Driving Up The Cost Of Driving Down Costs
I’m a physician, and my coworker is also a physician. We practice nephrology somewhere in the USA. We make a lot of visits to eight dialysis centers located along an interstate, and it involves a lot of driving to see the patients while they’re on dialysis. The system we work for pays us mileage plus a good salary.
Originally, we submitted our own mileage reports, and they always approved them. We were not trying to maximize the money; we both just wanted about $1,000 a month to offset the wear and tear and gas costs on our vehicles. We were actually just photocopying the same report each month, signing it, and turning it in. The original company we worked for was totally fine with this arrangement.
Well, the system was bought by another system that apparently believes all its doctors are thieves. We were told we were scamming them and that, from then on, a middle manager would review our billing and use Google Maps to calculate our mileage each month. This person would make sure we adhered strictly to their reimbursement policy. It starts from the office each day, no matter where you actually started; it doesn’t pay you to drive somewhere if you didn’t see a patient and only went to sign forms for nurses; and there was other stupidity.
Now, I don’t like being accused of thievery, especially when I was sure we’d been underbilling for the mileage just to keep things easy and simple.
These people didn’t know me, but I had an Excel sheet containing all my patients, their clinics, and a schedule that allowed me to drive out and see them all using as little time and mileage as possible. It was really efficient.
So, I dove into their travel policy and reconfigured my schedule, not to minimize mileage, but, within their policy, to maximize it. As a bonus, the new schedule actually had me home each day for lunch on the days I did dialysis rounds, so it saved me a little money and improved my mood.
For example, since they started and ended the mileage at the office no matter where I actually began and finished, I started my day at the clinic close to my house but far from the office. I ended my day at the one on the other side of town by my girlfriend’s house, where I’d usually hang out after work anyway. Midday, I’d go home for lunch, get a nap or a nooner, and then see a couple of people in town so I’d get paid to drive back. Then, I’d head out for the regular visits scheduled for that day.
Altogether, my average mileage, far from being lower as they expected, was actually 90% greater. On top of this, they were paying a middle manager to take a deep dive into all our billing, examine the locations, and compile the reports. She said that just processing the two of ours took almost eight hours; an expense they never had before!
