Interview: Jack Nixon of CMRE Financial Services, Inc

insideARM.com recently had the chance to engage in a Q&A session with Jack Nixon, CEO of healthcare collection agency CMRE Financial Services.  We talked about his career and the current state of healthcare collections.

Q. How did you get involved in the healthcare collections industry?

A. My experience in serving the healthcare industry in the area of A/R management started in 1965 when I became Executive Vice President of The Doctor’s Business Bureau of Southern California.  DBB had served the medical profession for over 50 years.  When DBB was sold in the late 1960s, I founded Medical Accounts Control and organized Hospital Physicians Business Bureau for a retail company, Credit Bureau Central.

Medical Account Control was sold, and in 1978, California Medical Receivables Exchange was founded as a soft-core collection company.  Soft-core is now recognized as outsourcing, early-out, etc.  CMRE absorbed HPBB and became our present company, CMRE Financial Services, Inc., which serves the medical profession exclusively, nationwide.

Q. Can you describe your agency a little more?

A. CMRE Financial Services provides professional and cost effective accounts receivable management services to medical, dental, and related healthcare organizations.  One thing that separates CMRE from similar providers, I think, is our focus and determination to lead the industry.  For instance, we were the first agency to receive MDHBA’s highest recognition: Healthcare Agency Certification.

Q. How much of your operation is devoted to healthcare collections?

A. We are an agency 100 percent devoted to healthcare collections – including A/R management, healthcash EFT plans, insurance follow-up, Worker’s Compensation, and installment contract management.

Q. What are the advantages/disadvantages of focusing solely on healthcare?

A. We only consider it an advantage to solely serve the healthcare industry.  Our experience in all phases of assisting both the provider and the patient in clearing financial responsibilities for healthcare services gives us the expertise in establishing the true responsibility.  We are compliant in all phases of revenue cycle management.  Our personnel are Certified Healthcare Account Managers.  Our company is an MDHBA Certified Business, and we are HIPAA compliant.  We carry E&O coverage and all of our personnel are trained and kept current with all the new laws and requirements concerning revenue cycles of the healthcare industry.

It’s a long laundry list – but it shows our commitment to this line of business.  Once you’ve made that commitment to service healthcare accounts, it’s difficult, and not terribly effective, to branch out into other lines of collections.

Q. What effect, if any, do you think single-payer healthcare might have on medical collections?

A. Medical collections will always be a problem regardless of single-payer or multi-payer insurance plans.  The problem is that the politicians are trying to convince the public that they will have no financial responsibility.  What politicians are overlooking is that it’s the physicians that serve the patients’ needs.  Medicare-Medi-Cal is already capitated reimbursements for physicians.  Any government control – either State or Federal – will ruin the physicians segment of the healthcare industry, especially the specialist.

I speak as a patient who has had excellent physician care since I was 16 years old.  What makes the politicians think they can promise and provide quality medical care when they wish to restrict payment for it?  Since when has healthcare become an entitlement instead of a responsibility of the patient’s?  Healthcare is requested when needed, not to be used as a daily remedy.

Q. Does an agency’s size hinder its ability in collecting?  Or do you think that businesses prefer smaller, family-owned operations?

A. I believe that the size of the operation is not as important as the quality and expertise of the personnel and management team that sets the bar.  With the increasing variety of requirements with which companies must comply, I believe experience and dedication to the healthcare portion of our industry gives those who maintain up-to-date knowledge, continue to upgrade their service and technology, as well as coming changes, will best serve the healthcare industry.

Q. How will healthcare collection agencies need to evolve to remain competitive?

A. I believe companies that have exclusively served – or at least had 75 percent of their placements come from – the healthcare industry and its ancillary services should establish other divisions or services.  These divisions should be based on their knowledge of their restrictions or qualifications to serve the healthcare industry.  As “Business Associates,” the provider should look to them for support and education with respect to acquiring more knowledge about the liability, new requirements, and laws that create financial responsibility affecting both parties if they fail to comply.

Q. How, if at all, does HIPAA constrain your operations?

A. We are HIPAA compliant, and have prepared our company to live with these requirements.  If you play by the rules and don’t try to interpret them to suit your needs, you don’t have to be concerned with the effects.  The companies that interpret these requirements to suit themselves make it difficult for those who play by the rules.  Anyone can make a legitimate mistake and be made to pay for it.  It’s those that continue to make mistakes without any effort to control them that create the problems.

Q. What conferences/resources do you find helpful as a small, family agency in order to stay current on healthcare collections?

A. Our company has had memberships in ACA and MDBHA for many years.  As CEO of our company, I have dedicated my loyalty and participation as a board member, past officer, and past president of MDBHA, an organization which is devoted primarily to serving healthcare providers.  Our company receives as many healthcare financial publications as we consider helpful in our education and training process.  We also stay current on proposed laws, both State and Federal, affecting the financial structure of the healthcare industry.