STP 176 | Ways to Stop Losing Time and Money to Insurance Billing with Jeremy Zug
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[00:00:01] Jeremy Zug: and I said, what are you charging insurance right now? Is it above or below this rate? And they said, it's well below. We haven't raised our rates on the claims in 12 years. And the insurance companies had issued raises very quietly, but they're not gonna tell anybody that.
[00:00:21] And
[00:00:21] James Marland: not sending out the notices like you
[00:00:23] Jeremy Zug: no.
[00:00:23] James Marland: more.
[00:00:24] Jeremy Zug: No way. That's not something.
[00:00:26] James Marland: What?
[00:00:27] Jeremy Zug: So they were taking a $30 per session cut,
[00:00:32] James Marland: Oh,
[00:00:32] Jeremy Zug: right? For the last 12 years.
[00:00:35] This show is jam-packed with advice from my guest, Jeremy Zugg, who has over a decade of experience in the healthcare industry. Uh, Practice Solutions is a medical billing company, and they offer excellent billing services, professional services, and resources, educational resources to thousands of behavioral healthcare providers [00:01:00] that help you optimize your revenue cycle.
[00:01:04] Jeremy knows his stuff, and I really enjoyed listening to him and what he brought to the table, especially on the, the biggest reason why claims are rejected. You will find that in the episode, and it's gonna open your eyes and his solution on how to fix it. Before we begin the show, I want to invite you to check out the resources that we are compiling on business workshops for therapists
[00:01:30] you will find the upcoming live workshops and also the recorded workshops. The next workshop we're going to do is on paid public speaking,
[00:01:40] This live workshop will be taught by Dustin Riverbank from Built Different Speakers Academy, Dustin has trained hundreds of professionals just like you to take what they know and turn it into paid public speaking events. I hope you join us. Go to the workshop page and find all the information.
[00:01:58] Also, the link will be in the show notes. [00:02:00] Now on to Jeremy Zug.
[00:02:02]
[00:02:05] James Marland: Hello and welcome to the Scaling Therapist podcast. I'm your host, James Marland.
[00:02:10] This is the show where we help you put your mission in motion. Today I have a special guest, Jeremy Zug from Practice Solutions. He is here to talk about insurance, billing, and how to help you take some of that off your plate. Jeremy, welcome to the show.
[00:02:25] Jeremy Zug: Yeah. Thanks James. Thanks for having me. This is, it's great to be here for sure.
[00:02:30] James Marland: Yeah, and I think we met at a conference or two in the past, and you've always been generous with your time and willing to share things. And I thought it'd be cool to bring you on the show because insurance is one of those topics that people you the, I was gonna say you love or hate, but I think it's like you, you hate or you hate more.
[00:02:51] Jeremy Zug: No,
[00:02:51] James Marland: that.
[00:02:54] Jeremy Zug: that, that's a good way to think about it. There's certainly an adversarial [00:03:00] vibe. Like you, you can scroll on LinkedIn for quite a bit of time on this topic and find nothing but negativity. I don't think it has to be that way. we were just talking about this before we started, that if I asked you, James to build out a healthcare system.
[00:03:19] Let's say we dropped you on a planet and they needed a healthcare system. You likely would not build out what the United States has right now as your system. And so we've arrived at a spot that's eminently complicated, very large and very hard to change. And so that's why we're here.
[00:03:39] James Marland: Yeah. What are some of those friction points that people talk about that they're like, oh I, I do not like this, about our system that you see day in and day out.
[00:03:48] Jeremy Zug: Yeah, the big one right now is rate transparency. So the biggest friction was in. Before 2020 for a long time, it's, you go [00:04:00] to McDonald's, you know what you're gonna pay for a Big Mac, right? It might vary from state to state a little bit, but generally speaking, you know what's gonna happen in healthcare.
[00:04:09] Pricing has been a hidden secret, has been proprietary data and provider contracts. Have locked up that data or the sharing of that data until 2020 when the transparency in coverage rule went into effect, which required insurance companies to publish all of their rates. Machine readable files. Now you need a piece of technology that does that.
[00:04:39] And Practice Solutions is a data provider in that regard. So we translate that data to show providers what the practice down the road is getting paid by insurance. Because you'll hear this a lot, James you've heard this a hundred times. I went to insurance company X and they said they [00:05:00] don't give out raises or they can't give out raises.
