12:42Key Takeaways
Amy Keeps Her Two Companies Separate on Purpose.
Limelight Business Partners consults for medical practices; Sublime Medical Billing Partners does the billing. Amy Thomas kept them apart because practices usually need one or the other, not both.
Unreconciled Payments Are the First Red Flag.
A check landing in the business account does not mean the practice got paid for everything. If a practice is not reconciling inside its EHR or practice management system, something is broken.
Never Write Off a Copay.
Writing off a $30 copay, even for a friend of the family, is a breach of the payer contract — and that could be big trouble down the road.
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Finding what is broken in a medical practice
I started this company during the height of the pandemic. It was first Limelight Business Partners, which is more of a consulting and management company for medical practices, but I also wanted to get into billing, which is why I then started Sublime Medical Billing Partners. I wanted to keep the two separate. A lot of practices need one sort of business or the other: they need help with consulting, someone to come in, see what is going on, see what is broken and come up with resolutions — whereas some practices just need the billing services because they have everything else under control.
Because I have experience going into different small practices, I know going in ahead of time if something is broken. A big resource I use is Maryland MGMA, the medical group management association, which helps practices across all sorts of areas — IT services, consulting, analytics. We have sponsorships with EHR and practice management systems, so if a practice is looking for something we can get them quotes and estimates and work out what fits. And there is the networking: if it is a specific speciality I will know other practices like them, and that really helps.
When you go into a practice and they are not doing that, right away those are red flags that something needs to be fixed and it is broken.
Amy Thomas, President, Limelight Business Partners
One of the biggest things I see is on the billing side: if they are not getting paid by payers, I want to figure out why. When I look at a practice I want to see who the big payers are and who is not paying as much, and whether there is a credentialing issue. Another is checking the EHR or practice management system — are they reconciling their payments? Just because a cheque is going into the bank account does not mean you are getting paid for everything, or that the accounts for patients are being worked.
You want to be a really good practice for your patient. You want the explanation of benefits they receive at home to match what is in your system. There are practices I have gone into that do not even send out statements, so the patients do not know what they owe. I am really focused on reporting — you cannot run an AR report if you are not reconciling within your system.
Practices also forget that you should never just write off a copay. Even if it is a friend of the family, that is a breach of your contract with the payer, and if payers find out they can audit you, and then you are going down a legal road you do not want to go down.
The best use of technology, honestly, is the internet. I had a whole team working 100 per cent remotely before the pandemic, so when everyone had to go home I actually ran webinars on how to manage remote employees. You have to trust the people working for you, but more importantly you need the analytics: how many accounts they touched, what they did in those accounts, how many phone calls were made. In an office you can see people working. Remotely you need software that gives you those analytics back.
On motivating a team, I like to do things outside the box. There is a time for work and a time for play, and I always found the pizza-in-the-office gesture insulting — you cannot do it when everyone is remote anyway. For our Christmas party we went to Topgolf, which worked because it was interactive and some people had never swung a club before. I like spouses and family to come too, for the camaraderie. And I like to wrap education into it: if there is a conference somewhere, we go, learn, and maybe get some hockey tickets while we are there.