Richard Quimby, president, Medical Claims Processing Solutions Inc.

We have seven employees locally, two part-time. We have about 10 outside people in other states. We’re a clearinghouse for medical claims. The company was founded in 1996. Basically what we do is take in claims in several different formats and output them … to different insurance companies. We edit the claims for correctness. I would be nowhere without the team of people that I have. … They’re important to me.

How did you end up in this position?

I was doing systems analysis and design before this. I did it for several different companies … the Internal Revenue Service and the U.S. Department of Agriculture, through government contracts, and it seemed to me that everybody else was making a living off my talents … so I thought, “Why not write a piece of software just for something that I wanted to do, and then exploit that software?” … I still travel a lot, but it’s for something that I created. The environment in the office is, we work as a team, so basically the group here designed the software that we’re working on now and the group is creating it as a whole … our claims-processing system.

How has the Health Insurance Portability and Accountability Act changed your business?

Security is tighter – the way we deal with personal health information. The cost of doing business has went up. We look at it as an opportunity. We’re re-writing every piece of software that we wrote in the past to take full advantage of the transaction and code sets and our ability to translate. Most places bought translators, and we decided just to rewrite what we needed, (to) rewrite our whole system.

What goals do you have for your company.

Within the next year … what we want to do is open up Missouri, Arkansas, Oklahoma, Kansas and Texas (for the client base) and that’s our goal for the next two years. We’re going to hire and train a marketing individual to take care of the five states. We have a few clients here in Missouri. We’re real strong in the Pacific Northwest and the upper Midwest.

What’s your biggest challenge for your company?

Our biggest challenge is our business philosophy. This industry works backward in its billing procedures from any other industry. This is the only industry I know where the person that is billing to get their money has to pay to do that billing – has to pay to get their money from the person that they’re doing the work for. Meaning that the provider does the work and sends their invoice to the insurance company … in the form of a claim. The provider has to pay for that. Well, in this day and time, the providers are just squeezed from both ends, so our business philosophy is not to collect our income from the provider. (We) collect our income from the insurance company. Sometimes there has to be some cost involved (for the provider), but it’s minimal.

[[In-content Ad]]