[00:05:03] And the problem is now we can look at the data and we can, and I'll tell you a quick story. I was at a conference the end of February. We also met at the Wise Practice Conference. So shout out to Whitney and everything she's doing over there. If you haven't signed up, you'll sign up. But we, I was at another conference at the end of January in Chicago and there was a 44 clinician group practice that was there, and they were like, oh we go to this payer every year we ask for raise.
[00:05:32] They say no can do. And we ripped up our tool and we looked up. What that payer was paying other practices and there was a nine person group practice in their same area making $40 more a session. Same uh, session. So the idea that. Try price transparency has for a long time been a friction point in private practices because you'll [00:06:00] hear, they say they won't give out raises.
[00:06:01] And so now providers are saying, I can see the data. We're either gonna come to the table or I'm leaving the network. And that presents a lot of problems for the insurance companies.
[00:06:10] James Marland: was, you've been working in this since what, 2017?
[00:06:14] Jeremy Zug: We've been, yeah. So almost 10 years.
[00:06:17] James Marland: Okay, so before 2020, that data wasn't available.
[00:06:21] Jeremy Zug: It wasn't available and you couldn't access it legally, so providers weren't allowed to
[00:06:28] James Marland: company?
[00:06:28] Jeremy Zug: Sure was. Yeah.
[00:06:29] James Marland: was their way to control prices
[00:06:32] Jeremy Zug: That's right. And as a patient,
[00:06:35] James Marland: seem very fair
[00:06:36] Jeremy Zug: no. It's horrible. And so as a patient, you, the idea of that rule is so that providers and patients can shop, right, can shop a free market system to say, where do I want to go?
[00:06:50] Because let's say you needed to go get therapy, right? And you went to a hospital system, it's, and you have a deductible. You are paying [00:07:00] eminently more per session for that provider than you would. Maybe a independent practice that's down the road that maybe provides better quality care than a provider in a hospital.
[00:07:11] So the impetus for the legislation was patients and providers should have the option to shop and decide on where to get care or who to credential with. And now we have that data. So it took six years to get it.
[00:07:25] James Marland: Wow.
[00:07:26] Jeremy Zug: Yeah.
[00:07:26] James Marland: so I've heard of the the pricing where you have to tell. People. So how is that working out in practice then? So we're get this information, what are people doing with it or how can you, I'm just asking as a lay person,
[00:07:41] 'cause I don't know what you do with the data
[00:07:43] Jeremy Zug: yeah,
[00:07:43] James Marland: how it help, how does this help or hurt a practice?
[00:07:46] Jeremy Zug: yeah. So
[00:07:47] James Marland: that?
[00:07:48] Jeremy Zug: one of the problems in. The mental health market is that therapists, and give me some rope here. And I hope that this doesn't come across poorly, but I think that there's a, there [00:08:00] has been a culture of not asking for more or not at, at least not asking what we're worth.
[00:08:05] James Marland: Julie. Julie calls it noble Poverty, Julie Harris from
[00:08:09] Jeremy Zug: Oh, I love Julie. Yeah, Julie. Yeah.
[00:08:11] James Marland: She's
[00:08:12] Jeremy Zug: Amazing.
[00:08:12] James Marland: listen to her show I edit her show, so I
[00:08:14] Jeremy Zug: Yeah.
[00:08:15] James Marland: to it a couple times a week, but but it's thrilling stuff. Like every word is great, but she calls it noble poverty, where you're you're supposed to be poor.
[00:08:26] You were taught to be poor. You were taught not to like, it's evil. To make profit and she fights against that. Like every practice should be profitable. So back to your thing, therapists are trained or they believe they have this belief somewhere or they that, that getting more is bad, right? Is that the,
[00:08:48] Jeremy Zug: Yeah. I think it comes from the nonprofit world where non, and there's this misunderstanding because nonprofit is a tax status, it's not a business plan. Right. And so[00:09:00]
[00:09:00] James Marland: tell me more about that? TA nonprofit is a tax status, not a business
[00:09:05] Jeremy Zug: a business plan. So
[00:09:06] James Marland: loaded.
[00:09:07] Jeremy Zug: yeah, like Blue Cross Blue Shield is a nonprofit. They make a ton of money every they make a ton of profit every year. So like billions and billions of dollars. So just because you come from an, let's say you come from an agency world, community Mental health or some other kind of agency, and the vibe was we're a nonprofit so we can't make money.
