The pitfalls of the instant billing world

June 2, 2020

The following is a column from Vachette CEO Mick Raich

Last week we received a call from a large legal firm that had a client who was starting a lab and wanted our help to set up billing. We often get these calls as we have the expertise to help this go smoothly and the national recognition to allow us to work with only the finest billers. Plus, our size and reputation for quality auditing allow the billers to know we are serious.

This client wanted to turn on laboratory billing for COVID-19 testing in just one week. They did not have a Laboratory Information System (LIS), nor a billing company — no clearinghouse, nothing. They just knew they could get paid for COVID-19 testing by CMS and wanted to make some cabbage.

We often get these calls from groups or firms with a large amount of capital and very little knowledge of what it takes to get through the correct processes to get paid. Instead, they call us requesting magic. Many times, these prospects want miracle billing to take place in 14 days. 

In some cases, we are able to instill some reality to help them back off their lofty dreams and come a realization of the actual process. We have a 30-page documented policy and procedure for this action. When we follow the processes, these situations work out best. The client understands how the process works, how an amortization of cash flow is projected, and the biller has time to get credentialing ready so everyone has the same expectations. 

In other cases, the clients blow through the stop sign of reality and attempt to do the impossible.  They end up signing with some billing entity with “really low rates,” despite our protests, only to call us three months later when their cash flow is virtually nil and their overhead is still rising. 

There is no free lunch. Getting billing up and running in a correct manner is hard. It is a very difficult process, and even with a strong billing company, the entire process is fraught with potential errors. Trying to do instant billing for COVID is not a reality.

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