THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Sunday, April 9, 1995 TAG: 9504070183
SECTION: CHESAPEAKE CLIPPER PAGE: 04 EDITION: FINAL
TYPE: Close Up
SOURCE: Janelle La Bouve
LENGTH: Medium: 80 lines
When an insurance company refuses to pay a claim from one of her clients, Karen Nichols goes to work.
Nichols operates Medical Billing Services from her home in Tallwood Estates.
Her career in the medical billing field began with a part-time job in a doctor's office while she was still a student at Indian River High School. During the next 23 years, she worked for several large medical groups.
``I realized that 50 percent of doctors have the same problem,'' she said.
Billing procedures were complicated. Sometimes, physicians failed to provide education for office personnel as rapidly as billing regulations changed.
``The old methods for billing insurance companies weren't working for doctors anymore,'' she said. ``All of a sudden the money they were not collecting became important. I knew what kind of problems they were having, and I knew how to fix them.''
According to her husband, Bob, Nichols takes it personally when someone refuses to pay her clients what they owe.
``When an insurance company refuses to pay a claim because of some procedural problem, she really fights for her clients,'' said Bob Nichols, who recently began working with his wife full-time.
``We have a cartoon in here that says, `Oh, dear God, please don't let the rules change before I get this claim paid,' '' Bob Nichols said.
He credits her success, in part, to the many relationships she has established with account representatives from ``a ton of insurance companies.''
Nichols and her three full-time employees do the complete medical billing for four groups of physicians.
Her referrals come from accountants and attorneys.
If a doctor is having problems with cash flow or if insurance companies have failed to pay claims and the medical practice does not know why, Nichols said Medical Billing Services can help.
``I'll go in with a team of people and re-bill the doctor's entire accounts receivable within four weeks,'' said Nichols, 39. ``Sometimes a doctor will have $500,000 owed to him by insurance companies. We go through each bill and unravel the problems. And we re-submit what we can to insurance companies. The doctor's practice gets a cash jump start.''
She also serves as a consultant on medical billing procedures.
``I focus on what a medical practice is billing and what they are collecting and what they could do differently to do better business,'' she said.
She is working with one medical practice which has completely closed down.
``We took their records and are continuing to bill as if we were their business office,'' she said.
Full name: Karen Nichols
Grew up: In Indian River
Spouse: Bob
Children: Patrick and Elizabeth
Occupation: ``I'm a medical billing consultant.''
Hobbies: ``My son is active in sports. So I see a lot of baseball fields. Usually, if I'm not at the baseball field, I'm home working.''
Favorite song: ``I listen to gospel music all day.''
Can't resist: ``Sweets''
If you could change one thing about yourself, what would it be? ``One of my obsessions is work. I would probably want to make more time for things other than work.''
Greatest accomplishment: ``Marrying Bob and having two wonderful children.''
Favorite restaurant: Anchor Inn in Virginia Beach
Favorite way to spend a day off: ``I don't take many days off. If I did take some off, I would take the family somewhere.'' ILLUSTRATION: Staff photo by STEVE EARLEY
Karen Nicholas
KEYWORDS: PROFILE BIOGRAPHY by CNB