'Find someone you can steal'

Hiring competent employees to staff their billing departments has providers like Joel Holland at wit's end. For some time now, Holland, president of Holland Medical in Nashville, Tenn., has sought to hire three employees to round out his 10-person billing department. He has paid for newspaper and online help wanted ads, contacted personnel agencies, and even asked his employees to look at their family members and friends as potential leads. Still, no luck. "It seems like every time (we have an opening), we have to go through three people--maybe more--to get one good employee," he said. Billing consultants like Bruce Brothis aren't surprised that providers still struggle to staff their billing departments. The main reason: There are few educational opportunities that attract employees to and prepare them for a career in HME billing, he says. "There are community college classes in coding but not billing, and Sally Struthers, to the best of my knowledge, doesn't have a correspondence school for HME," said Brothis, president of Allegient Billing & Consulting in Elizabeth, Colo. Holland also cites the increasing complexity of the Medicare reimbursement landscape as a big reason for his struggles. "It's not even necessarily finding someone with billing education or experience," he said. "It's finding someone with the intelligence to learn a confusing process with an unending number of twists." To make hiring billers a less onerous process, Carl Wallman, president of Galaxy Medical in Fort Lauderdale, Fla., has had to adjust his pay scale to $18 per hour. The result: When he has an opening, the right type of applicant is more likely to knock on his door. "Some providers don't want to realize that it's not a $14-per-hour position anymore," he said. If their pay scale is on target, there's still one rock often left unturned by providers like Holland, who have had little luck with more traditional hiring methods: "Fnd someone good who you can steal," Brothis said.