Are there any industry standards? We seem to be excessively staffed. Our average monthly census is 175 patients. We have two unit clerks/data entry clerks, a general secretary, two dietitians, 1� social workers, and me, the � biller/collector. I have a feeling this staff size has something to do with why I seem to be the lowest paid dialysis biller in the world. The only stats I can find is for the social worker, and we seem to be on track there. But our unit/de clerks do nothing but file and enter charges - in the days when we only had one unit clerk, I took over the charge entry one month while she was ill, and it took me less than an hour a day to enter charges. I have a very hard time believing it takes her 7 hours to file. Evidently it takes even longer, because our census has not increased yet we now have two clerks. The general secretary does nothing but lab reqs, payroll, and mailing the DON/Administrator's Medicare appeals. Our payroll is automated, so all she does it transmit the data. She doesn't even double check it first, so the payroll couldn't possibly take more than a few minutes every other week. I've never worked as a dietitian, but I actually have trained as one and cannot figure out how it takes two dietitians to see 175 patients - even if they DID all get diet counseling each month, which they don't.

Now, I know there are probably lots of things these folks do that I don't even see. So, any stats/facts out there? Any thoughts from anyone?

There are a number of problems with your analysis. First is you are looking at the lowest paid staff. So having a few extra does not have that much effect on payroll. The nurses and techs are where the major payroll expense is and you do not mention this. Social work and dietician are pretty much within reason. This also is not going to get you anywhere. Find out what other people in your position make, and either ask for a raise or move on.

You can check your state regs for staffing ratios pertaining to Social Worker, Dietician, Patient Care Staff, RN ratios. Your numbers sound like you have the correct ratios, at least from what you posted. Your Dieticians do alot of work that is behind the scenes, which you would not nec. know about unless you attend QA Meetings. Dieticians are a very important part of the team and in my experience are extremely hard working dedicated individuals. As far as your office staff go, that is pretty much a company or facility set ratio. Hope that this answeres some of your question. Forgive me is I sound a little preachy about the Dietician.

There are no state regs for anything except direct patient care staff.

I don't know why anyone would presume to know what my "agenda" is.

As usual, I get no help from this crownd.

On the contrary; there are mandated ratios for Dieticians and Social Workers.

You have my sympathy if you are indeed poorly paid. You have my respect if you get the billing without errors, follow up on unpaid accounts and get money in the bank. A biller can make or break a facility and I would say that they, overall, are usually only appreciated by the administration, who has to make sure that ends meet.

Every area has a local hospital-healthcare association, which keeps tabs on the average salaries of all healthcare and health clerical personnel. Do a little homework and find out what your local agency is and it's number. Call and tell them that you are doing a salary comparrison and analysis for your position. They will either tell you over the phone or send you a letter. Another idea is to call around to the local dialysis facilities in your town or even the state. Ask them if they are willing to share the salary information for billing clerks. If one out of ten responds, it's information.

Good Luck,

Joe Atkins