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.


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.

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.

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.

Staffing Issues To Consider

There was an article on a blog called Office Arrow titled Cost Effective Staffing Strategies that we found intriguing. It went in a totally different direction than our last post titled Can You Go It Alone, as it addressed taking a look at how your current full time staff is performing as it pertains to issues like absenteeism, overtime, and general work performance.

Those are definitely important internal issues for all companies to review because it could be indicative of a breakdown of work practices throughout a business. In an odd way, some of those issues could lead you to determine that you could use the services of a staffing agency when applied to your medical financial offices because they might highlight why you would want to consider getting outside help.

For instance, let’s take a look at overtime. If you’re paying your staff a lot in overtime hours and they’re still not catching up, it might indicate that you need more people on the job. One of the problems with just hiring a new person is that you have to go through a long training process and that could mean your departments will fall behind even further. Bringing in someone with experience already helps you catch up while also taking time to train a permanent employee.

The same type of thing could relate to dealing with high numbers of absenteeism. At a certain point you as the employer are going to have to do something about it, but you still can’t afford to fall too far behind. You could determine to outsource some of your work, or you could bring in an interim person or persons to help you catch up while training the new person. You could also bring in interim people while you evaluate things to determine if there are other changes needed.

Interim staffing companies can offer many business solutions that help companies buy themselves some time while making sure they don’t fall too far behind on the important daily operations that help them sustain themselves.

Can You Go It Alone?

Something that we are proud of at Expeditive is our white paper, titled Can You Go It Alone? This isn’t necessarily an advertisement for our staffing company as much as a recommendation for health care entities that are having difficulties with their revenue cycle operations and ways to review how they might get out of those difficulties. We’re not going to print the entire white paper here, as we’d love for you to download it and absorb what we have to say, but we will give you some highlights here to whet your appetite.

First, facilities must determine what their issues are when the believe their financials are performing poorly. Is it the billing department? Is it medical records? Could the problem be charge capture? Could there be an issue with how the budget was put together? Maybe there’s a logjam at registration which results in poor information capture. It could be many things, and they might take time to review.

Second, what do you want to do when you’ve figured things out? Can you handle it all with the people you have, or do you need some kind of outside assistance? Do you want to outsource things, or bring someone in to work on your issues? Do you need some leaders, or some independent workers? Do you need training of some sort?

Third, what would be success to you? Sure, you might want it all, but can you afford it all? Do you want quick results or are you willing to take the time to get it right?

And fourth, where can you go to get this help? For that one, click on the first link in this post and see if we might be able to offer you what you need.

What It Takes To Be An Independent Contractor, Part Two

This is the second part of our brief series on what it takes to be an independent contractor. You can check out part one, then read the rest of the series here as we pick up our tips from number four.

4. You have to learn how to pack for business travel. This is much different than packing to go on vacation. You have to remember to pack for business, pleasure and relaxation. You have to remember to pack any business manuals. You have to remember to pack all toiletries. You might have to remember to bring your laptop. You certainly must remember to bring any medications you might need. And you might want to pack things such as plastic utensils, plates, and even snacks and foods you can eat in the hotel.

5. You have to learn how to be self assured. You don’t get to be a shrinking violet if you’re going to be an independent contractor. Your learning curve is much shorter than working a traditional job; after all, you’re being promoted as a professional who knows backward and forward how to do the job you’re being hired for. You need to be ready to write reports of your progress, something you probably didn’t have to do as an employee. You have to be ready to give your opinion whenever asked. You have to learn how to defer to others at times. You have to learn NOT to give answers to questions you don’t know, but then know how to go find the answers required. You don’t go in as a know-it-all, but you do go in as someone who’s supposed to be very competent in everything you do.

6. You have to be ready for anything. You could arrive at a client site and be heading back home on the same day because they’ve decided to go in a different direction. You could be asked to stay much longer than you had intended. You could be asked to do a different job than what you had anticipated. You might have to stand up for yourself when it comes to the hotel choice. You might find yourself having to deal with many different personalities. And you might find yourself totally alone, not making friends with anyone you work with or outside of work, and spending a lot of time in your own company.