[00:09:29] That's not the idea. Nonprofit means you don't pay taxes on your profit. Right? It's reinvested back into the mission of what you're trying to do. It doesn't mean you can't profit as an organization. In fact, you should. Because in order to. Not to be hindered to do the mission, you have to have margin.
[00:09:48] So I don't want you to think that it's either margin or mission, it's budget or staff, it's growth or sustainability. That's a, that's a. Non-starter in my mind. So [00:10:00] I'll give you an idea of what you can do with this data. And it comes, there's a good example of this. There's a agency we were working with in Wisconsin, a big agency.
[00:10:08] We don't do their billing, but we're helping them with some other stuff. And I looked up their rates and I said, what are you charging insurance right now? Is it above or below this rate? And they said, it's well below. We haven't raised our rates on the claims in 12 years. And the insurance companies had issued raises very quietly, but they're not gonna tell anybody that.
[00:10:33] And
[00:10:34] James Marland: not sending out the notices like you
[00:10:36] Jeremy Zug: no.
[00:10:36] James Marland: more.
[00:10:37] Jeremy Zug: No way. That's not something.
[00:10:38] James Marland: What?
[00:10:39] Jeremy Zug: So they were taking a $30 per session cut,
[00:10:44] James Marland: Oh,
[00:10:45] Jeremy Zug: right? For the last 12 years.
[00:10:46] James Marland: I
[00:10:47] Jeremy Zug: And they said, how do we fix this? And I said, raise your rate. Right?
[00:10:51] James Marland: The heart, their heart probably dropped like how much money was left on the table for years.
[00:10:56] Jeremy Zug: Along to a lot of money was left on the table.
[00:10:59] James Marland: improve [00:11:00] infrastructure. They couldn't hire people, they couldn't grow,
[00:11:03] Jeremy Zug: That's right.
[00:11:03] James Marland: offer more training to their staff.
[00:11:06] Jeremy Zug: Yeah. Because they didn't know that they could just raise the amount that they were charging and capitalize on the raises that they had been given organically over 12 years right now. Yeah.
[00:11:19] James Marland: helps you find these.
[00:11:21] Jeremy Zug: Yeah. Yeah. 'cause if you know that insurance now pays, I don't know. Let's say, let's just use round numbers, right?
[00:11:28] Let's say you started and you started charging $60 a session. That's what's been on your claims. Your client pays 20, insurance pays 40, right? And you're happy. But the insurance companies over 12 years has raised their standard rate to 120, but you've been billing 60, right? When you could be billing 110 and you just got a raise, right?
[00:11:52] So that's an example there. I know the math is hard on a podcast to think through in your head, but essentially it equates to, oh, we [00:12:00] can do that. And it's yeah, you can do that. You can raise your rate and you should raise your rates above the standard rate. So you'd wanna know what's the standard rate now.
[00:12:09] So we can raise our rates and capitalize on everything that capitalize on our insurance relationships. So that's, that's one piece of that, and that's a simple way to do that. The other way to do that is if you're considering credentialing, find out what the market rate is. If the market rate is, if let's say the lowest rate puts you out of business, do not credential.
[00:12:29] If the market rate is something that you're fine with. Credential, but don't go through the six month process of trying to get in network for what's a losing bag in two years. Right, so cut out the two years of time.
[00:12:43] James Marland: You wouldn't know this before.
[00:12:45] Jeremy Zug: No, you'd have to credential and then
[00:12:47] James Marland: before.
[00:12:48] Jeremy Zug: No, not usually. They don't issue fee schedules until you've gone through the credentialing process.
[00:12:53] So usually at the end of the process they say, here's your fee schedule, and you either re, you've wasted a half a year. [00:13:00] So the data is meant to cut off six months of credentialing timeline. The other thing people can do with this information is you can negotiate rates. You can say, okay, for this 44 clinician practice, they're gonna go back to that payer that said, we don't give, we don't issue raises.
[00:13:19] And they're gonna say, why is the nine person practice getting $40 more a session if you don't negotiate rates? So that's a conversation we're navigating. But that's one piece. That's one friction point. So there you go. That's a long answer on what's one friction point. There's like a billion others.
[00:13:35] But that's one.
[00:13:37] James Marland: Wow. It really helps to navigate these things because many therapists get in the business for helping people, they're good at talking, they're good at understanding feelings. They're empathic sensitive. And when it comes to negotiation, they might not have that skill or they just don't know.
