An interview with Juli Ann Quinn: Delivering medical billing services during COVID

ENCRYPTED INTERVIEW SERIES

The Paubox Encrypted Interview Series allows us to chat with leaders in healthcare IT, compliance, and cybersecurity to pick their brains on trends and best practices. In this Encrypted Interview, we chat with Juli Ann Quinn, President of RSABill, Inc.

Background

Juli Ann Quinn: Hi, Sierra. 

This was something that I started in 2001. I worked for 18 years in different doctor's offices, and a hospital was my first job. I realized that what doctors needed in private practice was helped with practice management, particularly in medical billing. 

I started the business to serve more doctors than just the ones I was working for. To back up, the doctor I was working for was retiring. So things were changing in my life. 

I wanted to make more money, have more freedom, and do more good in the medical community's business side. So, I started RSABill Inc.

Sierra: Alright, we all want to have more freedom and have more money, so that makes sense to me! What's the biggest challenge or mission that you have?

Juli Ann: Actually, I have a response to both those questions. 

Our mission is to help private practice physicians stay in private practice. It isn't like the 80s or the 90s when it was pretty easy for a doctor to buy a practice or hang a shingle and say, "I'm going to now be in this community." 

It is very difficult for them to survive in private practice because of the enormous overhead and the number of resources it takes to succeed. They don't always know where to go for those resources or have the funds to surround themselves with an "A" team that knows how to access that. 

Our mission is to show them that these resources are available, and you can do it, that "I'm a champion," that they want to keep doing it, and as a patient, I want to have that choice of my private position. 

So that's our mission. If doctors want to be in private practice, we want to give them tools and resources to help them succeed. 

Our biggest challenge is the insurance company. 

The private practice does all this work and sets up the environment. They're paying for the staff, they're doing the work in hopes that they get paid, and the insurance companies now make it very, very difficult to jump through their hoops and get the doctor paid for what they did. 

That is definitely the biggest challenge is the insurance industry.

Sierra: Okay, great. Thanks for sharing that. Is there anything else that you'd like to share about your business that we didn't cover in the challenge or mission?

Julie Ann: We are a medium-sized company. Many billing services are typically extensive and connected to the electronic health record that the doctor purchases. They're outsourcing to labor in other countries. 

There are then some things falling through the cracks. The doctors are not getting that concierge service that we can offer, and that's our niche. 

Then there's the other side of the spectrum, which are the 1, 2, 3 person companies that very much cater to the doctor, but their size limits them. If somebody goes on vacation, or somebody quits, the work is not getting done. 

We have this excellent middle ground. The size that I have, currently, is 25 billers. So, if somebody goes on vacation, I still have 24 billers getting the work done, or if there's turnover, our clients do not see any change. We're able to have that hands-on concierge personal touch. 

That's our template, but we have enough size that we can keep everything moving smoothly.

Delivering medical billing services

Sierra: How has delivering your services changed with the coronavirus? I know that all companies have had to adapt. I am very curious about how RSABill Inc. has been adapting during this environment.

Juli Ann: Yes. 

We're in Southern California, and we've been hit pretty hard. We're actually in our second wave. In the third week of March, I believe, we were told to shut down. It was a government everybody "stay-in-place" mandate. We had to adapt to working from home quickly. 

I have a huge office, and we just set it up. It's new; we hadn't even been here a year! We set it up to have this excellent collaboration and synergy in what I call the war room. That is where all 25 employees were in teams and pods, but not cubicles. 

We have this very open concept of collaborating because everything's changing annually. It is carrier-specific that they have their own little rules, and it's like, "oh, well, now this insurance has started doing something different," so we're able to share that with all of the team.

That helps all of our clients immediately start making that change.

Where if you are doing your own thing, in-house billing, it might take you four months, six months to figure out "Why are they now doing something different" or "I don't get it" or "I'm on the phone, and I'm appealing, and I can't get a straight answer." We are getting that much sooner because of our many clients and the team collaborating on what happened this week. 

We work on a Monday through Thursday schedule of what the team's tasks are. On Fridays, we meet and say, "What happened this week? What are you seeing? What are any trends or changes that we want to be a step ahead of and share with our other teammates and report back to our clients?"

Coronavirus, all of a sudden, has us all working at home. We had to change our template and our workflow of being disconnected suddenly, knowing how important it is to have that collaboration and communication. How are we going to address that? 

I think we were very successful, considering it was a fire drill and in the initial phases. Now we have developed those protocols to work from home and not lose our communication with one another.

Sierra: Right, it's starting to feel like the norm. The coronavirus and working-from-home are beginning to feel very normal. I'm sure when everyone starts to go back into the office, it will feel very weird.

Juli Ann: Yes! 

We did start transitioning back a couple of weeks ago with all the new protocols as recommended by CDC and also to accommodate employee comfort levels, though. 

It's constantly changing. I don't know if we're going to get another stay-in-place order. Our governor keeps hinting that if things don't improve, we might be back there. So, worse, we're in a situation where we feel comfortable working in the office or not working in the office. 

We've got both systems going side by side right now.

