The Billing Crisis

One thing nobody tells you about in grad school is how heavily money drives service provision. You know that in order to survive, businesses need to make money, of course – but does it have to be a big red boxing glove uppercut in your chin big deal? Well, different settings have different ways of managing billing situations and your money isn’t necessarily always tied up in that confusion, but most recently for me it has. Coming from the SNF (skilled nursing facility) setting, where my hours may not have always been guaranteed, my time was always compensated without question or confusion. If I clocked in and clocked out, I received my hourly pay rate whether or not my billing and notes were all done properly. While that is never an excuse to slack on either billing or notes (don’t go and get fired!), it seemed fair. Taking my talents over to EI was not this way… at all. There was no clock machine, and I sure as hell wasn’t paid for the in-betweens including travel, phone conversations with other providers, advocate letters for families, nor the occasional drag to leave a child’s home when the parent has tons of questions that they don’t ask until after you’ve already completed your 30 mins. I decided that because each session paid an erroneously high amount for 30 mins of play time, all of those things were essentially priced in. Well, in the month of September, I was smacked in the face to learn that no it was not effectively priced in, and furthermore I might not get paid at all after I failed to fill out billing documents to the satisfaction of the agency’s billing coordinator who works with Medicaid for reimbursement. She returned THIRTEEN session notes marked with red circles and Xs and scribbles, bringing me back to the memory of 5th grade English class book reports. The agency clinical director put me through a mandatory retraining and advised me to return all documents ASAP to reduce delay of my payment. What else could I do? I worked tirelessly to redo the notes, but they were still imperfect. In the next billing cycle, I had 8 more notes returned, continuing on in the silly cycle. I legitimately missed session appointments just to ensure I got it all together. I drove to houses at odd hours, just to collect parent signatures the second time around. Still, two months after making EI my full time job, I had not received a PENNY for my services provided. If this sounds like an introductory episode to how to get away with murder, it’s definitely because I was sharpening the knife and polishing my steel toed boots. To be continued…