Don’t Up And Quit Your Job Just Yet

I remember many years ago when I was pretty young that I went to a staffing agency to help me find work. What I was told back then is that I needed to be available immediately whenever they called, and that if I had anything else going on that I should give it up, even if I was already working, because the company had something they were just about to close on that would be big, and I needed to be ready to go.

At this point you probably know the rest of the story. I quit my job, which really wasn’t paying all that much, and I waited for the call. After a couple of weeks I called them, as I hadn’t heard anything, and was told that it had fallen through and it wasn’t available anymore. I felt like an idiot; gave up a paying job for nothing, because money was money after all.

Every once in a while you’ll talk to an unscrupulous recruiter or staffing agency that will promise you the moon without having anything confirmed. They will make promises to you and ask you to give up a few things in preparation of a big thing. When this happens, you need to take stock of that recruiter or agency and decide if you trust them or not. The truth is that a credible staffing agency or recruiter won’t ever ask you to give up a paying job to work for them. They will tell you what’s available and let you make the decision as to what it is you want to do. If something is on the horizon but not confirmed, they’ll tell you that as well. They understand that everyone needs to be bringing in money to help pay bills and get on with life, and would never encourage you to do otherwise unless the position was a locked deal.

Always protect your own interests first, and try to make sure you’re working with credible people. If you ever feel pressured or confused by something you’re being told, you might want to consider looking elsewhere for help.

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5 Reasons An Interim CFO Might Be A Good Thing

The chief financial position, sometimes known as vice president of finance, is one of the hardest positions to hire for. It’s also one of the hardest to retain. It’s estimated that CFOs average only 2 1/2 to 3 years at best at most facilities. There are a variety of reasons for this, which we’re not going to touch upon. Instead, we’re going to give you 5 reasons why bringing in an interim CFO might be a good thing.

1. Quick learners. There’s a different between knowing you have to go to a new place and learn all the players that you’re going to have to work with for hopefully a long time versus going into a new place with a mission to accomplish. Interim CFOs normally hit the ground running, and because they’ve been around, they’ll often have a wealth of ideas to bring to the table.

2. Skilled communicators. Because they’re used to making more first impressions than the norm, they’re more skilled at creating positive relationships to help get things moving quicker.

3. Well rounded. Many times CFOs are only skilled in what they’re the best at, that being budgeting and finances in general. Interim CFOs often can come in and see the big picture as opportunities for improvement. Billing, medical records, even IT issues are easier for them to assist with because often those issues have come up at other places.

4. Evaluation. If you need someone to come in and help evaluate talent, an interim CFO is a good place to start. The CFO meets with every director that has something to do with financials, and could probably tell you if your materials management director is working on saving you money with your suppliers or taking advantage of offers that aren’t quite ethical for suppliers to make.

5. No strings attached. If you and the CFO don’t get along, you can change to someone else based on the terms of the contract. If you do get along, you could pretty much keep the CFO for as long as you needed. You’re going to get honesty from an interim CFO because they’re not worried about keeping their job. If you’re in trouble, or if you’re doing good, you’re going to get the truth. And no matter what the truth is, at least you know and can decide if you have to do something about it.

How To Interview To Be An Independent Contractor

So, you read our last post about the benefits of being an independent contractor and decided you want to give it a shot; congratulations on your decision. Now comes the next part, and it’s the hardest part; convincing someone that you’re worthy for consideration.

Unless you’re lucky enough to live in the same town as your staffing agent, the interview process will be much different than what you’re used to. Often, it takes more than just a good resume to be considered for a high paying independent contractor position. You might be able to get away with being average for a local working position such as being an independent billing professional, but if you’re looking to step up your game, well, you’re going to have to step up your game.

One thing you’ll have to get used to is talking about yourself more strongly than you might in a normal interview. You’re going to want to talk about your accomplishments as much as possible; you have to hope to have had some accomplishments to speak of. Truthfully, everyone has accomplishments; it sometimes takes a critical eye to be able to discern how you brought value to your previous employer.

