Ep 24 - Cancer to Contracts: Reinventing Healthcare Finance with Josh

What if transitioning from a 30-year career in the car business to founding a medical billing company after recovering from cancer surgery could revolutionize the way doctors manage their finances? Join us as we sit down with Josh, the trailblazer behind J3 Medical Billing, who shares his incredible transformation story and reveals how his expertise in contracts and business management shed light on the untapped potential of the medical billing industry. Josh's passion for educating and protecting healthcare providers shines through as he discusses how J3 Medical Billing supports doctors, allowing them to focus on what they do best—providing exceptional patient care.
 
 We also delve into the evolving landscape of medical billing and coding, where Josh highlights the impact of new Medicare codes like G2211 and the crucial importance of meticulous documentation. Discover the future aspirations of J3 Medical Billing, including their plans for nationwide expansion and the irreplaceable value of human touch in resolving billing issues amidst the rise of AI. Learn how strong client relationships and personalized communication can make or break a business, and why Josh believes that quality staff and client referrals are key to J3 Medical Billing's continued growth and success. This episode is a treasure trove of insights for anyone interested in the intricate workings of healthcare and the vital systems that ensure its smooth operation.

THE ANGRY BILLER, powered by J3 Revenue Cycle Management

Phone: (954) 544-2706

Website: https://www.j3rcm.com/

LinkedIn: https://www.linkedin.com/company/the-angry-biller/


Production of Podcast: VISUALS BY MOMO

Transcript

Josh Fertel

00:04

Welcome to the Angry Biller, a show where we explore the people in the businesses behind the scenes of healthcare, those men and women that are the catalysts that allow providers to concentrate on delivering exceptional patient care. 

Chris Baker

00:18

Welcome to the Angry Biller. Today I, chris Baker, from Visuals by Momo, will be interviewing Josh for our final episodes for this season. So very exciting information. Very exciting to have me here hosting and asking Josh the questions for the first time this entire season. So looking forward to it. 

Josh Fertel

00:35

Yeah, thanks for doing this, Chris. I'm very excited it's a different chair to be sitting in, but I'm looking forward to it. 

Chris Baker

00:41

Yeah a little bit different. Like usually, we're behind the scenes and you're the one interviewing everybody. 

Josh Fertel

00:46

So before we even get started. I I appreciate everything that that you have and momo have done it visuals by momo to get the first season wrapped up and, uh, you know, hopefully this will continue forever let's make it last forever, like let's, let's just continue to improve and improve, improve. 

Chris Baker

01:01

So this first, that's going to be a two-parter episode here, okay, and the first part, we're actually going to talk and improve and improve. So this first, that's going to be a two-parter episode here, okay, and the first part, we're actually going to talk and deep dive into J3 Medical Billing, okay. So tell me what inspired you to start J3 Medical Billing and how did the initial experience shape your values and the mission of the company? 

Josh Fertel

01:23

the initial experience shape your values and the mission of the company? That's a great question, you know. 

01:32

I've told the story of how I got into this a few times In 2021, I was in the car business my whole life 30-something years I was in the car business. I did every job in the car field. I ran dealerships, I was a general manager. I actually even went to dealer school to be a dealer principal. I ended up going out on my own and getting out of retail and went to broker. I was brokering cars Fast forward to 2021, june of 2021, and I had surgery for cancer. 

02:00

I had a malignant thymoma and I'm 100% better today, probably better than ever. I did not have to go through chemo and I did not have to go through radiation, which I'm very happy about, and I feel for those people that have. I have a scar pretty cool scar that I was housebound for two months and, as the process was going on and I knew the surgery was coming on, I was housebound for two months and, as the process was going on and I knew the surgery was coming on, I was like what am I going to do for two months? I don't want to waste the time. Time is short. So I didn't want to waste two months of just sitting around the house and I wanted to use that time to learn something new. 

02:41

I've always been interested in the medical field. I am too old to go to med school, but my whole life has been about contracts and about money and running big businesses that I was like. Well, let me learn about billing Cause. That that's the uh, that's the heart, right? That's the heart of of of an office. I took a class online through AAPC. 