[00:13:56] Like, why would you would spend. How much [00:14:00] time trying to uncover this? Who's the right person to call? What do you do? What form do you fill out?
[00:14:04] Jeremy Zug: Right.
[00:14:05] James Marland: how do you find this information? It's, and I'm sure there's a lot more details than that. And it's, I'm already stressed out just talking all those little details and then I have to,
[00:14:16] Jeremy Zug: Yeah.
[00:14:16] James Marland: Go present my case to somebody. Yeah that, that is interesting and that's a change that's happened recently. We, do you wanna take this conversation? 'cause we're like
[00:14:26] Jeremy Zug: Yeah, I know. Yeah.
[00:14:28] James Marland: talked about claims denials or reimbursement rates
[00:14:31] Jeremy Zug: that's right.
[00:14:32] Yeah,
[00:14:32] James Marland: what's,
[00:14:33] Jeremy Zug: think the next piece of this that aligns well with the show in general is. When should I outsource billing versus when do I take this thing in-house?
[00:14:42] James Marland: oh,
[00:14:42] Jeremy Zug: always, that's a constant question we get, and this is a good, this is a really good place to go.
[00:14:47] So can we go there next?
[00:14:48] James Marland: Oh, absolutely. So the question is, when should I outsource it and when should I bring it in house?
[00:14:53] Jeremy Zug: Yeah. And so here's some really actionable pieces of advice for the audience here. [00:15:00] You should outsource when billing takes up any amount of your time. So if you are thinking about billing at night over dinner.
[00:15:08] You should outsource it if you are doing any sort of eligibility and benefit checks, claim submission, denial.
[00:15:15] Follow up. If you know what an aging report is and you're posting payments and reconciling and all of the things that go into insurance billing. If you're doing any of that, you should stop and here's why you are now. If you're doing any of that, you are the highest paid, most frustrated biller that exists in the country.
[00:15:35] And let's say, let's go back to my a hundred dollars rate example, right? I don't know if that's the right rate for you. Maybe it is, maybe it's not. If it's higher than that, this is even more impactful. Let's say you're, you charge a hundred dollars a session and you spend an hour on billing. That is, there's no bill or paid a hundred dollars an hour.
[00:15:56] So you should outsource that and [00:16:00] Practice Solutions does that. And we have an army of billing people. Billing specialists that love billing. They love it. That's why they're here. They can't get enough of it. And so if there's a process in your practice that is consuming your time and energy, and more importantly, the opportunity cost spent not pursuing what you should be doing to grow the practice is way bigger than what you're going to pay an outsourced biller.
[00:16:30] R
[00:16:30] James Marland: There's a lot packed in here. But you just mentioned opportunity cost.
[00:16:34] Jeremy Zug: oh sure.
[00:16:35] James Marland: Did, can you define like we know what costs are. Like, oh, my computer costs this much, my internet costs this much. I pay this much money for, I have to pay my staff this much money. But opportunity costs, I think is the real hidden the poison here.
[00:16:50] What is, what does opportunity cost mean to you?
[00:16:53] Jeremy Zug: Yeah. I think this is best illustrated by using an investment example, right? Let's say you had a hundred [00:17:00] dollars to invest. You put a, and I'm not an investment expert. I'm not giving financial advice here, James, this is just for illustration. So you had a hundred dollars to invest and you put all of it in company a.
[00:17:14] Or all of it In company B and company A grew by 10%, so we made $110, but company B grew by 50%, so that grew by $50. The opportunity cost is the difference between company B and company A, meaning that you didn't lose it, but you lost out on $40 of potential growth on the money you invested. Here's how this translates to private practice.
[00:17:42] I.
[00:17:42] James Marland: that translate?
[00:17:43] Jeremy Zug: Totally. Let's say you're spending, again, any amount of time on billing, even an hour a week, right? 52 hours a year, right? 48, let's say 48 hours a year with four weeks of vacation, where could you spend a whole additional work [00:18:00] week growing the practice? Is it networking? Is it working on a course? Is it working on another revenue stream?
[00:18:07] 48 hours? A lot of time. And so especially when you think about, could that be spent recruiting a therapist that then translates into more revenue? Could it be spent learning real estate so that you can buy your building and then rent it back to yourself versus an administrative support structure?
