What Happens After the $100,000 Billing Hire?

You hired an experienced biller who understands your payers, processes, and the billing issues that require additional attention. The claims are moving, payments are being posted, denials are being worked. 

Then that person takes a vacation.

Claims still need review. Eligibility checks still need to run. Payments still need posting, and denials still need follow-up. Too much of the billing operation depends on one person to keep it moving.

That raises a broader question about billing capacity: how do you handle a growing workload without adding a person every time volume grows?

In the first episode of The Focal Point, Nitin Rai, President and CEO of First Insight and EVAA.AI, and Dr. Jay Henry, optometrist and co-owner of Hermann and Henry Eyecare, discuss what happened when his practice began moving repetitive work into the background.

Their experience points to a different way to think about billing capacity.

Does Every Billing Task Need the Same Level of Expertise?

Eligibility verification and complex payer denials are both part of the revenue cycle, but they require different levels of staff involvement.

Tasks such as eligibility checks, routine claim review, claim submission, and payment posting are repeated regularly. Complex denials, payer follow-up, and patient billing questions often require more investigation and experience.

In many practices, the same billing staff are responsible for both types of work.

Beyond the $100,000 Billing Hire groups these responsibilities into routine work and expert work. When the same team manages both, routine volume can take time away from work that requires deeper review.

This gives practices a more practical way to assess staffing needs: Which tasks require billing expertise, and which can be handled through a consistent, repeatable process?

What Happens When Routine Work Moves Into the Background?

Dr. Henry saw an early example outside the billing department.

When Hermann and Henry Eyecare introduced the EVAA Virtual Assistant, 15 to 20 patients booked exams through it on the first day.

The team noticed right away. The phones needed less of their attention.

“We aren’t having to spend all day just chasing the phones. We’re actually having time to have conversations with the patients when they check in and when they check out.”

The practice then expanded automation into insurance benefits, prior authorizations, claims creation and submission, and payment posting.

The goal was never to remove people from the workflow. It was to find which repetitive steps could keep moving without someone having to start each one by hand.

What Should Your Billing Team Actually Spend Its Time On?

A billing professional’s experience matters most when something does not follow the expected path, a payer responds unexpectedly, or documentation needs a closer look. Those situations call for judgment. Routine eligibility checks and predictable payment-posting steps usually do not require that same level of attention every time.

Dr. Henry describes AI as a “second set of eyes,” not the only set.

That distinction applies beyond clinical care. Technology can support repetitive processes and surface situations that need attention. But people remain responsible for understanding the context and deciding what happens next.

Can Your Billing Process Keep Moving Without One Person?

When a key billing process depends on one employee, a staffing gap becomes an operational gap.

A vacation, a sick day, or a heavier patient volume week makes that dependency obvious. Beyond the $100,000 Billing Hire calls this billing variability, and it points to the same fix: essential work needs to keep moving no matter who is at their desk that week.

Experienced billers remain important, particularly for work that requires judgment and payer knowledge. However, recurring processes should not depend on one person remembering each next step.

Documenting and standardizing routine processes gives the team a clear view of what is done, what still needs attention, and what needs billing expertise. That is what lets billing keep moving when one person is out.

What Does More Capacity Look Like in Practice?

Building capacity does not always require staff to complete more work in less time.

Eligibility checks can be completed before appointments begin. Claims can move through review and submission as visits are completed. Electronic remittance advice (ERA) can post with less manual data entry, while denials that need investigation get routed to the right person.

Experienced employees continue to oversee the revenue cycle, with more time available for complex denials, payer follow-up, patient questions, and decisions that require their expertise.

The guide and Dr. Henry’s own experience point to the same thing.

Dr. Henry describes what this looks like in practice: “Some of our best days are the days where we don’t recognize that the technology is even doing anything. It’s just doing it in the background, and our day is going great.”

In billing, this means routine work keeps moving while the team focuses on what actually needs their attention. The guide frames it the same way: capacity comes from using the team’s time and expertise better, not adding more of either. 

What Does the Patient Experience?

That shift reaches beyond billing, too. Nitin Rai has his own version of that story. At a glaucoma appointment, he spent most of the visit watching his doctor type instead of looking at him.

Dr. Henry puts the patient expectation plainly:

“They want our time. They want face to face. They don’t want our back. They don’t want us typing all the time.”

That same competition for attention plays out everywhere in the practice, not just the exam room.

Front desk staff can spend less time managing calls and more time with the patients in front of them. Reducing manual billing work does the same thing for billing: it frees experienced employees to focus on exceptions and patient questions that actually need their expertise.

Listen to The Intelligent Practice: Restoring the Human Side of Healthcare to hear Nitin Rai and Dr. Jay Henry discuss how automation changed day-to-day work at Hermann and Henry Eyecare.

Is Another Hire the Only Way to Add Billing Capacity?

As patient volume grows, billing workload grows with it. Practices can manage that workload by separating tasks that require billing expertise from routine work that can follow a consistent process.

Experienced staff can focus on complex denials, payer issues, and patient questions, while documented workflows and automation support recurring tasks. This allows the billing team to use its expertise where it is most needed, an approach outlined in Beyond the $100,000 Billing Hire.

Before adding another billing position, practices can ask: Which parts of the current workload require another person, and which could be managed through a more consistent process?

Build More Capacity Into Your Revenue Cycle

Your practice may not need another billing hire to create real capacity. It may need a more consistent way to handle the repetitive work that is already competing for your team’s attention.

Download Beyond the $100,000 Billing Hire to explore how eye care practices can build a more resilient billing operation around experienced people, repeatable processes and automation.