No Biller Needed in Direct Care

billing direct specialty care Apr 04, 2023

It's not uncommon to find complaints about a billing company that under delivers their promise to clients in getting them paid on time (or on a predictable schedule since it's rare in the insurance world to get paid the same day), controlling the accounts receivable, and following up on claim denials. While there are great billing companies out there, there are far too many bad ones and it causes stress and anxiety to the practice owners.

Getting paid has now become an art of knowing what codes and modifiers to use, combing through the contracts or endless mail of what is billable and what is not, and staying up to date with regular changes that insurance companies seem to take joy in doing so that ultimately, payment gets even more delayed.

Some physicians take on billing duties themselves, especially when they're starting out with a lower volume and have time to learn this skill. Some enjoy this task while most would prefer focusing on being with patients instead. Eventually though, realizing that with each passing year reimbursements for services continue to decline despite the rise of inflation, cost of supplies, rent and employee raises (and benefits!). To make up for this loss, physicians have to see more patients and then suddenly their days are overbooked with 30-50 patients per day.

Increasing the volume of patients also increases administrative work like charting and coding in a precise way as determine by the insurance regulators, neither which improves the quality of patient care but dramatically affects physicians' well being. One moment you've got the billing side figured out, the next you're drowning in debt staring at the accounts receivable that is now easily in the 5-6 digit number. This is money owed to you by the insurance company but only a fraction of it will ever get realized. 

No wonder people are out there are saying private practice is dead. Billing for insurance is killing us. 

A plausible solution to billing woes include creative billing aka fraudulent billing, but unfortunately some of us don't look good in orange. Yes, we can also find another billing company or do it ourselves. 

But what about an alternative where no billing company or complicated billing software would ever be needed? In what industry does a client pay to have their problem solved the same day, in full, without this complicated web? (Literally everyone else but physicians). How could one achieve an accounts receivable of $0 forever?

Dare I say it...Direct Care. 

Just like hiring a lawyer or babysitter, or even getting your hair done, the transaction between the client and professional is linear. A service is rendered, an invoice is generated, and payment is made in full on the same day. This is Direct Care, the beauty of opting out of restrictive insurance contracts means that you will never need a biller, billing software or outsource a collection agency ever. 

Let me repeat this, Direct Care is where you get paid in full on the same day service is rendered, which means your accounts receivable is always at $0. There's no chasing money owed to you because when you tell people you don't bill insurance, you tell them the price upfront, and you have what they want, they all come prepared to pay. You can offer financing options through another company, but even they will transfer money into your bank account in 1-3 days. When you bill insurance, they're going to decide when and how much you'll get. You'll always be at their mercy because the house always win.

So there you have it, how to get rid of your biller indefinitely by choosing Direct Care.

Side note: I had a really great biller but as I started to opt out of insurance, her hours got decreased. I told her how much I appreciated all that she's done for me and I wanted to keep her in a different role but she eventually resigned so she can focus on her billing company. She jokingly said to me she had a few clients who were also opting out and wondered if I had anything to do with it. She knows the deal, physicians just want to practice medicine in the simplest way where we get paid for our time, at full price all the time, and on time - just like every other service industry. 


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