[00:18:24] That's not growing your assets, right? So that's how that can translate. And I think practice owners know where to spend their time to grow the practice better than their time is spent focusing on a claim denial. So that's the idea there. So our clients tend to grow by 15 or 20% every year because the practice owner is focused on growing the practice, which profits from our expense essentially.
[00:18:53] So we're then a revenue generator because we, you buy back your time
[00:18:57] James Marland: Yeah, time's probably the most expensive thing you [00:19:00] have.
[00:19:00] Jeremy Zug: for sure.
[00:19:01] James Marland: and I'm just thinking about the owner who, who just heard that. growth number by focusing on the right things.
[00:19:13] Jeremy Zug: Yeah.
[00:19:14] James Marland: you're focused on the right things and you're adding your value to the company, whether that's hiring, seeing clients building out another product or a course.
[00:19:25] If you're doing that, you are, you're able to grow faster than doing the things you hate doing.
[00:19:33] Jeremy Zug: That's right. That's right. Even though it's, it seems oh, I'm giving you money,
[00:19:37] James Marland: Yeah.
[00:19:38] Jeremy Zug: you're giving yourself way more money by focusing on the things that you should be doing. And then we have other tools like our rate comparison tool. So let's say you work with us, you buy back 10 hours a week of your time, plus you raise your rate, plus you negotiate with your top five payers, plus you hire another therapist, plus you focus on another revenue stream.
[00:19:57] I mean, it really compounds up when you look at it [00:20:00] like that,
[00:20:01] James Marland: Yeah. I love your illustration of you're the highest paid biller. Ever,
[00:20:07] Jeremy Zug: it's true.
[00:20:08] James Marland: my I used to listen to a podcast called Manager Tools, and he called it manager Economics 1 0 1, where if somebody could do the job at a similar rate than you, or similar quality you can do or better.
[00:20:22] And you mentioned, oh, we have an army of billers who love this stuff. Like what a. What a relief that is. 'cause most people don't wanna spend any more time on the phone than they have to with a denied claim. Can you imagine how frustrating it is? I'm sure you can. I'm just
[00:20:40] Jeremy Zug: Oh yeah.
[00:20:41] James Marland: who's I'm skipping dinner to, to be on this call or I'm skipping my lunch to be on this call
[00:20:47] Jeremy Zug: Yeah.
[00:20:47] James Marland: session coming up 'cause I can't stop. Just how much better and how much less anxiety there is. So manage your economics 1 0 1, like if somebody else can do it, then with a [00:21:00] similar quality, then find a way to, pay them the 20, $25 an hour to
[00:21:04] Jeremy Zug: Oh yeah.
[00:21:05] James Marland: rather
[00:21:05] Jeremy Zug: Way less than that. Yeah. You should not be paying that for a Yeah, for sure. And and it's not even by the hour, I mean, we charge a percentage of what's collected, which means that we don't eat until you do. So we like to tie our bread to yours. And so in, in the sense that I, you know, I like to eat James Food's good.
[00:21:26] James Marland: yep.
[00:21:26] Jeremy Zug: only after they've eaten first. So it's an important piece
[00:21:30] James Marland: people have a different way of billing, I guess,
[00:21:32] Jeremy Zug: sure. Yeah.
[00:21:33] James Marland: charge you upfront fee or how, what's the.
[00:21:35] Jeremy Zug: Oh, you can find a hundred billers out there that will charge you by the claim. And when you look at the dollar amounts, you go, whoa, that's really inexpensive.
[00:21:44] But what you lose, what you gain in cheap. You, you also, you lose in quality,
[00:21:53] James Marland: Uhhuh.
[00:21:53] Jeremy Zug: And so that biller has no incentive to get you paid.
[00:21:57] James Marland: Right.
[00:21:58] Jeremy Zug: fact that biller is now [00:22:00] incented for you to submit as many claims as they can get you to submit, even if the claims are rejected,
[00:22:05] James Marland: Oh we'll just
[00:22:05] Jeremy Zug: Oh,
[00:22:06] James Marland: it
[00:22:06] Jeremy Zug: yeah. Too bad,
[00:22:07] James Marland: Yeah. Yeah.
[00:22:08] Jeremy Zug: So that's, and incentives really matter.
[00:22:10] I mean, when you think about therapists, they are experts in human behavior and the tools they have around. Incentives, rewards and punishment are some of the most powerful tools and systems that we've discovered as a species. And so when you have an incentive system set up around, Hey, you know what a claim's a claim, that creates outcomes you don't want.
