America's aging population is spurring a boom in medical visits that has taxed hospitals' ability to bill patients, forcing medical providers to either funnel more funds toward call centers, software and legal compliance, or else outsource their business operations to third-party vendors.
That's why independent billing firms like Medical Services of Chattanooga are moving to fill a need that they believe will only grow as hospitals get busier. Already, more than 60 percent of hospitals are outsourcing their business operations, officials said.
As soon as the hospital enters a patient's info, including what procedures were performed and the cost, that information is transferred to Medical Services of Chattanooga, which contacts the insurance company and the customer in order to get the bill paid.
The firm is a key part of North American Credit Services, and one of the top five independent "revenue management" services that do business by taking over many of a hospital's business and billing operations, allowing the hospital itself to focus on healing people.
Hospitals are pushing more and more services toward third-party vendors, to the point that some billing companies set up shop within the hospital itself, supply their own workers and install their own computer system, taking those tasks out of the hospital's hands completely.
The market for such firms is huge. North American Credit Services is on track to process $1.8 billion in hospital bills this year, with plans to grow to $2 billion in processed bills in 2015 thanks to a new addition to the campus near Lee Highway and Bonny Oaks Drive.
"We can do more in a day here than a hospital can do in three days," said Dallas Bunton, chairman and CEO, who owns the company. "Health care is beginning to change."
NACS will grow from 275 workers earlier this year to more than 300 in the next few weeks, after constructing a specialized call center to handle its medical billing business. Within 12 months Bunton will add between 50 and 60 more jobs at the call center, which is served by as many as 300 phone lines.
"This is what makes our country great," said U.S. Rep. Chuck Fleischmann, R-Tenn., who spoke at a ribbon-cutting ceremony at the new facility. "Doing what you're doing here is incredible."
But Bunton doesn't measure his success by the number of phone lines. In the billing world, success is measured by how much money a company can successfully collect from customers. To hear Bunton tell it, it's part science, part art form.
"Patients don't go to the hospital like you shop for a TV," Bunton said. "They go in for a check-up, then the ER, then you're moved into inpatient, and the next thing you know a $125 bill has turned into a $12,000 bill."
That creates a problem. Most patients don't typically have $12,000 sitting around, and if billers make their lives too unpleasant, they could refuse to pay or contest the charges. That's why Bunton says he goes the extra mile to make it easy on customers who need help.
"We'll try to get them a subsidy, or work with the insurance company," he said. "You don't want a person trying to pay if they don't have the ability to pay. Because then the hospital is missing a subsidy, and instead they get a bad debt."
Workers at the company aren't allowed to use the word "deadbeat" to describe a client who is unable to pay, and calls are recorded and reviewed at random to ensure that employees aren't threatening or abusing customers, he said.
It's that type of service-minded philosophy that Bunton credits with his rise to success since he bought the company in 1992 with just 45 employees. He bought it from Adventist Health System, which today is still the company's biggest customer.
"All our clients are word of mouth," Bunton said. "Once you build up trust, opportunity presents itself."
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