03:02

Uh when it was done took me about six weeks. I got a nice diploma and then I took a class in auditing and got my diploma for that. Then, come August of 21, my 60 days were up and I was like, well, what am I going to do with this new information? And I decided to see what I could do. I formed a company, I built a website and just started networking and trying to surround myself with people that were more experienced, obviously, than I was and wanted to see what I could do. So that is the origin story of J3. 

03:40

That's a very impressive or industry, what you went through and coming out at the end of doing something completely different besides brokering cars, and it's that doctors are not taught how to be business people and you're either an employee of a hospital or a big institution or you are practicing for yourself and you've gone to school for 8, 9, 10 years. Not one time were you given a class in business. So I have the ability to look at a practice through a different lens and you know it's important to me that that these men and women who devote their life to taking care of others are reaping the rewards of their hard work. And people are surprised when when you say that you know, not every doctor has a yacht parked in the back of their house. You know they're, just like I said, men and women doing their job and we want to try to help them do the best they can. So I would say at this point at J3, we are educators, we are protectors and we like to think ourselves as little partners in these practices that we serve. 

Chris Baker

05:14

Wow, that's actually amazing because you're right, I do know plenty of doctors out there that aren't. You know, they don't have the yacht, they don't have this and they are primarily just focused on helping the individual. And if they're running a bigger you know clinic or wherever they're working out of, they're not necessarily always worried about the billing portion of it. They're just trying to help the person and help the person. So I love this. 

Josh Fertel

05:40

Yeah, and and, and you know I'm not to knock anything, but you hire a controller, an office manager, to do those things and generally this is a salaried employee who works from 8.30, 9 o'clock till 4.30, 5 o'clock and they wipe their hands and you hope you have somebody that has your back doing that. But they're just one person back doing that, but they're just one person and they're the ones that are watching the, you know, watching the checkbook, opening the mail and, and you know, your, your physicians, they just they don't know what they're supposed to be doing to run the business. 

Chris Baker

06:13

Well, even as I, I'm guessing, even as a controller, right they're, they're handling everything that handles in the office. Yes, so you know, trying to track down somebody that hasn't paid one of their bills isn't necessarily the first thing on their brain. They're like, oh, I got to keep things moving day to day. 

Josh Fertel

06:31

And they're not. That's not a controller's job. Either you know they would have people on the staff or you know who are in charge of that, but that's where the outsourcing comes in. Yeah, you know, and just like you have a controller who's a salaried employee nine to five monday through friday, so is your billing person. If you have somebody in in-house and you know how much skin in the game does that person have, they're getting paid. No matter what, what, if the money's coming in or not, they're getting paid. You know, it's okay. It's easy for them not to chase after things that are 90 days old, receivables it's. It doesn't matter. You know we'd like to think that they, that they are doing, but well, it doesn't matter, they're getting paid, the same thing anyway they are getting the pay the same. 

Chris Baker

07:16

So having somebody that's an expert in this and it kind of helps generate your income right it gives that offset right so yeah, you're an expert in that field and you can help and assist the doctors in this way we do, we do and and we get. 

Josh Fertel

07:32

You know we are a business and we get paid by a percentage of what we collect. So it is in our best interest to collect as much as possible, you know, and not let's and as quickly as possible and for the right amount. 

Chris Baker

07:47

Yeah, I've actually heard on this show like how many times people like their mail just sits there because they don't know how to pay or they don't know who to send the payments to. So there's a lot of other challenges that are happening in the medical billing area. So, as somebody that's deeply involved in this medical billing, what are some of those other common challenges that the healthcare providers are facing, and how does J3 medical billing specifically address these issues? 

Josh Fertel

08:19

Okay, the most important thing and we've learned this from handling audits from Medicare is you have to go through your mail and you have to respond to the things that need to be responded to in a timely manner, depending on what your specialty is. Many times the insurance payers Medicare, blue Cross, you know them all they ask for more information and they want it in a timely fashion. So if a letter goes sitting on somebody's desk and it's unopened and it sits there for a couple of weeks and then you open it up and now you have to go track down everything, you're behind the eight ball and there's something that you might not get paid. Or, if you were paid, they're going to take the money back and that does happen. So the first thing we want to do is we want to respond to every piece of correspondence that comes into the office. So who are the persons that are doing that? 