Another thing to get used to is talking about money up front. There’s a fine balance in trying to determine what you’re worth, and you might find that you’re going to be asked what justification you have for asking for a certain dollar amount. Do you do something that’s hard to find, such as diagnosis coding or charge master? Have you a background where you reduced receivables by a big amount over a short period of time? Have you worked in large well known facilities? Do you know the ins and outs of home health care billing?

Whatever you can find that sets you apart from everyone else, you’ll want to prop that up. It helps to be known for something special, but it also helps to be known as someone who can be counted upon. Do you have what it takes? Can you convey that? If so, go for it.

Considerations Of Consulting Outside Of The Country

Occasionally Expeditive gets requests from hospitals outside of the United States for interim consultants who can do a variety of revenue cycle projects. We’ll then put out feelers for these positions, knowing that there will be some takers, and also knowing that there will be some people who will cringe at the idea of going to certain places.

Traveling as an independent consultant is always a dicey proposition. It can be a lot of fun, being in a new place and getting to know the area over the course of being in a new location. At the same time, it can add an interesting layer of stress when one has to consider things such as how to pack, for how long, and how to make sure bills can still be paid.

This is definitely important when one is considering leaving the country to work. Heading to a place like India or Dubai will not only be a culture shock for many people, but you don’t go to places like that and expect to fly back home every two weeks. You might have to be ready to make a commitment to stay in a location anywhere from 3 to 6 months at a time; that’s pretty much like moving to a new city. Or you might head to a place like Mexico, which has some pretty strict work standards for non-citizens that you might at times feel chafing.

We have to be honest; this is one of those times when symbiosis between client and the consultant might not be totally achievable. For clients, they can be assured that a staffing company will send them someone that’s competent. For the consultant, guarantees aren’t as solid. The only guarantee is that the consultant will get paid.

Because it’s rare for entities outside the country to fly representatives of interim staffing companies to their locations to take a look around, the status of the location can’t easily be verified. In some countries, the mores as it applies to both race and sex are much different than in the United States; telling someone what they are and having them be experienced are two different things. There’s also the language barrier that has to be overcome. And finally, probably the biggest skill will have more to do with learning how to be an effective communicator and negotiator than even the skill set.

Still, some consultants have a great time in other countries. It’s not an easy decision to make and shouldn’t be taken lightly. If it’s something you’re considering to make yourself available for, so some research on the area to see if you believe you could deal with it. Because if you accept it, you’ll be there for a long time.

Think Of Staffing Like Joint Commission Does

Every hospital in the country has heard of the Joint Commissions on Accreditation of Healthcare Organizations (JCAHO), even if they don’t use them for reviewing their hospital standards. JCAHO is known to be tough, with a great emphasis on regulations and rules for every area of consideration a hospital has to address, even down to things such as putting stoppers in doors (they don’t like that).

Something many people might not know is that JCAHO also has thoughts on proper staffing levels at hospitals, including interim staffing standards. Though not specific to the revenue cycle, it’s interesting to see some of what they believe:

* At least once a year, an organization must provide its Board of Directors with written reports on: (i) all system or process failures; (ii) the number and types of sentinel events; (iii) whether the patient/resident and their families were informed of the event; (iv) all proactive and responsive actions taken to improve staffing safety; and (v) all results of analyses related to the adequacy of staffing.

* When an organization identifies undesirable patterns, trends, or variation in its performance related to the safety or quality of care, it includes the adequacy of staffing in its analysis of possible causes.

* When analysis reveals a problem with the adequacy of staffing, an organization’s leaders responsible for patient/resident safety are informed of the results of this analysis and action is taken to resolve the identified problems.

* At least once a year, an organization’s leaders responsible for the patient/resident safety program review a written report of the results of any analysis related to the adequacy of staffing and any actions taken to resolve identified problems.

