I started four months ago running the revenue cycle and billing for a pretty large size medical group. Little did I know when I accepted the job offer that this was cleaning up 8 years of damage. I have a lot of experience in this space but the issues are going to take a long long time to fix.
To give you perspective:
1. Our processes and the way we are billing many things can be perceived as fraudulent
2. Our electronic medical record and billing system is completely misconfigured and set up incorrectly from a billing standpoint
3. Our contracts are not loaded in the system at all meaning we have no idea if we are getting under or overpaid by insurance companies
4. The vendor responsible for all of the billing functions (it was outsourced two years ago) this has completely fucked up everythjng they have rolled out and are not managing our account. They are doing more harm than good at this point and I feel like I have to babysit them.
There are many more issues I could list but while I am open to challenge, this job is affecting my mental health. I feel like I get small wins then I uncover the next huge compliance issue or I get a patient complaint thrown on my desk.
I feel like I am climbing a mountain that does not have a top and I am waking up in a panic on a nightly basis. I’m getting to a point of just flat out resigning because if we get audited or there is a huge issue discovered externally, this could potentially fall on me.