09:16

At J3, we use what's called eBridge, which is basically a Dropbox, and we ask our providers whatever correspondence that you get, drop it into this Dropbox it. And we ask our providers whatever correspondence that you get, drop it into this Dropbox. It's HIPAA compliant. And we go through the mail anything that has to do with billing or anything that has to do with payments, and sort it out and make sure that it gets put into the system correctly and everything is accounted for. And when we see something that needs to be addressed to the commercial payers, we jump on it right away. 

Chris Baker

09:45

It's a lot of extra work, especially for working with your clients, so I think that's valuable. It's a valuable tool for them to have somebody watching their back. 

Josh Fertel

09:59

And the most important thing, chris, about that is it's not just one person, it's not Josh sitting there going through everything, right, if you're in an office and you have one person, that person's sick, or that person gets a better offer somewhere and quits you know where. You don't know where to look right. We, you know we have a staff we're up to seven, eight people now doing the work, so it's always next man up for us. If somebody's out or somebody's on vacation, there's somebody else looking at that, that, that client of ours. That practice to make sure everything's getting done correctly. 

Chris Baker

10:29

You've got their back, which is great. I actually do appreciate that we do we, do we, we? 

Josh Fertel

10:34

we like to think that we're doing the right thing. 

Chris Baker

10:36

No, I believe, I definitely believe you guys are so. 

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Chris Baker

11:13

All right, welcome back to the Angry Biller. Again, chris, here interviewing Josh Fertel. Thank you, chris. J3 Medical Billing. So as we left, we were talking about just some of those challenges that you know some of those healthcare professionals are experiencing, but now I'd like to go into a little bit more of the education. So you've mentioned the importance of educating healthcare providers about the business side of their practice. Okay, can you share a story or example of how this educational approach has transformed one of the clients that you've worked with? 

Josh Fertel

11:53

Absolutely. We monitor the codes and we monitor the diagnosis constantly. Medicare will come out with the codes right around now every year for the following year. Last year they added a code called G2211. And what that is is providing continuing service to a patient and we made sure that all of our providers, all of our clients, knew about this code, because this code paid $20, right, sounds like $20, not much. Added up over the course of a month for the same amount of time that you're spending with a patient to spend a little bit more time, medicare is going to pay you extra $20. We made sure that our doctors knew that. Like I said, we want them to be as profitable as possible. 

12:52

Doctors to chronic care management, which is a great service that Medicare provides to Medicare patients older individuals to make sure that they're being taken care of outside of the hospital, that somebody's checking up on them monthly to make sure that they're living their best life and keeping them out of the hospital. 

13:04

And Medicare actually pays a doctor's practice to do this service. So we make sure that our doctors are taking care of that practice to do this service. So we make sure that our doctors are taking care of that. We make sure that they're coding the correct time, that they're spending with the patients, that they're not undercoding. Medicare will say they're based on amount of time. Did you spend 15 minutes, a half hour, an hour with this patient? Was it in person, was it virtual? And we make sure that everything's documented number one and that they're spending the right time so that they're collecting the right amount. So it's a constant communication. Constant communication when we see something that can be fixed or something that needs to be adjusted, as we're doing our daily job of submitting, we make sure that we tell the doctor that there's other things that they can be doing or they should be doing differently. 

Chris Baker

13:51

That's's fantastic. It's like you're the superhero behind them that's actually just making sure that they're 100 covered and safe, like I don't know about superhero well, but in a way it's. You know if they're not learning how to do the business side of it and there's all these other expenses, but you're coming up with the hey, did you know about this? And you're giving this information. You have this whole plethora of just amazing knowledge that you're giving to your clients that you're working with. 

Josh Fertel

14:23

Yeah. 

Chris Baker

14:23

And you're giving to them in real time, yeah, like you're making sure they have it at the moment they need it. I think that's fantastic. Yes. 

Josh Fertel

14:30

Yeah, I totally believe it. You know, communication is the one thing that we really. You know, everybody's gonna sit here and say we're great communicators, but I really think that what sets us apart and that's you know from from other companies, we are based in the United States. 

Chris Baker

14:44

Um we. 

Josh Fertel

14:45

You know, there are a lot of companies that do what I do and they're overseas and they're less expensive and there's the competition. But there's also a time difference and sometimes there's a language barrier to that, but we're there If there's a question, or if a patient goes into the office and they have a bill and they have a question about the bill, we can answer it while the patient is still in the office, and we often do Not. For me and patient payments, that's a whole another story about it. That's another thing that doctors really need to concentrate on is the. My pet peeve is the way we handle patient payments. 