[00:22:35] But when you set up a system around results and results, only you get the results you want, and that makes sense.
[00:22:42] James Marland: I love talking to you. Just like you're, you have a lot of just understanding of the
[00:22:50] process that is easy to understand. 'cause this
[00:22:54] Jeremy Zug: Aw, thank you.
[00:22:55] James Marland: it like pe people would rather go to the dentist than talk about [00:23:00] insurance
[00:23:00] Jeremy Zug: Oh yeah. Step on Legos in the dark, then do.
[00:23:05] James Marland: step on Legos or do denied claims where the,
[00:23:07] Jeremy Zug: yeah,
[00:23:08] James Marland: do I need to step on?
[00:23:10] Jeremy Zug: and I'm not trying to say that all this stuff is fixable, right? There are, for example, like Tri West Tricare merged. They merged a lot and anybody who took TRICARE over the last 18 months just started getting paid last month for sessions they did in January of 25. So I don't know how there's not a lawsuit around that.
[00:23:33] James Marland: dependent
[00:23:34] Jeremy Zug: You're gone. You're gone.
[00:23:36] James Marland: Oh,
[00:23:37] Jeremy Zug: you took out a lot of loans. I mean, it's
[00:23:39] James Marland: Yeah.
[00:23:39] Jeremy Zug: I'm not saying that there aren't systemic issues. There are a lot of them, the people in Ohio right now who take Medicaid or see Medicaid clients, you all are struggling big time with the P and MMCO problem. So you have these. These national or localized crises that happen all the time in the billing world, and that's, that'd be [00:24:00] another reason not to pay a by the claim biller.
[00:24:02] Right. Especially if you know those people, our Tricare client, the clients that we have that take tricare, we haven't invoiced on those claims for 18 months. Right. Because. They didn't get paid. They didn't eat yet, and so we're very incented to keep after it and file appeals and talk to Tricare and try to expedite it and network as best we can to find where the solution is.
[00:24:25] I mean, it's very important for sure versus the by the claim people that have paid for those claims already.
[00:24:32] James Marland: That I love how that is set up and just what a blessing you probably are to those clients who haven't been paid yet, because it's not something that is killing them,
[00:24:44] Jeremy Zug: right. Yeah. We still have to work,
[00:24:46] James Marland: yeah.
[00:24:46] Jeremy Zug: Yeah. Even though
[00:24:48] James Marland: Do we have time for that question about the number one claim denial reason in your practice?
[00:24:53] Jeremy Zug: sure do.
[00:24:54] James Marland: a
[00:24:54] Jeremy Zug: Yeah.
[00:24:54] James Marland: or two?
[00:24:55] Jeremy Zug: Oh, I got time.
[00:24:56] James Marland: bigger topic than that, but like what's a tip for that?[00:25:00]
[00:25:00] Jeremy Zug: Yeah,
[00:25:00] James Marland: denial.
[00:25:02] Jeremy Zug: we can definitely do this. So the number one claim denial in the country is duplicate claim. So what this means is that you submitted a claim, it was denied for any number of reasons. Reason doesn't matter right now. The reason does matter, not for our conversation. Claim was denied biller or clinician or admin or someone.
[00:25:25] Resubmitted the claim took no action on the original denial. So now what you have is a second denial called a duplicate claim denial. And you can have tens or even hundreds of duplicate claim denials because let's say you submit a a a claim denial, that is a duplicate claim. Denial. Now you have two, right?
[00:25:48] The way to solve that. Is you stop putting priority on claim submission. Claim submission is not the most important part of your billing process. [00:26:00] Claim submission is actually the last or the least important of your claim process. So what I want everybody listening to do is to stop doing claim submission first and start payment posting first and documenting denials the first time.
[00:26:16] Then you fix the denial in your aging follow up process. Only after you fixed it, you then either submit perfectly clean claims the first time, or you fix the original denial reason. The first time the cost. There was a study done in 2022 by a law firm Neil, LLP, I think it was quoted in an Availity article.
[00:26:40] In 2022 or 2023 that said the average cost to rework a claim denial is $25 in staff time. And so $25 is a lot for a therapist with the reimbursement rates the way they are. So you don't have the budget to rework a denial two or [00:27:00] three times because a duplicate claim denial can feel like wading through concrete 'cause it's, you can't fix it.
