THE OFFICE MANAGER.The article below reviews the role of an Office manager and some things you need to know before hiring one;

By. James K Irungu.

The role of an Office Manager in a doctor’s office is as critical as the role of the physician in that office. Office managers have the responsibility of ensuring that all parts of the office are functional and smoothly running.

We will look at the role of the office manager in revenue generation and flow, and the effect these position has on the Business Office. In a typical small doctor’s office, the office management is limited to the Office manager and the physicians who mostly double as owners too.

The OM is tasked with the responsibility of recruiting, hiring and managing staff.  It goes without saying that to succeed in recruiting, the hiring person needs understand the position they are hiring and recruiting for.  But before we get into the hiring process let us take a moment and think of the qualities we need in hiring the OM.

Most physicians tend to hire OM who have experience working in their specialties. The OM usually has clinical experience in that particular specialty and this comes in handy in hiring and training of the clinical staff and also dealing with patient’s issues.

Normally, it is very rare to find an individual who has mastered the clinical part of the physician office as well as the business office. And this is where the dilemma comes in. Its either one or the other. When the Business Office is faced with a challenge, they will approach the OM who in this case happens to be the clinical expert. So who really helps solve these problems?

This is the biggest problem that is facing most physician offices. The performance and motivation of the Office staff relies entirely on the performance of the office manager therefore making that position the spine of the office. It is recommended that upon hiring an OM who, say, is very experienced in the clinical side, that the practice consider sending them for additional billing training and vice versa. This ensures a balance in skills and leadership.  

Another recommendation is for the practice to create a Business Office Manger position and fill it with a highly experienced professional. Most of the aspects of the billing office from Software training, claim submission, interpreting electronic reports (see separate article) among other things requires experience and knowledge and unfortunately there is no way around them.

It is a very difficult choice whether to look for clinical experience or billing experience in an OM and therefore, the physicians have to come up with a way of striking that balance. In future editions, we will continue to highlight the qualities to seek and look for in hiring an OM.  As part of our services, we assist your practice in recruitment and hiring of office staff. We welcome your contributions and ideas at:

info@capitalbillingservices.com.

To sign or not to sign

Lately, I have been receiving  a lot of phone calls from doctors offices requesting that we (Capital Billing Services, Inc) assist them with credentialing and contract negotiations with insurance carriers. It was largely expected that with all the technological advancements, and strides that the Insurance industry has made, the process would have become simpler and less complicated.

The truth is, with resources like CAQH, online credentialing and paperless information delivery, the process has become very efficient, fast and at the same time very complex. Providers have to enter all the pertinent credentialing information into CAQH, a process that takes an experienced person about 2 - 3 hours to complete. It is important to note that not all insurance carriers participate in CAQH. CMS (Medicare) still requires all the paperwork to be mailed in with every application. Most Worker's Compensation plans do not participate in CAQH either and therefore the paperwork also has to be mailed with the application.

With a lot of practices switching to EHR/ EMR programs, the need to also go paperless on claims submission, remittance advice delivery and patient statement billing has arisen. Most of the carriers require separate applications to be sent to the carriers separate from the credentialing process. In today's market, the need for professionals with extensive knowledge on all the above and other insurance requirements continues to grow. We will utilize this blog to keep posting ideas and  relevant topics to in order for other like minded professionals to share ideas and suggestions on how to continue navigating through this muddy insurance waters. I hope you will all find the blogs helpful.