Chris Baker

15:19

Oh, that's yeah. Having quick answers immediately when you need it, that's invaluable, especially if the patient's in there and you want to be able to get that answer to them right away. Correct? Yeah, that's something where? 

15:30

yeah, it's going there and you want to be able to get that answer to them right away, correct. Yeah, that's something where, yeah, it's going above and beyond. I love that, thank you. All right, so, looking forward, where do you see J3 Medical billing in the next three years? What are your key goals and how do you plan to achieve them? 

Josh Fertel

15:46

We've been very fortunate in our growth. We are a three-year-old company. I'm not the kind of person who's afraid to surround himself with people who know more than he does and my team. They've been doing this for a long time 10, 15 years and they know what they're doing as far as the coding and they'll know more than I'll ever know. I expect us to be a countrywide company within the next three years. For sure, that's excellent. We're not afraid of the extra hours going from East Coast to West Coast or even Hawaii. We're not afraid of that, we are. We're right. 

16:36

I think that there's a lot of education that needs to be done. When people say the word revenue cycle management, nobody knows what that is, even if you're in the middle field. But if you are outside of the middle field, you have no clue as to what that is. And I explain it as what we do, and people don't even know that this service exists. So if I can do my job of being the face of the company and marketing and getting the word out that this service exists, so if I can do my job of being the face of the company and marketing and getting the word out that this exists, I think that our growth it will absolutely happen without any outside forces. We've grown totally from word of mouth and referral and reviews and I think we can do that, you know continue that growth, absolutely. 

Chris Baker

17:17

Education is so important and you can get the word out there and they can understand the revenue cycle management and all of this, like I don't even understand those words, so maybe you know. Just because some of our listeners might not understand it, can you explain that a little bit more in detail? 

Josh Fertel

17:32

Revenue cycle management is like exactly what the words say. You know, from the time the cycle starts when a patient calls up to make the appointment. Okay, at that point, if done correctly, the insurance information is being taken care of their demographics which is their name, their age, their address is all being taken care of and done perfectly. That's the start. Second thing that happens is now we verify the coverage. Does the patient have any deductibles that they need to cover? Is there going to be a copay which there always is, unless it's a wellness visit? So we make sure that the patient knows that when they come in they're going to have to pay $20 as their copay. 

18:19

Patients comes in the doctor, does their thing, sees them, cures them, whatever it is, and puts all their notes into their computer system. And that's where we take over and we get the technology to submit all that to the insurance companies or Medicare and make sure that they get paid quickly. Once the money hits the bank, then the cycle is complete. So it starts from the appointment. All that to the insurance companies or medicare and make sure that they get paid quickly. Once the money hits the bank, then the cycle is complete. So it starts from the appointment. It ends when the dollars hit the checking account awesome. 

Chris Baker

18:39

Okay, that actually makes a lot more sense and I think that was a well state. So, um, excellent. So now let's talk a little bit about technology. Okay, everything's coming in. Ai is coming in. How do you think advancements and technology, particular in ai and automation, could help impact the medical billing industry in the near future? 

Josh Fertel

19:00

okay, so I think ai will help with coding, and when I say coding, um, your, your doctors will be able to talk into the computer, say this this is the problem and the codes will come out correctly. They actually have that technology now. Yeah, when it comes to the billing part and certainly people ask me this a lot insurance companies' job is to not pay Right. Their job is to not pay or to delay payment. That's how they make their money. Right, okay, right, yeah. I know Our job is to make sure done correctly. So I cannot envision two computers arguing about something whether it was done correctly or not right. Nobody would win. So I can't see and maybe I'm just ignorant, but I can't see how ai would affect the billing, because you need to have human interaction when something is wrong. 

Chris Baker

19:57

Yeah. 

Josh Fertel

19:59

So garbage in garbage out right. 

Chris Baker

20:01

Well, and that's true and honestly that's with any AI right now. It's like if you don't know how to put in the right prompt, you don't get anything good as a result. So that makes sense, like if you're not putting in the right billing codes right, the insurance company is not going to want to pay, exactly Because they're like no, that doesn't make any sense. 

