Why I am happy that work from home is declining and possibly coming to an end

Amazon, Goldman Sachs, Boeing, UPS, and Tesla have all announced full-time return to office mandates. A survey of over 6,000 employers found that 70% have changed their policies to favor a return to the office. Robotic Orthopaedic Institute St George is among them.

A survey of over 6,000 employers found that 70% have changed their policies to favor a return to the office.

As Administrator, in the past 3 years, I have suffered two employees falsifying time records and claiming more pay for little to no output. One was an insurance biller. On her final payroll, she reported 55.5 hours when in truth she only worked 4. My revenue plummeted. Claims were unprocessed. Comes now the attempt at recovery and we are receiving denials for untimely filing. When confronted, I asked "WHY" She looked me right in the face and said "I don't know." What kind of answer is that?

When I asked for a detail of the work she did in 55.5 hours, she made things up that could not possibly be true. Things like "waiting on hold for 6 hours with UHC" to obtain a copy of our PA's contract which a) she didn't need for any reason, and b) does not exist.

When the previous insurance biller (former receptionist for whom I paid for a billing training course) learned that I was cancelling work from home for her, she went straight to the doctor while I was at the AAOS annual conference and tried to explain that she could do my job (from home) and that he could fire me and pay her half of what she pays me. She was 19, a single mom, and only half trained as a biller by the time she went out on maternity leave, and then begged to work from home. My revenue improved greatly after she left.

With 44 years of experience in running and managing orthopaedic practices, ortho revenue cycle, owning a billing service of my own, I finally just gave up and redesigned the entire billing work flow. An external billing service that was incompetent with "astro-turfed" ratings and reviews made things worse.

Now I am able to complete coding and billing for a full clinic day of two providers in an hour. I do it myself. I then submit it to my new billing service provider (offshore) and bills go out immediately. They are also clearing the backlog and chaos left behind of Biller #1, Biller #2, and the previous incompetent billing service. As administrator, I take this responsibility as my own failure.

? Bad hires

? Allowing them second chances, and most of all,

? Allowing work from home.

But with the current trend out there of requiring return to the office, no longer can anybody can declare that I am unreasonable. No, insurance billing, per se, does not have to be done in the office. But there's no way short of a keystroke logger and other things, like maybe requiring CCTV to be able to observe them while they work, to control time theft.

But there's no way short of a keystroke logger and other technologies, like maybe requiring CCTV to be able to observe them while they work, to control time theft.

Call me a hard a$$, but if you can't come to work to work, and you claim you need to be at home for for some reason, you are not eligible to work at ROI. It requires punctuality, flexibility, reliability, job knowledge, and onsite attendance. Period.

When I announced to the doc that I was reducing this key position... he said, "How will you handle this addition on your plate? In my other practice they had a billing company and a certified coder." (What a payroll overhead load!) I jokingly said, "Hey I still have enough time for a paper route or DoorDash if I don't sleep. Right?" The old saying goes: "You want stuff done? Ask a busy person."

I don't need a certified coder. I can read. I know anatomy, physiology, medical terminology, surgery (as a former surgical nurse) and coding and billing rules. I can code. I can research coding and billing rules. I don't have modifiers memorized. I look them up.

I have coded and billed with integrity and compliance since the 1980s. Now with my degrees, training, paralegal skills and experience, I am held to a high standard of professional integrity and compliance. I would be judged very harshly by authorities if I did anything less.

Billings for Friday are done by Monday. Billings for Monday are done by Tuesday. Surgery billings are submitted at the end of the surgery day but prepared for submission to the offshore billing service as soon as the surgery block time is completed. There is no question about "if" the billing has gone out. I can do this because I schedule the surgeries and complete the boarding slips. I also do any necessary prior authorizations so the coding is done the when the case is readied for authorization. There's no need to delay the process.

The only other position that can work from home in our practice is my IT person. He's part time, will call, and mostly comes in to the office. But if something is required of him on an unscheduled urgent basis, I allow him to work an hour or two from anywhere. His job is in-person, onsite, as a standard rule. What's also beneficial is that since I oversee 7 practices and DBAs under one roof, his time is cost allocated to each DBA or practice.

I receive more than 40 Linkedin pitches every day for AI-managed, remote work receptionist, remote biller, remote marketer, and most recently "remote AI medical assistant". I just laugh out loud and delete. I don't even answer.

I can also do my own graphics and desktop publishing in Adobe. I know marketing, branding, advertising, and content management. Together with my IT staffer, we manage the website, SEO, content, and more together.

He is also now helping me design EMR templates so that coding, billing, and documentation are all improved at once. We lay down the formatted note and the MA checks boxes of variables. Fewer things are overlooked. I get the data I need to code better, faster, and more accurately. Noridian and other insurance requirements are built into the templates to demonstrate medical necessity - or not. Documentation is done when the visit is over. He couldn't do it as well if he wasn't in the office to hear the comments and situations that need improvement.

What about Artificial Intelligence?

And yes, we deployed AI into the mix more than a year ago. It fact checks me. It gives me an opportunity to correct my mistakes if I am unsure. It offers me options on CPT codes, ICD10 codes, Snowmed crosswalks, modifiers, and LCDs and medical necessity guidelines. It even helps me decipher the doctor's handwriting if necessary. I put in everything I can read and ask it to deductively reason what the handwriting might say.

AI also helps me create checklists and outlines that I can use to check my own knowledge of 44 years for process improvement. It reminds me of things I've forgotten, things that have changed over time, and details that are golden revenue opportunities. It enhances my creativity and innovation.

I also use AI to help me develop training rubrics so that I can personally manage professional development for all my staff. I do the training, but the AI helps me organize, edit and rewrite the training outline. I should state for the record that I am a "very advanced" user of AI and I have yet to see anyone match me in terms of prompt creations. Like a database designer, you must specify the prompt by already knowing the subject matter and what output you want. That takes time and practice.

So, while the current trend of returning to the office might not be universally necessary for all roles, my experience has proven that certain key functions, especially in billing, demand accountability and presence. Trust is built through demonstrated responsibility, and time theft is too easy to hide in remote work settings without invasive oversight tools. For a specialized practice like Robotic Orthopaedic Institute St George, onsite attendance ensures the highest level of efficiency, accuracy, and compliance, especially when it comes to critical billing functions. I’ve learned from hard-earned experience that hands-on leadership, transparency, and control are paramount to maintaining operational integrity. And with the integration of AI and a hybrid IT structure, we’ve found a balance that maximizes performance without sacrificing the human touch that keeps everything running smoothly. Our practice thrives on personal accountability, and that’s something no remote option or AI tool can replace.

If you’re an editor, investor, or market researcher seeking expert commentary, or a healthcare executive looking for top-tier consultation and coaching in healthcare management, medical travel, or revenue cycle optimization, I’m here to help. With over four decades of experience, I offer unique insights and practical solutions that can transform your organization’s performance.

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