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Entrepreneur: Owen, Girardin untangle government red tape for medical pros
Sure, federal bureaucracy is a pain.
But if it didn’t exist, neither would High Plains Medical Consulting. The business is owned by Thomas Owen and LaVonne Girardin and exists solely to help medical professionals jump through all the right insurance hoops.
Gazette Staff
"One problem is that Medicare can’t make up its mind," Owen said. He described one new Medicare rule that changed 10 times within a period of months.
The constant changes make doctors nervous, they fear a federal audit could find something wrong with their books. "And, these doctors aren’t trying to do anything underhanded. There is just so many things they have to keep on top of," Owen said.
The pair also trains health professionals in using the elaborate coding system required on most insurance forms. If you visit a doctor with a sore elbow, for example, the visit would have one code, the diagnosis another. The tests would have their own codes, and there would be a code for the prescription, along with other codes.
Owen can be reached at 633-2742 or [email protected]. Girardin can be reached at 628-7425 or [email protected].
Here’s what else Owen had to say about running an ever-changing consulting business. He also explains what the Latin phrase "Ad astera per aspera" on his telephone answering machine means.
Why start this business?
High Plains Medical Consultants, Inc. was organized in 2002 by me and LaVonne Girardin for the purpose of working with medical providers and their staff to assure compliance with Medicare guidelines. Compliance issues may involve medical coding, the new HIPPA act, education or denials. We conduct medical coding audits for providers and write reports concerning the audit findings. We then meet with them and discuss any anomalies found during the audit. We can assist with insurance and fee issues. We also hold classes to train coders. The class is designed to prepare the students to take a national examination and after they pass they become certified professional coders.
Where did the start up funding coming from?
There wasn’t a need for a great deal of financing. What we did need was provided by personal finances. We already had our own computers, office equipment and reference materials.
How long have you been in business?
We had been working as partners for two years before we incorporated in January, last year. We have both been working in this field for many years. LaVonne was a reimbursement specialist with the largest medical facility in Montana. She had many years experience working with third-party payments and Medicare billing. She has worked with all aspects of the coding, billing and auditing profession. I have taught coding and reimbursement for many years. We actually began doing the audits three years ago when a group of providers requested that we audit them and ascertain whether or not their documentation was adequate. After working as partners, we finally decided to form the company as a Montana corporation to better serve our customers.
The biggest challenges in running the business?
The real challenge is staying current with government guidelines and coding changes. "Medicare releases new rules and then changes them constantly," Owen said. "We spend a great deal of time researching information for our clients and this is not always easy."
What was done to overcome those challenges?
We obtain all new coding and reference books every year, as well as attending seminars and researching via the Internet to stay up with the constant coding and billing changes.
What is being done to expand the business?
We have done mailings and telephone calls as well as holding additional classes.
Your worst business mistake?
We have yet to commit our worst mistake. If we were to pick something, it would probably be that we did not incorporate sooner.
Advice for someone running a business:
Anyone starting an incorporated business should find both a good lawyer and a good accountant. Then follow their advice.
Number of workers?
There are just the two of us now.
What is your five year plan for the business?
We hope to have expanded throughout Montana and into Wyoming.
A question you would ask other entrepreneurs?
If we were to question a successful entrepreneur we would probably ask them their best method for getting known.
If you weren’t doing what you are now, what would be your dream job?
I have been a teacher for many years, first in the public school system and later in the private school sector. With the exception of health care, I don’t think there is a more rewarding profession. With this job, I get the best of both worlds, working with health care professionals and teaching. LaVonne also feels that consulting allows us the freedom to educate and practice as professional auditors and coding specialists at our optimum abilities.
By the way, the "Ad astera per aspera" on the answering machine means "To the stars through aspiration." If you set your goals high enough, anything is possible.
“Entrepreneurs” appears regularly in the WorkWeek section. The feature will help readers become familiar with new businesses, as well as educate others in the challenges of starting a business. If you have been in business for at least one year and would like to tell your story, please contact:
Chris Jorgensen
Billings Gazette
401 N. Broadway
Billings, MT, 59101
657-1311, office
657-1208, fax
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