I was just talking to a dear friend who’s starting up her own solo practice and finding out for herself the roller-coaster ride that this journey is.
She may not be feeling it today, but what today is teaching her is priceless.
The way life schools you, no book can. No private practice consultant, no matter how much you shell out, will impart quite the same lessons, quite as effectively.
So, the backstory is, my friend had hired a credentialing company to do her credentialing and contracting with the insurance companies. She was paying this company by the week as long as it took to get her in-network with the insurers she was interested in working with.
This credentialing company, in turn, worked closely with a billing company. And she had preliminarily signed up with them, to do her billing once she started.
This was 2 months back.
In these 2 months, she has repeatedly received letters from CMS, regarding errors in her Medicare application. Yesterday, she received another one.
Every time she calls the credentialing company, they sweet-talk her, assuring her they’re doing everything to keep moving forward.
Today, she called me, feeling rather frustrated that it’s been this long, given that she was hoping to start her practice in February!
That’s ONE WEEK away.
To top it all, even the billing company is not able to answer simple questions about expected reimbursements for her procedures or help her figure out workflow, etc. Things that are their bread and butter.
“If they’re the ones getting paid, why do I feel like I’m doing all the work?” she asked me.
I asked what she wanted to do. And she didn’t know yet. So we went over some options, and the pros and cons of each.
I gave her some tough love. I hope we’re still friends!
Here are some lessons I think we can pull from this and learn from a colleague’s experience:
“When someone shows you who they are, believe them the first time.” ~Maya Angelou
The credentialing company and the billing company are both telling you in so many words that either they’re (1) incompetent or (2) unethical or both.
Either way, you don’t want to have anything to do with these kinds of people and services.
And they abound, in the industry designed to “help” private practices. Why? Because there’s easy money to be made.
Medicine is highly paid, private practices have been very profitable (at least, until recently) and doctors make very trusting, almost gullible, clients.
Vet your people well.
In business and in life, it works best when the interests of both parties align.
My mentors taught me this about real estate syndications. They taught me that it was okay that the syndicator made a lot of money in these deals. It was not my job to resent them that- but to focus on whether thier interests aligned with mine so I could make the most out of my investment.
One of the things that struck me most when talking to my friend, was that the credentialing company was getting paid by time. Usually, credentialing companies get paid a flat rate based on how many insurers you want to get contracted with.
That pays them commensurate with the amount of work they do. And it is in their interest and not just yours, to complete this process as soon as possible. They complete the work, get paid and move on.
Which reminds me,
Don’t trip over dollars to save pennies.
The reason my friend initially went with this company over others is because they charge a low weekly fee instead of a large dollar amount upfront. And being between jobs, this naturally felt appealing.
I get it. I run a low overhead micropractice. If anyone knows, I do.
I am huge on cost-cutting and frugality. I wear it like a badge of honor ?
When I first started, my husband couldn’t believe what I was up to.
Heck, even I wasnt sure what I was up to ?
But, whether then or now, I am always mindful as to what the result of that cost-cutting will be.
And I never let it undermine the core guiding principles of my practice or cause me to lose more than I saved in the first place.
And this ties in right with my next point…
–“Time is more valuable than money. You can get more money, but you cannot get more time.” ~Jim Rohn
My friend was hoping to start her practice in February. That’s one week from now. And she does not even have her Medicare PTAN yet. In fact, even the application for the PTAN is not yet correctly submitted.
And everything is a domino effect from here. Most other insurers need your Medicare PTAN and therefore they haven’t submitted any of the other applications are in for her, either.
And this is after she’s paid them for a couple of months already.
So, even though the upfront payment to a credentialing company may have been $$$$, by letting her start up earlier (that’s a big assumption, of course!) she may’ve come out ahead.
Be decisive.
Now, my friend has some decisions to make. Does she stay with the current companies and ride it out? Maybe give them a good talking-to and see if that helps.
[But remember point #1?]
Or, does she cut her losses (both with time and money) and start afresh?
Being decisive is crazy hard. For everyone or almost everyone.
But you know the funny thing, I once heard Brooke Castillo saying that decisions are always made in split seconds. All you’re doing when you draw out a decision is delay making the decision.
So, its a way of procrastinating. And all the things we do from the time we KNOW we have to make the decision vs actually MAKING it, we’re just distracting ourselves.
Yes, sure, take your time and weigh the pros and cons. But don’t delay beyond that.
And these wise words should help:
“Our unconscious is really good at quick decision-making – it often delivers a better answer than more deliberate and exhaustive ways of thinking.”~Malcolm Gladwell
and
“The percentage of mistakes in quick decisions is no greater than in long-drawn-out vacillations, and the effect of decisiveness itself makes things go and creates confidence.”~Anne O’HAre McCormick
There’s no way to know beforehand which decision will yield the best result. This is often the thought that keeps us stuck. Once we realize the fallacy in this thought, we can move forward far quicker.
At this time, it is impossible for my friend or me or anyone else to predict whether this company will come through or not. Or whether the alternative will prove any better.
And, like Kin Hubbard said, an executive is a man who makes quick decisions and is sometimes right. ?
You just gotta decide one way or the other and take whatever comes, because….
–“There are no failures, only outcomes. As long as I learn something, I am succeeding.”~Tony Robbins
This ?a million times!!!!!
Go through life and your entrepreneurial journey as it it were an experiment. You had a hypothesis, and you’ve disproved it.
It’s a null hypothesis, that’s all it is.
“There is no failure except in no longer trying.”~Chris Bradford
….and….
“Everything you want is on the other side of fear.”~Jack Canfield
Have faith in yourself
I suggested to my friend that she do it on her own at this point, since it may be easier to just do the work rather than wait on these people to deliver.
And she didn’t think she had it in her to DIY it. And that’s just not true. I know this lady.
She’s a rockstar.
She’s going to be a kickass boss lady private practice owner not too long from now. And she think’s she can’t do credentialing and contracting!?
I am not suggesting everyone DIY everything. You may have better things to do with your time.
You will probably make more money doctoring than doing things that can be outsourced for $15 an hour.
Outsource it because you decide to, not because you are afraid of taking it on.
Because like Janet Jackson said “Believe in yourself. Have faith in yourself because no one else is going to.”
