The 80/20 Group helps doctors increase productivity, office efficiency and profits.
Arlene Guerra, CEO of The 80/20 Medical Management and Billing Services Group is, in her own words, an adrenaline junkie.
This is a good thing considering that her business – jointly owned with two other women – is growing at a rapid rate. The 80/20 Group opened in May 2007, but by October of that year they started full physician practice consulting. Billing and collections services were added in February 2008.
Soon after doctors were confident and pleased with the financial and practice consulting services, they began to request that 80/20 handle their billing and collections as well.
“As we reviewed several of our physician’s current billing services, both in house and outsourced, we knew we could do a better job” says Guerra. “As result, we added medical billing and collections to our menu of services.”
Guerra, 46, has always worked in the health care field. The youngest of seven children, she graduated from McCollum High School in 1981 with a scholarship to the nursing program at the University of the Incarnate Word. She attended UIW for one year but family obligations made it necessary for her to leave college.
“The decision to quit was very difficult for me,” says Guerra. “I had worked very hard to earn a scholarship that would allow me to go directly into nursing school. I always knew I wanted to be a nurse and had structured my life around that goal. When faced with the choice between education and family, I chose my family. I knew that one day I could go back to school.”
She worked as a restaurant manager and attended school at night to becomea medical assistant. After graduation, she began work in a physician’s office. “I helped open the practice, eventually became the office manager and learned how a medical practice works,” she says.
Guerra’s interest shifted to the management and financial aspect of a medical practice, and she began attending night school to obtain an accounting degree. At the same time, she worked for Tammie E. Jones, CPA. “Tammie’s practice includes tax and accounting services for physicians,” Guerra says. “I learned a great deal about the financial end of a physician practice, but came to realize that accounting was not for me.”
She returned to her first passion and began attending night classes toward her degree as a registered nurse. She was accepted into the nursing program at San Antonio College and graduated in 1999.
Graduation was followed by almost 10 years of adult ICU nursing at Baptist and Santa Rosa hospitals.
“I continued working part time for Tammie during my years in ICU, and began referring doctors to her for their tax and accounting needs. It became clear to Tammie and me that we had a great deal of knowledge and experience that could combine to help physicians increase the productivity and efficiency of their practice.
“I love hospital nursing and it is definitely rewarding, but the nursing shortage, long hours, patient loads and mandatory overtime burned me out,” she says. “And the work schedule is not great for family life. I have a son, Jared, (age 4) and wanted more flexibility. That desire helped me take the leap into starting this business.”
And so the company was born. The name of the business comes from the Pareto Principle – the observation made by Italian economist Vilfredo Pareto – that most things in life, such as effort, output and reward are not distributed evenly. Some contribute more than others.
“Applied to a physician practice or any business, 80 percent of effort often produces only 20 percent return. It should be the reverse,” Guerra says. “I see so many physicians working incredibly hard in their practice, but they don’t have a solid grasp of the source of their biggest return. They often aren’t aware of their reimbursement percentage or how they might improve their productivity by making adjustments in their payer contracts, improving coding practices or restructuring their office. Our company is specifically designed to assist them toward improving their operational efficiency and maximizing reimbursement.”
Jones, who is now the company’s CFO, was an inspiration for Guerra through the years of juggling work and school by pushing her to be the best she could be.
“Arlene had the tax and accounting background and the doctors trusted and respected her as a caregiver,” says Jones.“ That trust made them willing to open their business to us so we could help identify their individual needs. I believe Arlene’s most valuable quality is her drive to resolve problems as they arise. She is very sharp in identifying specific details in a physician’s practice.”
Physician clientele of the 80/20 group includes a wide variety of physician specialties, and each client is approached as a unique business.
“If we serve them as a 'practice consultant,’ we will literally be in their office as longas necessary, as much as several weeks,” says Guerra. “We are qualified to take over roles in the office if needed, and can hire and train staff on site. We use a pool of PRN medical assistants to staff our doctors’ offices on a temporary basis until replacement staff is hired and trained. Some physicians may keep us on retainer in which case they can call us at any time for any urgent need or question.”
“As we reviewed severalof our physician’s current billing services, both in–house and outsourced, we knew we could do a better job. As a result, we added medical billing and collections to our menu of services.” – Arlene Guerra
The third company principal, Ellynor Herico, is COO. She also is a registered nurse and certified office manager. Her expertise is human resources, staffing and training, credentialing and developing policy and procedures. Guerra’s areas include reimbursement, equipment needs, electronic medical record requirements and negotiation of payer contracts. Jones provides tax and accounting services, physician compensation benefits and financial planning.
“Now we are a 'one stop shop’ for our clients,” says Guerra. “I am a certified medical coder, and we have six full time CMCs on staff. Our open door policy allows the doctors to stop by at their convenience to drop off information, ask questions or discuss any aspect of their business.
“We know how busy they are, and we are responsive to their needs. They know what we’re made of, having worked with us in the hospital setting, and I believe they are pleased with our contribution to their business. Our aim is not to create dependence, but rather to support them as they grow their practice.”
For Guerra, the most satisfying aspect of this endeavor has been watching how her company can impact a practice. “Watching a physician practice grow and transition to the point where a physician can concentrate on taking care of his orher patients and not have to worry about the day to–day business office activities is very gratifying, she says.
There is a downside, however.
“I thought I would work a bit less,” she says with a wry smile. “I’m working harder than ever but loving every minute, and I still have quality time with my son. My goal is to be the best resource for physicians as well as the company every physician cannot afford to be without.”