[00:27:06] You can't fix a duplicate claim denial. You can only fix the original denial. And that's a five millimeter process fix you take. You take payment posting from the end of your billing process and you deprioritize claim submission, it would be better from a cashflow perspective to submit your claims every other week on Friday, but make sure that they're all perfect than to submit them every day and have a high denial rate, like financially cash flow.
[00:27:37] It's better to be slower on claim submission. But perfect on the cleanliness of that submission than to do it every day.
[00:27:46] James Marland: It sounds like you're batching the process too,
[00:27:48] Jeremy Zug: Yes.
[00:27:49] James Marland: like you're
[00:27:49] Jeremy Zug: you are.
[00:27:50] James Marland: your time by dedicating a certain amount of. Resources to getting it right and then a certain amount of time to [00:28:00] fix it, but you're not doing it every day. 'cause that startup and process switching and all that, it's time. And if you're getting the flow more efficient.
[00:28:11] But if you're just doing it a little bit every day not super efficient.
[00:28:15] Jeremy Zug: Not super efficient. Yeah, that's right. And then you're touching it all the time.
[00:28:19] James Marland: Oh
[00:28:19] yeah.
[00:28:20] Jeremy Zug: don't touch it all the time. Touch it when it matters and then move forward.
[00:28:25] James Marland: So that's that's something you can help people do, right? And
[00:28:30] Jeremy Zug: Sure.
[00:28:30] James Marland: and and make sure that they're, they are processing clean claims. So that, I guess that leads us to what can you help people do and where can people find you on the internet?
[00:28:43] Jeremy Zug: Yeah, so our website is practice SO l.com. We also have a podcast, the Claim Game podcast, if that's okay to shout out. You can find all of our. All of our resources on our website, you can reach out to us about taking billing off your plate if that's where you wanna reclaim some time. [00:29:00] The rate comparison tool that we talked about is on our website.
[00:29:03] You can find that in the hourglass, which is our learning platform that you can get into. And otherwise our podcast is there. Our newsletter we update every month. So we send out a monthly newsletter with. Industry highlights and what's going on at Practice Solutions, what we're excited about, conferences, where we'll be, that kind of thing.
[00:29:19] So
[00:29:20] James Marland: Fantastic.
[00:29:22] Jeremy Zug: all the normal stuff. But yeah, we really like it. And you can follow along there.
[00:29:26] James Marland: Yeah, I was I was listening to you talk about, oh, this article about this thing that I had would have no interest in reading.
[00:29:33] Jeremy Zug: Yeah.
[00:29:34] James Marland: You've read it, you know it, you've digested it, and you know what it, you know how it
[00:29:38] Jeremy Zug: Yeah.
[00:29:40] James Marland: So it's good to have people around like you to help with these. It's a necessary for most, for people who take insurance.
[00:29:48] This is super necessary and what a relief it would be to have somebody take this off your plate and somebody who enjoys it and knows what they're doing. Thanks so much for being
[00:29:58] Jeremy Zug: Yeah. Thanks for [00:30:00] having me. Yeah, it's been great.
[00:30:02] James Marland: All right, listeners, you've heard it here. If you spend any time thinking about billing, when you should be sleeping or frustrated because you have to do these, you have to hang out on the phone with denials or things are getting denied and you would rather be building your business and getting a better return on your investment of time and energy than. Look up Practice Solutions, delegate some of this information, and then you can be efficiently putting your mission in motion. We will talk to you later. See you next time.
[00:30:40] before we end the show, I wanna thank our pro-level sponsors for sponsoring the show: Humor Speaks, RevKey, The Practice Co-Lab, Arc Integrated, TheraSaaS CRM, Guest Compliance Consulting LLC, Private Practice Elevation, Freedom Business Solutions, Bosco LLC, [00:31:00] Profit Comes First, River Street Studios, Wealth and Worth Within, TherapyFlow, and of course, coursecreationstudio.com.
[00:31:07] If you're looking for businesses that can help you break through your, your therapy practice business bottlenecks, go to scalingtherapistservices.com.
[00:31:16] You don't have to do everything alone. And one last thing, please like and share this episode if you found this useful. If you know a private practice owner who has been struggling with the topic of this show and their insurance billing, send this to them. They will be so happy that you introduced them to Jeremy Zug and Practice Solutions.
[00:31:37] See you next time
