Dr. Sarah Holt discusses her latest endeavor

Administrator, professor, author. Dr. Sarah Holt's titles and responsibilities are extensive. Holt -- the administrator for Cape Surgical Clinic Inc. and Breast Care Center, Cape Medical Billing Corp. and the Doctors' Park complex -- is about to add another to the list with the launch of a medical insurance course Jan. 19. Holt says the class is already full and there's a waiting list for one she hopes to start in the spring.

BT: You wear a lot of hats at Doctors' Park. Can you describe your various roles?

Holt: The job that I have that has allowed me to grow as a health care professional is as the practice executive for Cape Girardeau Surgical Clinic. I took the administrative role with the general surgery group in 1988 and realized very quickly that health care was like no other business that I had ever encountered. I realized that this was an industry that captured my interest and one that I wanted to study so that I could excel in the work that I would do. I fulfill the role of practice administration for the general surgeons -- that means that I coordinate the people, processes and technology in the practice. That day- to-day work is very different from my role at Doctors' Park, which is more of a property management role. Also, the Doctors' Park Association allows me to meet with other colleagues in Doctors' Park to discuss and develop approaches to current issues.

BT: What is your favorite part about what you do?

Holt: I enjoy the challenge of being a medical practice executive, as it allows me the opportunity to pursue excellence in a complex, challenging environment and the opportunity to participate in a higher calling by supporting physicians who have dedicated their lives to improving the health and well-being of people.

BT: How have you seen medical billing change through the years?

Holt:When I began working in health care it was very different than now -- people had health care insurance, a medical practice would bill insurance when services were provided to patients and carriers would pay for those services. Medical billing was much less complicated then. The days of filing a claim with the expectation that the claim will be paid are gone. The American Medical Association publicizes that one in five claims filed will not be paid correctly. Today health care insurance is confusing for everybody involved. People and their employers pay so much for health insurance. First, they pay their premiums that are high, then when they get ready to use health care services they are required to pay a co-payment. Typically, the co-payment doesn't count toward helping patients meet the deductible requirement so they have to pay the deductible amount before insurance pays. When finally insurance pays, patients are still responsible for their co-insurance to settle the account. Most people don't understand their insurance benefits package and often make the assumption that because they have insurance they will have no health care expenses -- that isn't at all correct.

BT: What brought about your first book, "Get the Money in the Door"?

Holt: Medical Group Management Association, MGMA, is the premier trade and professional organization for medical groups in the nation. MGMA has over 21,000 members that represent 280,000 physicians. The organization, in an attempt to help medical practices, collects and compiles data on medical practices to identify organizations that meet "best practice" standards. Every year they designate organizations that meet those standards -- Cape Surgical Clinic has been named as a best practice for many years consecutively. This distinction prompted them to do a story on the practice. Then I was asked to author and facilitate several online classes for MGMA that are offered every six weeks. The success and feedback on the classes caused them to ask me to author a book so that a broader audience could be reached. That book was MGMA's best seller in 2010.

BT: Can you tell me about your latest book, "Medical Office Billing: A Self-Study Training Manual"?

Holt: This book provides comprehensive instruction to medical office billing staff. Medical office insurance staff members need consistent and accurate training in health care insurance basics and a working vocabulary of industry terms so that they can serve two groups better -- the physician group for whom they work and the patients to whom they feel a fiduciary responsibility. Medical insurance staff members take the role of helping patients wade through understanding their insurance very seriously.

Successful medical practices must have hard working physicians but the other piece of the equation is a well trained billing staff to ensure that regulations are followed and appropriate payments as received from carriers.

BT: You're also about to start teaching a medical insurance course. What inspired you to start that?

Holt: I was encouraged to teach the class by several people, physicians and administrators, who believe like I do that "a rising tide lifts all boats," and I am eager to share with others the framework that I have been able to figure out.

BT: What type of issues will the course cover?

Holt: The course covers the major types of insurance and the elements of each type, an understanding of commercial and government insurances, the total revenue cycle and the importance of each phase, as well as health care regulations and requirements.

BT: How did you get started in the health care field?

Holt: I was contacted by two of the general surgeons, both of whom are deceased -- Drs. David Clark and Robert Hunt. I deeply respected both of them and when they asked me to consider taking the administrative role in their organization I was excited about the opportunity. I took the job and have devoted my energy to it.

BT: What is your educational background?

Holt: I have an undergraduate degree, bachelor of science in education and a masters in counseling from Southeast Missouri State University. My Ph.D is from Saint Louis University and is in public policy administration and analysis with a health care emphasis.

BT: What hobbies or activities do you enjoy when you aren't working?

Holt: The hobby to which I am most devoted is travel; I have traveled to all seven continents. Although I have visited many countries, there are still many places I want to go. I also enjoy collecting antiques, good food and good wine.

I also enjoy teaching students who are preparing to work in health care administration. I teach in the MHA program at Saint Louis University and in the MBA program at Southeast Missouri State University.