The Fear of Not Knowing

In 2002, Donald Rumsfeld famously said:

As we know, there are known knowns. There are things we know we know. We also know there are known unknowns. That is to say, we know there are some things we do not know. But there are also unknown unknowns, the ones we don’t know we don’t know.

Although somewhat confusing, the meaning of this quote is very true and says a great deal. “You have to know what you don’t know.” To do so, you must be able to admit the things you don’t know.

Society has high expectations of doctors. For example, a 2012 Gallup poll suggested that people believed physicians to be among the most honest and ethical professions. The only professions that ranked higher were pharmacists and nurses. There is also a tendency for people to think that doctors know more than they do as well. For example, patients often expect doctors to know the cost of their care.

Breaking the Misconception

When it comes to medical billing, there is an expectation that doctors know, and comprehend, medical billing. Among doctors, there is a fear that they will be “found out” that they don’t. As a person who deals with radiologists daily, over the years I have come to realize that very few really understand medical billing. Even those in the practice whose job it is to handle medical billing, don’t have a complete understanding. It’s complicated, and it’s also just weird.

Related: Case Study--Disarray in radiology billing

A practice I work with was recently sold. The accountant wanted to reconcile to the accounts receivable. If this were a retailer, manufacturer or a distributor being sold, reconciling to the AR would be a straightforward process. In medical billing, AR is not real dollars. You can charge whatever you want for a procedure, but you are only going to be paid what you are contractually due. This inflates the AR often three to five times what’s there in real AR.

Because medical billing is so complex and different than typical accounting, there is no shame in not knowing how it all works. However, you still need to understand the health of your billing. There is an old Russian proverb that says, “There is no shame in not knowing; the shame lies in not finding out.”

If you are unsure what is going on in your billing for your radiology practice or imaging center, give us a call. We will be glad to walk you through the basics and get to a point where the numbers make sense to you--let us help you know what you currently don’t know.

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