Do You Need an MBA for Urgent Care Startup Billing?

I saw an ad for a biller today. It read, “______ Urgent Care (a recent startup) is seeking a Billing Director to support our central billing office and multi clinic operation. Complete revenue cycle knowledge a must. MBA preferred….”Interesting! This urgent care decided to save money by doing their own billing. But now they realize that they need serious expertise–so much so that they are willing to hire an MBA (at $60-80,000) to manage their revenue cycle.Early on with Practice Velocity, we actually encouraged startups to do their own billing, but we rapidly realized that this was a mistake. Doctors had their spouses do it part time. Others hired someone who had “done billing” for a doctor’s office, but then learned the hard way that the person had simply entered charges from a superbill in a physician office. This so-called “biller” had no significant knowledge of the entire billing cycle, from contracting/credentialing, coding, electronic billing, electronic remittance, clearinghouse exception reports, denials, non-contractual discounts, audits, compliance, payor downcoding, and much more. A simple mistake in just one aspect of the billing cycle can cost a center 10% or more, and costly mistakes are inevitable when a novice is doing the billing.Startups often decide to do their own billing to “keep control” and “save money.” But what they quickly discover is that they don’t have control of systematization, rather they own their own chaos. And the supposed money “savings” were overwhelmed by the losses incurred by the ineptatude of the novice biller.

This center has realized the truth: you do need a very high level person to manage the extreme complexities of revenue cycle management. However, few MBAs have any medical billing expertise, and crackerjack billers are hard to find and are just as expensive as an MBA. Our own urgent care centers struggled for more than 10 years until we were finally able to solve the problem with the appropriate expertise and finances. Finding and funding the necessary expertise for successful revenue cycle management with an internal billing department is a classic conundrum–you need true expert billers for financial success, but until you have financial success, you can’t afford true expert billers.

That is why we took our seasoned billers from our urgent care centers and turned them into a billing company (PV Billing) to help centers focus on providing excellent medical care and growing their business while we took care of the revenue cycle management.

It has been extremely gratifying to see more than 100 successful startups use PV Billing as a tool for success. We have been delighted to see so many startups rapidly open a second — some even a third — urgent care centers within two to three years.

Our motto at PV Billing is simply this: “You take care of patients; we’ll take care of the rest.” It is great to see it work so well for so many.