By: Barbara Cataletto, MBA, CPC
Business Dynamics, Inc.

Well we certainly have been hit with some game changes in the medical industry. How do you believe you will fare in the upcoming months and into the years? Are you looking to your practice/business to promote change, enhance existing services, or overhaul the existing corporation? Well before you do anything rash, make sure you fully research these moves and opportunities.

Several different mechanisms of change will come about if you look to your basic success and failures of the years' past. Critical analysis is a gold mine if you choose to assess your findings.

We have noticed a trend in our business: an expressed increase in the opportunity of outsourcing the revenue cycle to talented groups who provide as much transparency as possible, while keeping the practice out of the day to day grind of billing and collections. We have been able to identify our clients' true need to provide educated, trained billing staff at a price point that is acceptable, remove the unnecessary staffing issues that they often cannot manage, and increase their bottom line at the same time. How did we do this? We listened to the statements of resistance to outsourcing. Bad experiences with previous billing companies, not having a good connection with the management teams who do not really understand the mechanisms and flows were often key issues to change. So we set forth to focus on those key elements.

We expanded our access into our RCM system to allow for three different levels of access, based on the practice's comfort level with their staff member's security level. We provided additional reporting as needed for the individual practice's accounting and finance needs and then we follow that up with surgical case audits so that the practice could see just how each surgical case was paid, not just each code. We could not have done this if we didn't listen to our current client's suggestions and other interested parties' wish list requests.

But with each added value service is a hidden cost; how would we manage to provide these services with the staff already involved in the day to day operational tasks? Certainly we needed to be mindful of the bottom line and look to promote ways of completing required work while increasing transparency, so we looked to the brightest and the best staff for input. They indicated that we needed to train our already existing staff to a higher level and bring in new fresh blood to continue with the steady growth, work with technology to remove unnecessary delays, and allow for a continued succession of promotion of supervisory and management teams. These teams would be responsible for the continued daily training and development of their staff, allowing for a cycle of growth and continuity.

We have continued to develop training when we believe that the processes in some areas have too many gaps. This forces us to address inadequacies in our departments and engage the staff to find agreed upon solutions that ultimately develop into a standardized training program. We have utilized those that do the work into those that teach the work/ responsibilities so that we have a true appreciation of the mechanisms and client responses. This avenue of training has been very successful and replaces the "on the job" training that most practices have in place. The return on investment is the ability to get new staff quickly up to speed, while providing a cohesive program for all existing staff to rely on. With that result, we have increased our capabilities to bring on more clients while maintaining our quality and confidence in our work.

Producing higher level skilled employees will also promote success, no matter what the challenges may be ahead of you. The smarter the staff is about the business environment, the easier it is to identify problems and quickly adjust or correct. An educated staff becomes the business' advocate, and ultimately the clients' advocate as well. Open discussions with managers about client concerns allow for dissemination of resolutions amongst each other and can be carried on if these same issues appear again over time. Confidence and collaboration will help the management team to develop stronger bonds with both staff and clients alike.

Our technology needs have been under some scrutiny, as we head into the area cloud based server management, something of concern for all of us who have been hit hard with the many satellite offices and offsite employees we have to contend with. And let's not forget the bizarre weather patterns that have been both devastating and harmful to many businesses in so many regions in the country. Committing to upgrading your servers and redundancies is critical in this upcoming year, simply by looking at the past weather histories of the past years. The trending is also to allow for staff to work from locations outside of the immediate offices, both for convenience and cost saving, so looking towards the IT companies that have a good handle on this will enhance both the financial and the physical bottom line.

All of these changes will not come easily and preparation is an absolute requirement, as the devil is in the details. Be sure to include your top level staff and get their feedback, and modify your plans to get their support and ultimately the best results. Keep your clients in the loop about changes as well and know that most clientele will be more than willing to engage if they know that there will be benefits in it for them. Know when to modify and manipulate plans to keep the final results in check. Not all programs go as planned. Communicate, inform, and involve all areas of problems, resolutions, and shortfalls. Staff and clients that are committed will be willing to help with managing a positive solution. This is not easy as it requires the ability to admit mistakes, errors, or even just bad ideas.

This industry has turned us on our heels and all involved have concerns about their future incomes, profitability, and overall survival. Keeping abreast of changes, forming alliances, and operating a superior business will help reduce the damage now and in the future.

Barbara Cataletto, MBD, CPC, is CEO and Managing Director of Business Dynamics, Inc. Affiliates of Business Dynamics, Inc. include Business Dynamics RCM, a full-service spine coding and reimbursement firm that provides the spine industry with the support and tools needed to improve their revenue cycle management and develop and grow their spine business; and The Business of Spine", customized education and consulting for the entire spine industry. Barbara is considered the nation's subject matter expert in the field of spine coding and reimbursement and sits on the ISASS Coding Task Force, Adelphi University's Robert B. Willumstad School of Business Board of Advisors, won a National Stevie Award, and was named one of the 50 Most Influential Women in Business in Long Island, New York.
For more information about Business Dynamics RCM, visit www.businessdynamicsrcm.com or email contact@businessdynamicsrcm.com or call (516) 294-41