7 Hard Lessons Learned at Altus Pediatric Billing

Think back to when you started your practice. Are there some things you wish you had done differently? Are there things you do today that you changed or incorporated because of the lessons learned during those times? Are you holding on to a negative review of your practice from the early days when you just hadn’t found your groove yet?

We’ve all gotten negative reviews we are holding on to. If we can learn from the feedback and make meaningful changes, we can let go of them and move forward.

At Altus, we’ve learned so much over the years and are committed to continuous improvement. Here are some of the things we have learned and implemented.

1. Billing Process: Our process is fantastic. We have been audited by multiple consultants who have all commented on how thorough we are. While we did always have a checklist, we did have a client in our earlier days who wanted us to do things communicated to her in a different way, outside of the system. She also wanted us to work her denials and rejections in a way that didn’t align with our workload.

This resulted in poor communication, unnecessary work on both sides, and some things taking longer than they should have. We have built in some ways to customize certain parts of the process and some of our actions, but we no longer deviate from the core process. The result is that nothing slips through the cracks.

2. Team adherence to the Process: While we had a really great process, we didn’t have everyone checking to make sure every team member was consistently using the process, and we didn’t regularly audit their work. While we were still getting great results for most of our clients, we did have some things that weren’t up to our standards.

To address this, we rolled out a formal expectations guide and added a tool for our team where practice preferences and specific payer rules are documented. This is audited regularly by the leadership team and documented on a company dashboard that is updated weekly to ensure consistency.

We now know our process is followed by every team member, every time, and have the tools and numbers to verify this.

3. More collaboration with offices about how to gather required patient information.. Billing starts with the front desk, and we can’t deliver on our promises if we don’t have great communication with our clients about what we need.

We developed a client success guide and training tools to help the front desk be successful with getting insurance cards and verifying eligibility, creating a smoother process throughout the billing cycle. By offering this training any time there is a team change, our clients are able to make sure the front desk has clear information about what’s needed and a strong relationship with us to ask questions when they need help.

4. Hiring and onboarding practices. We hire great team members who are passionate about getting pediatricians paid. However, when we were starting out, we were hiring people with experience and who fit our corporate culture, but we didn’t have formal evaluation and training.

Our screening process now includes an assessment that is taken before an interview is scheduled and a longer, personalized training period. We know billers come from all types of backgrounds and expectations, so we don’t place a new team member with a client until we are confident that it’s the Altus process and standards that will be followed.

5. Internal metrics. In our early years, we pulled about five pieces of data every month to ensure we were meeting our high standards. We learned that this simply wasn’t enough and sometimes actions could be taken sooner if we had more regular data or insight into other metrics beyond these five.

We took action and developed a longer list of metrics that need to be monitored. These are all recorded in our company dashboard and now, we have a long history of these metrics so we can identify changes quickly.

We also moved some of those metrics to our weekly review, so we can spot trends and react with quick action when needed.

6. EMR-specific training on reports and what we look at. We believe in complete transparency and that you should be able to see exactly what is happening in every claim we are following up on. We’ve always done the work in the client system, but we didn’t provide any guidance on how to see what we are working on.

To help practice administrators and practice owners, we now have training resources for each of our EMRs and send practice-specific videos with a step-by-step guide on to pull your own numbers and what to look for.

7. Accelerated timing of our 30-point review. We take each client through a thorough review of their practice profitability. We used to like to get everything completely cleaned up from the previous billing and get some time under our process before analyzing the total practice, but now we have accelerated this so clients can get feedback sooner.

High Expectations and Extreme Accountability

I expect a lot of myself and of my team. I believe in extreme accountability, continuous improvement, and acting on feedback.

I have learned we are not the right billing company for everyone. While we are always seeking feedback and looking for ways to make the client experience better, there are some clients who need different support and who have different expectations of their billing team. We work hard to be transparent and give as much information as possible so a potential client can gauge if we are the right company for them.

My hope is that everyone has an incredible client experience 100% of the time. When that hope isn’t met, though, here are the promises to my clients:

  1. I am available. My calendar is literally published on my website and in every one of my emails. I am always available to discuss concerns.
  2. We always act on feedback. We take all feedback very seriously and act on it not only with the client who shared the feedback but also with our entire leadership team to address how we can improve our total process.
  3. We will always make it right. No billing company is going to be perfect 100% of the time. We have lots of safeguards in place to make sure nothing gets missed, and our leadership team is very regimented in their review and follow-up of accounts. If something doesn’t go right, though, we will make sure we fix it.

Altus has been incredibly fortunate to work with some incredible clients over the years, and we have been lucky to have people trust us with feedback so we can improve our client experience. We constantly work to have a stronger team, better processes, and a more robust leadership review to ensure we deliver on our promise that you can expect (and receive!) more with your work with Altus Pediatric Billing.

If you are interested in talking about any of these lessons or learning more about how Altus works, book a 15-minute discovery call to learn more.