[Insights] Growing Revenue Means Also Growing Operationally

Don’t overlook your insurance billing operations when you plan for growth.

An Interview with Scott Jens, OD, FAAO, Business Coach, and SaaS Entrepreneur

By Cindy Braden, VP of Sales, OneSpot

Practices that aspire to grow might overlook the small things that can make a big difference.

When you add a location, or an associate, you end up trying to run the practice the way you did before. One principle of revenue growth is that it also means operational growth – if you want to sustain true growth overall.

Your practice needs to change what it does operationally as it takes on new people and new patients. Practices that start to grow often don’t have the right sort of operational ability to keep up with their aspirations.

Scott Jens—a seasoned OD, business coach, and SaaS entrepreneur—has worked with countless practices in growth mode. One area he sees consistently overlooked? Billing.

ONESPOT: WHERE DO GROWING PRACTICES MOST OFTEN UNDERESTIMATE THE NEED FOR CHANGE?

Scott Jens: Insurance billing and collections. As a practice gets larger, staying on top of cash flow becomes critical—especially tracking aging.

Take a solo OD, for example. You might look at your numbers and say, We brought in $125,000, and our accounts receivable is sitting at $110,000—that seems pretty solid.

But AR totals alone don’t tell the full story.

WHAT'S THE RISK WHEN THAT AR NUMBER LOOKS GOOD ON THE SURFACE?

If most of that $110K is under 30 or 60 days, you’re probably in good shape. But if a large chunk is aging past 90 days, that’s money you may never collect—and it’s often a sign that your billing or follow-up processes need serious attention.

DOES THAT KIND OF QUICK MATH STILL WORK WHEN A PRACTICE GROWS?

As your practice grows, so does the complexity. Add staff, another provider, maybe a second location, and suddenly it gets harder to see what’s really going on.

Let’s say you now have two ODs. Revenue hits $200,000, but AR balloons to $175,000. That’s a very different story—and a clear warning sign that money could be slipping through the cracks.

WHAT MAKES BILLING MORE DIFFICULT AS YOU EXPAND?

Cash flow management becomes more essential—and more fragile. You’re making payroll every two weeks, and you need cash moving. But claims start getting stuck with payers as volume increases, and that slows everything down.

WHAT SHOULD PRACTICES BE TRACKING FOR BETTER CASH FLOW AND A HEALTHIER BOTTOM LINE?

Aging is one of the most important KPIs in billing. There’s a general rule that 70% of claims should be paid within 30 days. The other 30%? That’s where problems build.

If you let those claims age past 60 or 90 days, you risk write-offs. Your biller needs to watch that number closely.

WHAT HAPPENS WHEN THE BILLER CAN'T KEEP UP?

I’ve seen it firsthand. One biller trying to manage claims for five ODs—doing her best, but struggling to follow up on denials and rejections. The backlog of 90-day-plus claims kept growing.

She didn’t need more effort—she needed support, better systems, and technology. That practice was still operating like a small clinic, even though it had already grown past that model.

WHY DON'T EXISTING SYSTEMS SOLVE THIS?

EHRs and practice management systems often connect to clearinghouses, but they’re not built for direct billing. You don’t get a dashboard. You don’t get KPIs.

Instead, you’re relying on Excel sheets, sticky notes, or printed claims—none of which offer real-time visibility. As you grow, that just doesn’t cut it anymore.

WHAT SHOULD GROWTH-MINDED PRACTICES BE DOING DIFFERENTLY?

They need to get more sophisticated. If you’re growing—or planning to grow—you need to evaluate your billing operation.

Ask yourself: Where can I add technology to improve efficiency? How can I move cash through the system faster? What KPIs will give me and my team visibility into what’s really going on?

Growing your top line is only part of the story. The real work is growing operationally alongside it.