A Day in the Life of a Collector

A collector employed by Integrity Billing Company is a tenacious, insightful, detail-oriented, and persistent individual. Jane works at Integrity Billing; arriving at 8:30 in the morning ready to work. She immediately checks in with the Benefits department to offer assistance to an abundance of Verification of Benefits (VOB) requests. After she wraps up her VOBs, she immediately begins reviewing that morning’s EFT payments issued by major insurance companies, Medicaid, Medicare, and others.

Carefully examining as she posts, Jane searches for inconsistencies or discrepancies, taking note of any claims that need to be addressed. Sure, a computer could enter the payments and save her time, but at Integrity Billing, we appeal every inconsistent payment, regardless of the reason:  an incorrect deductible or coinsurance, a low payment, a short payment, or any other type of insurance payer error.  Jane is a member of the Integrity Billing team for her critical thinking. Jane is a member of the elite team of lead collectors at Integrity Billing.

Next Jane pulls a report of all claims outstanding, organizing and prioritizing the order she’ll work them. While on the phone with various insurance companies Jane works as a human lie detector, knowing exactly when to challenge the information she is being given by the health plan representative. She also knows when requesting a supervisor is appropriate. Jane spends her day advocating from the provider’s stance.  Armed with the information the health plan provided she then measures the situation, choosing the most effective way to solve the puzzle; whether it be submitting a corrected claim, writing an appeal, or continuing to verbally dispute the issue with her adversary. These intricate measures are some of the few actions Jane takes to ensure that the provider is receiving accurate payment for the services they provided. This is only a fraction of what makes Jane, and the other collectors at Integrity Billing the crème de’ le’ crème of behavioral health collectors.

Not everyone has what it takes to be a Behavioral Health / Mental Health elite collector. One needs to have the ability to remain resilient so one can continue to push forward despite barriers. One needs to be calculated and deliberate, so that a strong and unshakable case can be presented to the opposing side.  Lastly, one needs to be creative, abstract, and able to gauge a situation; so that the problem can be approached from a different perspective when previous efforts fail. These attributes and talents are not possessed by many.  This is strategic daily planning. That’s why the collectors at Integrity Billing are considered Elite.

Without question, if I were a Substance Use Disorder or Mental Health services treatment facility owner, I would want Jane or another “Jane” from the team of elite collectors at Integrity Billing to handle my collections. These are the type of professionals that I would want on my team.

Having seasoned collectors that stand head and shoulders above the rest is one of the many factors Integrity Billing prides itself on. It is a tremendous contributor to what distinguishes us from other revenue cycle management companies and one of the driving forces behind our “Expect More” tagline.

 

Sean McDonald

Road to Becoming a Successful Leader

As I evolve personally and professionally, I find myself seeking out opportunities to learn more about leadership. Working in Billing and Collections for behavioral health providers of Substance Abuse Disorders and Mental Health facilities, I will always work on my skills and knowledge; however, learning a technical skill in Revenue Cycle Management is vastly different then learning how to be a great leader.

I have decided to write a blog about leadership so I could become a respected leader. One of the aspects of being a great leader is you must be knowledgeable in the line of work you choose to be a part of. You must be dedicated and committed to your team. It is essential to have considerable communication skills, the ability to approach and establish an understanding of the mindset of your team.

A great leader should have the ability to support and guide the team to success. Leaders must be able to motivate, delegate, listen, make decisions and problem solve. Integrity is one of the most important things to convey to your team as leader, integrity is regarded as the honesty, truthfulness, and accuracy of one’s actions. I cannot express how crucial it is to have strong ethical or moral principles.

Leadership is an ongoing process to broaden and differentiate one’s capabilities required to perform effectively. As I develop myself into becoming the best leader I can be, I find one of the key aspects is attitude. Great leaders should influence their team towards their goals. In my experience a great leader is not about being the smartest, but it is more about understanding others and what makes a team work together to reach solutions.

Setting clear expectations is extremely important. In order for a team to succeed, they have to understand what is expected of them, and what their goals is. When expectations are clear the team bears the proper skills, knowledge, and resources to complete the task at hand. They are more likely to show accountability for the work they are preforming. As a leader it is very important to have team meetings to review and discuss the progress, trends and to ensure the team is meeting their individual and team goals.

Learn to motivate through recognition by giving feedback, new responsibilities, encouraging productivity, setting effective goals and team building. Anytime I find that feedback or assignments are not received well I immediately make a mental note to provide more encouragement. In my experience the more I give feedback and encouragement, the easier it is received.