Overall, it’s a great outline to use when thinking about staffing levels at your hospital in all departments. As it pertains to the revenue cycle, verifying that there’s enough staff to handle all outstanding claims is critical to the success of the billing department. Making sure that there’s someone who understands how a charge master works and why it’s critical to the success of a hospital’s financial standing is important. Making sure things such as denials, secondary billing, and even proper collection efforts are taken care of might mean taking a look at staffing and determining that interim staff is needed to help address these issues.

Sometimes, you just might need an interim consultant to come in and take a critical look at your organization, especially if those already in leadership positions are too close or too entrenched to give the effort a fair appraisal. Often the claim is that it costs too much money to bring in interim staff, no matter what level they’re at. The reality is that the money you spend just might be the different in ending the year above or below budget, based on what interim staffing can do for you.

Benefits Of Interim Leadership

A blog for a company called Compass Clinical Consulting recently had an article titled Investing in Interim Hospital Leaders: Reaping the Benefits. It mainly talked about some of the benefits hospitals can receive by bringing in interim leadership when needed. It talked about how things such as morale, recruitment, and fixing major problems can be addressed when bringing in a qualified consultant.

Frankly, there’s nothing to disagree with in the article. We have heard of many success stories from clients talking about many of the interim leaders we’ve placed in some hospitals. Many hospitals have had great financial turnarounds when compared to where they were before our consultants were placed. One hospital actually showed more than a 100% increase in revenue and almost 40% increase in cash collections via the efforts of interim leadership we placed.

We have been happy with the quality of the consultants that have worked with us, and our clients have also. Of course, no one is perfect, because you just never know how a consultant will work with certain elements in some hospitals. Often there are situations where our consultant might not have a chance to break through the hierarchy. That’s not just us, as many independent consultants will tell you that management’s reasons for bringing them in weren’t really clear once they arrived on the scene.

However, when clients, interim staffing companies, and consulting leaders achieve a symbiotic relationship, good things happen more often than not. If clients are willing to allow consultants to do what they came to do and accept many of their suggestions, they’ll often find that things will end up working pretty well on the back end. They’ll be able to reap the benefits and skills of someone who usually has a background of previous success.

That part, weeding out the skilled, is the staffing agency’s job, and it’s what they gear themselves to be. Their reputation is on the line, and they won’t risk having it ruined by placing the wrong person. In the end, they also want to reap the benefits of skilled interim leaders as well.

Why A Specialist? Critical Access Hospitals

Sometimes people want to know why a specialist might be needed when a general consultant can usually do so many things, often quite well. Let’s take a look at the needs of a critical access hospital as an example.

Critical access hospitals are small. They’re located in rural areas, at least 35 miles from other hospitals, or 15 miles from another hospital in mountainous terrain or areas with only secondary roads. In other words, they’re pretty remote. For Medicare purposes, they’re paid based on costs, which means in many instances they’ll get paid more than their other counterparts because their needs are unique.

This usually means that more impetus should be given to things such as how charges are captured, how they’re priced, and ultimately how they’re billed out. Charge capture is important because CAH’s must be vigilant in making sure that they’ve captured every potential billable item and procedure that they’re allowed to charge for. Pricing is important because hospitals not only need to make sure they’re not under-charging based on Medicare reimbursement, but not pricing themselves so far out of range that they would trigger an audit. And billing is important because many services have relationship issues, which means that other charges, supplies, or pharmaceuticals are either supposed to be billed along with the main charge, or are a component of that main charge and thus aren’t allowed to be billed.

Not all patient account directors know these types of things because they didn’t have to know it in their background. Some hospitals have a charge master person who handles that sort of thing. Most hospitals leave all charging issues up to others who have set those rates, never going back to see whether the rates are in line with Medicare or other insurance company reimbursements. CAH’s need interim staff that truly is more of a jack of all trades, who understands both charges and billing at the same time, to truly be effective.

Going through an agency such as Expeditive helps to verify that a client’s time isn’t being wasted by looking at people who don’t have a background that shows they have skills in many different areas. Trying to hire the right person sometimes can take a long time in rural areas, so hiring an interim consultant with those skills already present makes a lot of sense.