about that before we're learning fqhc as a team right and it's a necessary thing that like we all are comfortable with the little nuances from the revenue cycle the concept of revenue cycle it's all the same it doesn't matter what it looks like there's some that don't that have less patient responsibility liabilities some that have more there's you know carriers that cover more and less you know there's little things like that but there's really the truth is is that the revenue cycle itself is the same it's the nuances with the specialties that make it different because of the coding and the rules from the payers so um you will want to build on that information so you have you want to get as much knowledge as you can um you don't necessarily need like coding training to know more about it to do ar um but it could be helpful because you might understand like ways that you could to potentially shift um a a an issue with a coded something coded by a provider that he didn't know you know how to select the proper codes but then you'd have to also study the pair guidelines which coders don't typically know um they're tip coders there are guidelines in that coding book wow and that's what their coders are more familiar with the coding guidelines in the coding books billers we pay attention to more what the insurance companies say like what are the payers talking about that's what we need to know um so sometimes a coder might suggest something that feels 100 accurate and right but a particular insurance company doesn't want it that way if you want it billed to them they need it in this particular format i don't want to get too deep in the woods woods the weeds because we gotta wrap up here soon um we're gonna be in the woods too so let's see okay so basically i can deal without providing oh my god yeah for sure you absolutely don't need to do credentialing or coding at ali um i would say that the bulk of something that's valuable for a provider is going to be the the extending of the claims posting of the payment and the following up even the patient billing you don't have to do you can tell them to do it somewhere else or do it themselves and some clients don't do it at all like i said i mean some some specialties they just don't have that as a necessary component um so so yeah so i would totally not do credentialing or coding i would i would even suggest don't do it even if you have all the free time in the world and you want to start your own business don't do it at all to start like specialize as much as you can in certain things that you can get really comfortable and more proficient and you do not want to get out there and be like drowning in credentialing christina how awesome is credentialing like that's just a very long drawn-out process yeah and a lot of follow-up you have to be a professional of following and following up circling back thank god for um for uh google with the um what is that thing called the snooze this is something the email so it reminds you because it's just a babysitting job you have to be a professional babysitter yep it is it's all human driven at the insurance company level so it's a lot extra work um most of it is not uh automated in any way like where we find some things in the revenue cycle has the support of technology credentialing not so much so we have credentialing that's managed by i mean christina oversees the team but they do it and nobody else in the billing department touches credentialing because it's a pain in the butt it's the pain so i would not not not do it um yeah don't you don't you would not get stuck in me because you can branch out you don't have to you don't have to only do one i would just if you started with one to build your own infrastructure something that you're familiar with you'll feel better you'll feel much better you already have that familiarity the next thing that you could do is hire somebody that can help you that has another specialty experience so you know they can help you grow so maybe you if you're an ortho for example probably the next closer like sister specialty is like neurology right where you can bring somebody on that has ortho and neurology experience and you know they can help you build the knowledge that you need in that specialty hope that helps can ar be outsourced on other vendors i've never i okay i have never outsourced fully ar yes you can use offshore resources but everything needs management and oversight tiffany you want to share what i mean by that ar is just really hard to train because there are just so many small small details and you know it sticks with some people and others just really have a tough time with it if it's not black and white um but ar is just really hard to try to train someone especially you know if it's going to be offshore where they want everything all the you know the guidelines written out and it's just not every scenario it's hard to have every scenario documented on what you're supposed to do you're gonna see a lot of the same denials and things but sometimes it's not like a cookie cutter you know this way um so it's really hard to make a list of stuff it would be awesome uh we've tried to do that but yeah you won't ever cover everything you have to have somebody that is willing to like have the eye to look for it like it's like that pi investigative thing you gotta like be willing to kind of say that kind of looks at like that scenario but it ain't the same like and that's that's where you know because a lot of companies fail at that variability they think it's all black and white and really most of ar is very gray like there's and sometimes it's just a processing issue sometimes it's a major thing that you need to work on an appeal for you know like it just there's you just have to not you have to be willing to be more flexible in it and that's where we've found we've we work with offshore um for ar but it's not it's not like um they do everything we'll just say that they don't do they don't do everything we manage the whole process there are companies that hand it off and they don't touch it but that's not us because we just we like to make sure we have a standard maintained um because our name's on it there are some companies that they don't necessarily care so much it's not to say it like that they're just kind of like as long as it gets done even if it's not done right they're okay you know so yes i think it should be included lee i do it's i mean the truth is is that um ceo 16 amy name though everybody knows it and nobody knows really what it means it depends on the scenario right it's like claims information which is needed for adjudication say what that's super detailed not they think when you use big words doesn't that mean it's detailed [Laughter] say that it says the insurance clearinghouses um yeah is so there the thing about it is lee that ar as a function is the way that we recover the revenue so when there are denials or the claims are missing though that's really where we will find most of the ar now certainly denial management can be done without ar per se because ar is the concept of af