Josh Fertel

20:21

So, okay, I definitely see that If it was 100% payable never a thing that's turned down or rejected or denied can you imagine what your premiums would be Right? So I don't know. At this point I can't see where AI is going to affect the process of billing. 

Chris Baker

20:41

I do see, like you initially stated, like if the doctor is talking to the computer and says what should this be labeled? 

Josh Fertel

20:49

as. 

Chris Baker

20:50

And if they can get it all correct, it'll help speed up that process. Oh for sure, and honestly, that might just be it. So then it can speed up their process to hopefully get it to you so that you can continue the rest of the actual billing portion of it. Exactly, okay, excellent, all right. So building relationships? Oh, okay, building relationships seems to be a critical part of your business. Yes, that's where everything's come from. So how do you maintain strong relationships with your clients and how has this approach contributed to the success of your business? 

Josh Fertel

21:23

well, first off, building relationship. My business, any business right, it's the core right. You can't have a business unless you can't have clients, unless you have a a relationship with them. 100 my clients know I'm available. Is that a good thing or a bad thing? I don't know. Right now it's a great thing. Three years from now maybe it's a little, I don't know. I always like to think that I'm going to be the one that they can call first. I'm going to strive to do that. 

21:52

So, with that being said, I'm a great texter. I get texts early in the morning, I get texts late at night and I try to answer them as soon as possible. If I'm sleeping, I answer it first thing in the morning. But when you are, it's not lost on me. In the position that we're in when it comes to the financial health of a practice, right, it's not lost on me. 

22:14

What our job is is to keep this practice afloat. You'd want to imagine if you were able to call your banker whenever you wanted. That'd be great, wouldn't it? Oh my gosh. So that's the way I look at it. You know these people are depending on me. You know to make sure that they're running, that they're running correctly, and you know, no company is perfect. You know, do things fall through the cracks? Of course they do. Of course they do. But the thing is, once somebody finds it, we make sure that we communicate. Okay, look, here's the answer to that question that we didn't have the answer for before, and we try to do it as quick as possible. It's a matter of trust. They're opening up everything to me. They're checking information, everything. I know everything. It is about the practice that we're working with. So the relationship has to be there. 

Chris Baker

23:08

And then the second part of your question was as far as growing yeah, to maintain those strong relationships with your client, and how has this approach contributed to the success of your business? 

Josh Fertel

23:21

You know, the best referral you can get is from a client right. 100%, absolutely. You know um luckily for us, doctors hang out with doctors right. They play golf together. We do a great job for somebody. 

23:36

They're going to tell their friends um you know, and uh, and then we do a great job for them and it's just exponential at that point. And we have, you know again, we're a little bit blessed that we've had that situation where our clients have told clients, who have told clients and down the road, and you know. So we just plan on making sure that we continue with that. That's amazing. 

Chris Baker

24:00

So you always ask this question If you were to have a magic wand, what would be the one thing that you would change in your company right now? 

Josh Fertel

24:09

And you would think that I would have the answer for that Probably Quality people to do the billing work. They're out there and we I've added on staff as we've needed. So the continuous um influx of trustworthy, hardworking people who don't look at the clock, um those, uh, if I had a magic wand, I would make everybody like that and uh, you know I I do have a a great team around me, that that you know. 

24:49

Sometimes I'll get a text in the middle of the night that they're working on something and it makes me, makes me feel good. I like to think I'm good to them, which is why I get that response. But that that's what I'm. Uh, that would be my magic wand. Second magic wand if I had two magic wands. It was to really get my footprint across the country and I do believe that's going to happen 100 I I think it will too yes, matter of time. 

Chris Baker

25:14

It's just a matter of time and honestly, you know you got a three-year plan. I think three years is plenty of time to make that happen. 100 so from your mouth, as they say yes, but you know if I'm putting it out in the universe, there you go I will let it come in. 

25:29

Let it come in, thank you. Uh. So, thank you so much for letting me oh, thank you host this episode of the angry biller. You put me in the hot seat. I did put you in the hot seat. I did put you in the hot seat. This is fantastic. So stay tuned for our next episode, where I will also be interviewing Josh on a whole other topic. So stay tuned. 

Josh Fertel

25:51

Thank you for listening today. Please follow us on Facebook and LinkedIn, and you can check us out at theangrybiller.com.