Overall, leading a team is extremely challenging at times, however, it is very rewarding. We have worked hard to create an environment of integrity and transparency. Effective leadership requires fluidity to help deal with each situation on an individual basis. Mastering this provides us with the strongest chance of leading the team to success. We strive to be the best of the best, and with this mindset the leaders of Integrity Billing will guide our organization into a prosperous future.

“LEADERSHIP IS NOT ABOUT TITLES, POSTITIONS OR FLOWCHARTS. IT IS ABOUT ONE LIFE INFLUENCING ANOTHER,” — John C. Maxwell

SUD Billing Wellington, FL

Expect more from Us – A Utilization Rant

Working in the behavioral health revenue cycle management field behind the scenes performing utilization review and utilization management, advocating for those struggling with Substance Use Disorder and Mental Health Disorders has its challenges.

I chose to write this for its therapeutic value; although I do hope to get the attention of my colleagues to see if they are experiencing some of the same frustrations I do.  I have often thought of creating a supportive blog or platform where Utilization Review Professionals can share dissatisfactions, disappointments and exasperations over what are sometimes jaw dropping denials for patients struggling with potentially deadly issues.  It could also be a forum to discuss successes, as we know there are many of those as well.

Baffling are comments such as “we know this case, multiple treatment attempts- they will be fine in intensive outpatient” and “don’t expect a long length of stay, she is young she will bounce back. “   And my all-time outlandish award goes to “expect a step down at next review” – have you ever heard this and thought to yourself, “but I haven’t even provided the clinical for this review, how are you able to future trip my step down?”

These comments coupled with the denial letters received after a Peer Review make for further fodder. I do hope everyone is reading them. Personally, I can hardly recognize the clinical that was pulled out of conversations and used as rationale to deny a level of care. In most cases the information cited in the denial letter does not remotely represent the clinical information that was relayed to the doctor and it scarcely resembles any clinical documentation in the patient chart.

I often wonder if the physicians and clinicians at the insurance companies understand that comments such as “he is not homeless; he can sleep in his car” or “she is able to function day to day” after the patient attempted suicide the previous day, is homeless and also experiencing paranoid thoughts, could be considered discriminatory and stigma – possibly at its worst? That their oath to “do no harm” applies whether they are working in an office or working for an insurance company.

As I express my frustration, I would also like to convey that no matter what obstacle we face, an arrogant physician, a cranky care manager, a lax insurance payer, an indignant supervisor, we can’t give up on trying again and again and yet again to help those that are currently unable to help themselves. And further, we must always “Expect More” from those who can.

Although exhausted, we must pursue integrity. That takes stamina and the willingness to never give up. Our company tag line is “Expect More” – we never fall short of that; we give much more, that I can say with certainty.  We love what we do, we do what we love. We believe, that if you do not believe that a patient can get well and turn their life around then this is not work that you will be happy to do. I hope to see the day that the care managers of the insurance payers demonstrate the same belief.

At Integrity Billing, we celebrate victories such as overturned denials and appeals by ringing a bell every time those claims pay.  These are the types of things that make our day. Therefore, we are here.

Expect More.

Five tips for keeping a neat work journal.

My thoughts are constantly scattered. Having a broad range of work duties can make it difficult to keep track of responsibilities. At times, intense focus on a single task can cause a loss of sight for tasks that seem unrelated. I have kept a work journal for the past few years. It has helped me immensely. However, I have learned a few things along the way. Here are five tips for keeping a work journal.

Handwrite your notes. Scientific studies have shown handwriting notes can help you retain the information better.  Most people can type faster than they can write something out by hand. The ability to type notes verbatim ends up being a detriment. Handwriting, being slower, forces people to actively think about the information and decide which parts are important. This active process makes it more likely that the information will be retained.

Start a new page every day and do not forget the date.  I rarely reference my notes more than a week back. However, on the rare occasions I cannot remember the status of a task, having a record and date of completion will alleviate self-doubt.

At the beginning of each day start a new task list to prioritize your goals. Allowing yourself ten minutes in the beginning of the day will help you decide which items on your task list are most important. It can also help you block off your time efficiently.

When you do something that was not on your task list, write it down just to cross it off. Not only is this an extremely satisfying symbolic gesture, but it is also good to have it as a reference in the future.

Break large tasks into their smallest possible pieces. It will help you be more productive. Large goals can be overwhelming and time consuming. It is much easier to block off time for four several smaller tasks than for one large task.