A little bit of my backstory…
This has been my journey, full of unexpected turns.
I graduated with a master’s in social work in 1991. My career goal was to become a therapist in private practice. Like you, I didn’t learn the business skills needed to operate a private practice.
Because I had no means to start a full-time private practice and live without income while growing it, once I was licensed, I got a job as an employee assistance therapist. Just two years later, I was burned out by the unrelenting demands of management to schedule 36 clinical hours per week plus unpaid on-call duties. I left direct clinical work in 1996 to “take a break.” Little did I know that I would never return.
My temporary “break” led me to a clinical care manager role at a corporate predecessor of Magellan Behavioral Health. While there, I became fascinated by the toxic US healthcare system.
Every day, I was yelled at, by clinicians and clients frustrated with “the system.” I was powerless to help. As I learned more, an idea came to me: why don’t I start a company helping therapists and psychiatrists, so they could concentrate on what they had trained for – behavioral health care?
Sink or Swim
It wasn’t long before I dreaded going to work every day, knowing I would be yelled at by someone. Racking my brains over how I was going to make a living for the next 4 decades, I decided to take a chance on that crazy idea. It was “sink or swim.”
Becoming a biller was not the original intent; I was still a clinician at heart. I started off helping my clinical colleagues obtain authorizations. At that time, if you wanted insurance to cover treatment, you had to justify “medical necessity” every month or two.
Authorization requests became tedious. But everyone needed help with billing and credentialing – and I learned to navigate it. Years before the 2008 Mental Health Parity Act, I had jettisoned authorization requests completely, in favor of credentialing and the full suite of revenue cycle management services.
I’ve watched the private practice challenges come and go. Or not go. Or come back again with a new twist. Life is never dull, as a biller.
The challenges are multiplying and never-ending, and the pace has quickened in the last few years.
In billing, as soon as you think you have something figured out…it changes.
