Monday, October 13, 2008


Stress... Does it ever let up? Seems my life is always full of kaos. Suzy Orman would say, you've got to organize! Without organization, life is kaotic. I don't know, I'm cluttered but not disorganized.

Today, I had a surprise review by my Corp office, a telephone conference review. I think I've just said it, Corp office, the root of my stress. We are a hospital in a company that specializes in skilled nursing facilities (SNF's.) Actually, we are the only acute care facility in all of the company. There's over 200 SNF's, throughout the nation, and our little hospital in Boise, Idaho.

The mentality of the Corp folks appears to be hard to educate on how we do things slightly different from the rest. For example, we bill daily for our outpatient clinic and upon discharge for our inpatients. I believe SNF's still bill at month end.

SNF's patients may stay at their facilities for years, so billing is done monthly. Our inpatients have an average length of stay of 14 days, and billing is done after discharge. Medicare is the primary payer for 90% of my accounts, the rest of the accounts are Medicare HMO's, with a very small percentage of claims being regular insurance or private pay.

So, at the end of the month, when there's a glitch at Medicare, totally out of my control, and our money is not going to make to the bank to cover the claims we've billed before the middle of the month, my boss is asking why other facilities are not have the same problem.

Well, other facilities (in our company) are SNF's and they probably billed right after they do their month end close, so they normally would receive their Medicare money by the middle of the month. And we are billing every time we have a discharge, and try to bill all claims that have discharged by the middle of the month so we would still receive payment by the end of the same month. (Medicare pays in 14 days if a claim is submitted without errors.)

Anyway, I'm probably boring you with all this but I'm really burnt! I am expected to collect at least 103% of last month's revenue. Last month, I collected 108% and this is the thanks I get. It is so hard to collect some of this money, and I work as hard as I can to get as much collected as possible.

I have been in health care billing since 1984. Every time I try to get into something else, I always seem to fall back into this. Boy, the stress is really getting to me though, and I feel it, feel it deep inside, it's time to move on. I really feel the stress is getting the best of me.

It never fails, just when I feel like things are clicking together just right, I get slammed up side the head, figuratively speaking. I am sure most of this is just a communication mishap and once I am able to explain, things will be better. But then again, I was in a bad marriage for nearly 20 years before I finally saw the light.

Then, late tonight, my guy calls. He's had a huge disagreement with his boss and tells them he quits! OMGosh! This is kaos!!! No stability! Both of us cannot be having horrific days at the same time!

If you made it all the way through this post, thanks for listening. I'm just in a bad place at the moment and a good night's sleep will do wonders.


Donna said...

I've had days like that back when I was working. And when you have a job, so much of your time is spent there that if the job doesn't go well, nothing does.

Nancy said...

Your boss asking about why others dont' have this problem is not necessarily an accusation. S/He may just be trying to figure out the difference.
But you do have a rough job and the shit seemed to have hit the fan! Maybe take a a day off just for you.

: )


a corgi said...

hoping today is a better day; health care is stressful!! my husband is in mid management (purchasing) and there is always one crisis after another and it usually involves money in some way

hugs to you


gulfcoastdee said...

Hugs to you my friend.
I know all about billing mishaps and I've seen total disasters such as 700 thousand dollars in rejected reimbursements. I am in Medical Informatics and I used to run a medical reimbursement recovery company and now I am just a lazy slacker hiding behind graduate school. LOL.
Hope today is another day and stress is history.


ELLIE said...

sending BUG HUGS your way - it must be the moon or something because I have read too many peeps have some major problems with their jobs...I also think that the economy being so topsy turvy is causing anxiety in the background of every business out there!
Take some time for yourself - just quiet time to get rejuvenated - positive thoughts being sent your way..take care--Ellie