The following is a profile of just one of the thousands of revenue cycle leaders across the U.S. I'd like to thank Terry Armstrong for generously offering his time to provide his insights. If you are a revenue cycle professional and would like to participate in a profile like this, please contact me. I would love to hear from you.


What's your name, organization & position? 

Terry Armstrong - President, State Collection Service, Inc.

How long have you worked there?  

6.5 years

How long have you worked in the revenue cycle field?  

Over 40 years

How did you land in the world of revenue cycle?  

It’s a long and interesting story, but I will try to be brief. I wanted a new opportunity and the University of Wisconsin alumni job board had a hospital management job open so I applied.  I didn’t get that job, but the administrator who selected someone else recommended me to the CFO.  The hospital CFO wanted to implement a new concept for the Business Office (what we call Revenue Cycle today) called the patient counselor concept (innovative for the 1970s) and was looking for someone to lead that program.  It sounded good to me because I had no healthcare experience.  That started my long career in healthcare revenue cycle.

If you could thank just one person in the industry, who would it be?   

I guess I would have to thank Dick Berger, the CFO who gave an inexperienced kid a chance.  I worked with him in one other setting, which ultimately led to a 20-year stint with HCA.  

What does your typical day at work look like?

I focus on our strategic goals and spend most of my time on sales, client relations and staff interaction.  Retaining good employees is critical in today’s employment environment (we have over 560 employees). Happy employees make happy clients that lead to new sales, which in turn lead to revenue and profits.  


Can you think of something great you've learned about this business you'd really like to pass along?  

I don’t think there is one magic bullet to being successful but it is key that you deliver what you promise, whether it’s to employees, clients or partners.  This industry rewards people and companies they can trust and count on.  If you build strong and trustworthy relationships, they pay off for years.

Is there a TV show or movie that you can't live without?  

I usually can’t wait for the next season of House of Cards.

If you weren't in your current career, what else would you most love to do for work?

It’s hard for me to think of what I would do since healthcare and revenue cycle has been such a big part of my life, but I think I would have liked being a defense attorney.  While I know that most courtroom scenes are not like what we see on TV, helping people in tough situations would be rewarding.

What do you think needs to change most urgently in the revenue cycle field?  

I still believe that the administrative side of healthcare, specifically the billing and collections side including pricing, is too complicated and expensive.  We waste too many resources chasing too few dollars, with a reimbursement system that most consumers do not understand.  It is still too difficult to read and understand an EOB (explanation of benefits) and there are too many inconsistencies between what the provider bills and the insurance company says they pay.  

How can a hospital charge $30,000 but only get paid $8,000 by insurance?  How can a doctor charge $359 but only get paid $83?  We need to streamline the pricing of healthcare and provide simple bills to patients that are easy to understand and pay.  What do I really owe and why?  Many accounts end up in collections because of this confusion.  I am somewhat optimistic because of the trend towards consumerism, patient friendly billing, and payment portals that provide the amounts owed and allow an easy method  to make payments.  We still need to make it more convenient for patients to get access via cell phones, email, texts, etc.  


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