Cyndi Walker – President, Medicus
Billing and Consulting
As President of Medicus Billing and Consulting, Cyndi is passionate about delivering high-quality medical billing and operational consulting services that ensure medical practices don’t lose out on their hard-earned revenue. In this interview, Cyndi talks to me about her experience in this field having spent over three decades here and the significant changes she has observed.
Starting Out In The Medical Billing Domain
As a teenager at 19, Cyndi applied for a position at a physician’s office. Enjoying the business side of medicine, she transitioned into a consultant over time. Next, she began working with large groups followed by a large billing company.
Over the years, having seen the losses medical practices incurred due to poor medical and coding procedures, Cyndi became passionate about helping physicians recover their revenue. Having worked out the best possible processes to get the billing done right and get the claims paid quickly, she started her company, and it grew from there.
Cyndi has worked in medical billing for 36 years and has seen many changes in healthcare. She recalls a time when all clams were typed on the typewriter, and nothing was automated. Over the years, Cyndi has seen a drastic change in the way medical billing and providers are paid and the way they participate with insurance.
Recalling signing up her first account, Cyndi recounts a time when she had just started her company. A good friend of hers knew a provider that needed help with his billing. He connected the two of them with an introduction and that is how she got her first client who was a general surgeon.
‘I think getting to know your community well helps if you are a new business and you’re starting out. I think that’s important.’
Even today, Cyndi values networking and referrals for her business. She stays connected with several societies and is a member of the National Society of Certified Healthcare Business Consultants.
Current Business Structure And Organization
Presently, Cyndi’s firm is working with multi-specialty groups and handles millions of dollars in claims every year. Their clients are typically general physicians or surgeons who may be starting new practices or making a move from the hospital back to the office. Her company also gets referrals on a regular basis from physician groups who need extra help understanding the billing process.
Her clients include physicians all over the United States in different specialties. The firm has three offices located in Arkansas, Oklahoma, and New Mexico, but they work with clients in any state.
Her firm has a staff of 40 people which includes management and then client managers that work directly with the physicians and their staff. Next, come the payment posters, charge posters and highly skilled people working the AR, certified coders.
Talking about outsourcing services, Cyndi feels there is a place for outsourcing to offshore for some of the phone calls. She has partnered with some companies to help communicate on the claim level with the payers. Her company handles patient communication, all of the charge posting and payment posting in their offices here in the US, but they do outsource some of the communication with the payer.
Standout Moments As A Business Leader In The Domain Of Medical Billing
For Cyndi, being a part of patient care and working with physicians tops the list. Watching the way physicians worked during COVID, how hard they worked to take care of the hospital patients and work long hours was a defining moment.
‘I am proud to be a partner with physicians and participate in caring for patients. That has been my standout moment in working in the medical billing side.’
Regarding her company’s achievements, Cyndi feels pride in her ability to help physicians with the complicated side of billing so that they can focus all their attention on their medical practice.
She is also proud of her company’s team of providers. A lot of the company staff has been with Cyndi for a long time and brings quality service to the medical community by helping them navigate through the complexities of getting their services reimbursed.
Overcoming Challenges Over The Years
A significant challenge is an ever-changing way that medical billers are presented with, in getting the claim paid for the provider and the service reimbursed. There are constant updates in the insurance industry, and it is important to keep up with what is going on with payers.
Right now, telemedicine is the norm. Medicare is going to update the way telemedicine is billed in January. This means everything the billers have learned about this process till now becomes obsolete after January 1st. The payers want the claims and the medical records in different formats, some of which are available on their websites.
‘You have to keep up with an ever-changing industry. The technology for providers as well with the EMRs is ever-changing and so are the rules, making it an interesting industry.’
Business Plans For The Future
For her firm, Cyndi is satisfied with the work her company is currently doing and is not focused on growth as much as fine-tuning processes. Her company is looking at some artificial intelligence right now to see how that might help with some of the day-to-day tasks and automation possibilities.
The key to this industry is staying on top of things and turning around denials in a timely manner. Anything that can be done to speed up notification of the denial and the update of the denial is beneficial.
Talking about marketing methods that have helped her company grow over the years, Cyndi credits referrals as the main source. She also has a website that clients can go to where she updates information about the latest trends in telemedicine and the changes in the industry.
Top Philosophies And Core Values In Business
For Cyndi, core values include staying on top of the industry and its changes and coming up with new ideas and technology. Technology helps map claims for the providers by category so that instead of just concentrating on working the errors, they can identify where the errors originated.
This helps identify what was missing or what started the process for the claim to get rejected and make the submission as clean as possible. Also, it is important to help providers understand the processes within the office that are required to get the right data.
‘The collection of data is very important. 30% of your rejections from insurance claims are from basic data information required by the carrier that we are not supplying.’
Understanding and training, meeting with the offices on a regular basis helps them understand what is causing a rejection of their claim. Nowadays, smart edits come from the insurance company which could be something as simple as getting a patient zip code wrong.
The top reason for claim rejection is data collection, followed by coding and medical records or information from the patient.
Advice For Newcomers Looking To Start A Career In Medical Billing
‘You need to find something that you’re passionate about and set out to be the best that you can be.’
Set yourself out from the crowd as being someone who concentrates on customer service. Getting to know clients and making sure that the product produced in the industry is cutting edge, doing the best job and fulfilling a need for the client base – this is how a business grows.
Cyndi states that she gets lots of referrals from her clients to their other physician friends. Her business has been built on referrals and that comes from making sure you are friends with your client; that you understand what they need and help them by being a good partner.
Two Key Learnings From This Business
- Know your industry well. Keep your fingers into a lot of different societies and be on the listserv with the payers. Do a lot of reading and be on top of what is going on to keep up with the payers’ changes and the industry changes in general.
- Keep yourself educated and network with others and help them in their business or go and get a group of people that excel in your industry. Then go and learn from really experienced people.
Key Benefits Of Services At Medicus Billing And Consulting
The key benefits are that customers can have certified consultants, certified staff, and experienced staff in their specialty helping them with their accounting and their billing. This can be very difficult to manage in the office which makes it a major benefit for physicians outsourcing their billing to a billing company like Medicus.
Vision For Future Of The Industry
Cyndi believes the future is again going to be about automation which is where the carriers are going. They have automated their claim screening process, their process to communicate to the physicians about any denials or information they need.
Now, most medical records are uploaded online with very few going out by mail. COVD led to many people working from home which furthered automation adoption. Artificial intelligence is where most companies, including insurance companies, are headed right now.
For companies and professionals looking to remain successful in this domain, Cyndi advises getting a certification. This is an industry that takes a lot of time and dedication and study to master. People would need to work in a physician’s office for a couple of years and learn the industry.
‘I started working in this industry at 19 years old, and I never changed. I was fascinated with the fact that we communicate numbers to the insurance company, understanding what those numbers were about, and how it all comes together. It’s very detailed and very complex.’
Leadership Lessons Learned Over The Years
The most important aspect of any good leader is learning to listen. Listen to the staff, the clients, and learn from that. When someone first gets a managerial position, they think everyone needs to listen to them but listening to everyone else is the key to having good relationships and building on those. That is how businesses gain long-term employees which is where the power of a business comes from – experience is very important.