DoctorsXL is adding jobs just as quickly as it can in Reno - 60 positions in the first half of this year alone.
The problem?
Lori LeBlanc, chief executive officer of the fast-growing company, loses sleep at night worrying about the difficulties that DoctorsXL encounters in recruiting more workers with the skills it needs.
The company in recent months hired medical billing specialists and certified coders, revenue-cycle managers, insurance-contract specialists, medical practice managers and technicians and programmers to handle information technology jobs in healthcare.
There simply aren't enough of them in northern Nevada.
DoctorsXL has taken to hiring completely inexperienced workers with potential and training them in-house even though the company often needs to invest six months or more before the new worker becomes productive.
"What we need, Reno can't provide," says LeBlanc.
Launched with LeBlanc as its sole employee in 2008, DoctorsXL today employs 175, most of them at its headquarters facing Highway 395 in South Meadows. The company also operates smaller offices in Las Vegas and in Cary, N.C.
The company's growth is a direct result of the growing complexity of the American healthcare system.
"Physicians became doctors because they have a passion for medicine and want to help people," says LeBlanc. "But our current healthcare landscape necessitates that physicians spend more and more time on the business side of medicine, which ultimately reduces the number of patients they can see."
The Reno company's growth begins with the billing service "revenue cycle management" in the profession that Doctors XL provides to physicians, hospitals and other healthcare providers.
A professional group, the Medical Group Management Association, estimates that 30 percent of insurance claims by physicians are rejected and 15 percent are never paid because of incorrect billing.
Medical coding and billing is a highly fragmented business dominated by small, often one-person, organizations that contract with medical offices.
DoctorsXL pitches its expertise one insurance company, for instance, has 350 separate addresses in the U.S. to which various types of claims are sent and it's developed a reputation for tenacity with the claims it files.
"You have to go for every penny on the table," says LeBlanc.
The company won a major victory a few weeks ago with a contract to provide revenue-management services to the 16-physician Saint Mary's Medical Group in Reno.
While her company works in 12 states, DoctorsXL feels particularly comfortable working in its home state because of the knowledge of the insurance system its staff has developed, LeBlanc says.
Helen Lidholm, chief executive officer of Saint Mary's Regional Medical Center, said the contract with DoctorsXL was particularly important to position the medical group for rapid growth.
"We are very confident that DoctorsXL will help us effectively manage our growth as well as the revenue cycle operations of our practice so we can focus on our patients and the latest advancements in medicine," she said.
While coding and billing account for the largest share of DoctorsXL's revenues, the company also is seeing growth in its practice-management services.
Those services, which range from strategic consulting to work on nuts-and-bolts issues such as purchasing and accounting, are a natural development for many medical practices that have turned to DoctorsXL for revenue-management services.
But LeBlanc acknowledges that physicians often are reluctant to bring outsiders into the management of their practice, and DoctorsXL emphasizes that it's not going to take over.
"We are the doctor's co-strategist," says LeBlanc, who worked 14 years as a medical-practice executive and consultant before launching DoctorsXL.
The third leg of the company's strategy involves development of information technology systems for healthcare professionals.
It's developed, for instance, a proprietary software that helps physicians to keep better records while they're making their rounds in hospitals or other out-of-office locations.
The privately held company is owned by LeBlanc and 37 investors.