Sierra: Juli, what differentiates your business from other medical billing providers?

Juli Ann: I would say that it's definitely our personal "White Glove" treatment. We act as though we are the doctor's billing department. 

Yes, we have a template for success. However, each office is unique, and we want them to feel comfortable that we're interacting with their patients, the same tone as they would if they had one of their employees talking to the patient. We want to respect their way of dealing with their customers.

We represent them. It's a balance of us doing a great job, we know how to do the billing side, and we also want to be part of their team. 

That's what makes us very different from other billing services. Our results speak for themselves on our performance. 

There are benchmarks for evaluating billing and collections I incorporate every month in our month-end reports to our clients: what our grade is, how are we doing, how is your database performing, and we are accountable to that. 

I'm very transparent and proud to show them that we're right in the "A" grade where we're supposed to be.

Sierra: Fabulous, customer experience and transparency are key.   How do you see the healthcare and insurance industries evolving in the next ten years?

Juli Ann: We've seen so much change just in the last ten years; it will keep evolving very quickly. 

Telemedicine was a by-product of COVID-19. I say that because we had telemedicine before, but it was very restricted. It was very limited as to which providers and which patients were eligible for those services. Where I am, in Orange County, this did not apply to any of our practices. It is designed for rural, underserved areas that—that type of thing. 

Because of this emergency, HHS declared, we want to keep medicine available and keep patients and doctors safe, so we're going to open up all services. All providers can access telemedicine during this emergency.

The doctors love it. The patients love it. It works. It makes sense. I think the insurance companies will love it. When this emergency is over, it's going to, in my opinion, be an everyday tool available. 

That's going to be the first thing we see, and then there's going to be more technology. New technology is every three months, six months in medicine. 

I'm not sure why this industry has always been a little bit behind all the other industries when it came to technology advances, especially in the delivery of medicine. Not on the research side, but in the provider, delivering medicine to the patient side, we've always been the old school. "Come sit down, let's have a consultation, and examine you."

Those are so important, but I think technology will help us take medicine to the next level.

Industry trends and personal life

Sierra: Okay, great. I absolutely love this next question. How do you keep up with industry trends? Are there any good podcasts, blogs, influencers, or newsletters that we should be following?

Juli Ann: I belong to a professional organization in GMA. They are wonderful at getting so much information, news, and the latest and greatest to their members. That's one that I really enjoy. 

We are also encouraging our practices to share with us all of the professional organizations and anything related to the business side and billing. They will even invite me to go to some of the lectures at the conferences related to billing. I love that. We stay very active in those types of communications.

I also really enjoy business books. 

I live in Arizona, while my business is in Santa Ana, California. So, I used to fly. I've moved my business right by the airport, and I used to fly every Monday, and I'd fly back every Friday. 

Because of COVID,  I've not been flying. I've been driving, so I've been listening to so many audiobooks.

I love Jim Collins. He did "Good to Great" and after which had been recommended to me and was very inspiring for me.

Sierra: I'll have to look it up.

Juli Ann: Yup! It's called "Good to Great." 

Then I found out he has, I think, five books, so I enjoyed it so much. I'm now doing another one. I'm doing, "Great by Choice." He definitely is one of my influencers.

Then a fascinating book that I enjoyed and just recently finished is written by a rabbi, Daniel Lapin. It's business secrets from the Bible. It's interesting how he approaches business, any type of business. His approach is that we don't work to make money; we work to serve others. If you're doing a good job serving others, you get rewarded by having more money.

It has renewed me, especially at this time where we're in this very unusual, scary, and maybe even depressing time because we're socially distant from our friends and family and, and any kind of social interaction. 

I found it as kind of a renewal of why I'm getting up and going to work every day, and that is to serve these doctors and their staff and their patients in the way that I know-how. 

So, I'm feeling very excited, energized, and wanting to work through this crisis and into medicine's future opportunities.

Sierra: Juli, I love your outlook. I will look both of these up, especially the rabbi book about being more client-centric. I think that's great.  My final question for you is, what do you do to de-stress and relax?

Juli Ann: Yes.

Normally, I would say I love spending time with my family, but we don't spend a lot of time together right now because of social distancing. 

My husband and I live alone, so, of course, I spend lots of time with him. I have grown children in other states, and they're just not traveling right now. We usually would travel quite a bit. I love to travel, so that's on hold. 

At home, I've had a renewal of something I enjoy very much; and that's cooking. I love to cook and to garden. 

I have an amazingly beautiful garden. Probably half the time that I'm home during sunlight hours, I'm playing with my plants, or I'm just enjoying them. I'm growing food, and I'm using that food to cook fresh meals at night. We're just having a great time with the cooking and some nice wine drinking.

Sierra: Must include the wine! That's what everyone says, the wine and alcohol consumption has increased during the pandemic.

Juli Ann: Yes! I also have increased my exercise. So, that's been a nice side effect as well, that I have more time to devote to personal enrichment, whether it's my books or my exercise that was getting put on the back burner in the past. Now it's really nice to have those back.

Sierra: Yes, I completely agree.