"We're doing a lot of good things in right ways in a sloppy industry," Bijon Memar said in a conference room at Medac's processing center in west Augusta.
Augusta-grown Medac does medical billing for anesthesiology companies. It has about 12 percent of that specialized market, with $1.8 billion in charges in 2009, and is the second-largest company of its type in the nation.
The 18-year-old company is about to get bigger.
When co-founder Kam Memar died in 1998, the company had 60 employees. It has 350 today.
Bijon Memar has been at the helm since the traffic accident that claimed his brother's life.
Most people know him as John. His business card lists his name as B. John Memar.
"John is how everyone in the industry knows me," he said. "Doctors said 'Can we call you John? It is easier.' So it started that way."
He is meeting with developers now to turn seven acres of property along Jimmie Dyess Parkway into the new office park for Medac and its sister company, Kam Technologies.
There are 230 people working in the Medac processing center on Scott Nixon Memorial Drive and not enough parking for them and the 25 people the company wants to hire this year.
The 50,000-square-foot building is expected to open in 2011, Memar said.
"Our business has been growing due to the reputation that we have. We really don't have a sales force in the company. Most of our business is from word of mouth," he said. "No one is signing up because we do a good sales presentation."
Medac has 3,000 clients in 27 states. Its heaviest concentration of anesthesia group clients is in Pennsylvania.
Memar said his industry is filled with a lot of mediocre medical billing companies.
"We don't want to be the billing company for all. We want to be the billing service for a few and provide a level of service that they're looking for," he said, stressing that Medac is not a discount service that processes everything overseas. All of its processing is done in Augusta.
He is proud of the ability of the staff and the home-developed software to recoup more money for its clients from insurance companies, partly because of the accuracy of the claims. The software has more than 30,000 rules built in.
"Before it goes out of our office, we know it will be denied. We force someone to fix it ahead of time," Memar said. "Our clients are recouping 95 percent of all of their underpaids. That is a nice bottom line at the end of the year."
Memar said some problems in health care stems from doctors not getting paid enough money because of inaccuracies in billing: $5 billion of doctor charges are underpaid, and only 6 percent of them are appealed with insurance companies.
Some medical billing standardization could also help cut health care costs. Memar said 30 percent of health care billing is just shuffling of paper.
It takes a unique skill set to code for medical billing, he said. He makes sure that his employees are all American Academy of Professional Coders.
Greg Zinser joined Medac as CEO a year ago, having been offered the job after consulting with the company as a client.
"I saw an opportunity to set some new standards for performance and transparency and integrity," Zinser said. "Medac is far ahead of the curve in almost every area. There is still a lot to do, and that makes it fun."
It is hard to be on a sales call with Memar, Zinser said, because it is hard to get a word in.
"He is extremely high energy, extremely passionate," Zinser said. "He is the perfect salesperson for this type of business because he is genuinely excited about it."
Bijon Memar was born in 1958, nearly two years after his brother Kam, and grew up in a part of Baltimore County, Maryland, called Randallstown.
The family moved south in 1978.
Memar describes it as a sudden exodus from Maryland. His father, a family practice doctor, attended a convention in Atlanta and fell in love with the city.
"Basically, within six months, he came down here and opened a new practice. I was straight out of high school; I was torn about leaving my friends," Memar said.
The change of city was "night and day," he said, and he also fell in love with his new home.
He selected Georgia College in Milledgeville to pursue a degree in marketing. It took him six years to graduate because he insisted on paying his own way. He said that his parents offered to cover his expenses but that he wanted to do it on his own. He paid his way by bartending and waiting tables.
"It is the only way to make money," he said. Bartending earned him $8 an hour, well above the minimum wage for the early 1980s.
His brother graduated in 1983 from the University of Georgia with degrees in chemistry and zoology. Kam Memar turned down the courtship from pharmaceutical companies in favor of starting his own firm -- Atlanta Investment Services.
"My parents' neighbors called one day that they have an opportunity to get a billing company that is for sale in Augusta," Memar said. His brother got involved, and in the negotiating process, the Augusta company owner decided to deal strictly with Kam.
Bijon Memar did not join his brother in Augusta at Medical Bureau Inc. until 1989. He was working for an Atlanta advertising firm as a sales trainer when his brother asked for help dealing with a former owner who had become a competitor.
"I took a leave of absence for two weeks and help put things together. I'm scratching my head, 'Why don't you guys market this thing,' " Memar said.
The argument was marketing wasn't needed since word-of-mouth was working. Memar joined the company and started marketing it.
"It was too successful. We grew too fast," he explained.
Medical Bureau Inc. was dissolved in 1992 when the brothers wanted a billing company strictly for anesthesia billing. MBI handled a lot of different medical specialties, including pathology, radiology and family practice offices.
The brothers liked that anesthesia required specialization.
"You had a fee schedule. You knew what Medicare paid. You billed for the fees and it was cut and dry," Memar said. "Because anesthesia is based on time and the procedure, it makes it difficult."
Medac's initial software was general billing software from a couple of national vendors.
Kam Memar researched the industry and found there was no software just for anesthesia billing, though there were some medical billing programs that had some add-ons.
The Memar brothers decided to develop their own, as quickly as they could.
In 1998, they introduced technology that had some bugs in it.
"We paid dearly and some of our clients paid dearly," Memar said.
But the program was revolutionary, allowing clients to track reimbursements in real time via the Internet. It launched just weeks before Kam Memar's death and was later renamed KAM 2000 in his honor.
The technology might have come out in 1998, but it had been in development for two years. Memar said the company has poured $12 million into the development of its proprietary software.
"It is paying off for us today," Memar said.
Kam Technologies is the off-shoot company that maintains and develops the software. What began as an office of two people is now an office of 20.
It is now in a office on Wheeler Road but will be incorporated into the new facility.
There is constant communication between the Medac and Kam Technologies offices.
"We have billing companies much larger than us knocking on our door that they want our technology," Memar said. "We don't really find people competing in the kind of work we're doing. We pick and choose who is going to be using it."
Many of the users are large groups of anesthesiologists who do billing themselves rather than through a company.
A tough year
Problems with the launch of new software was not the most difficult aspect of 1998.
In January, FBI personnel descended on Medac's office, launching an investigation into its billing practices that was prompted by a "whistle blower."
The company had been accused of fraud, specifically of overcharging health insurance companies.
Memar said the government was misled by a couple of former employees who left to form a rival billing company.
"We were taken by surprise by the investigation. We had a compliance program and certified coders in the office. We took pride in our compliance department," Memar said.
He doesn't hold any animosity toward the federal investigators.
The last of thousands of seized records were returned to the company that December. After a thorough combing by the FBI and IRS, nothing was found.
"Not only did we come out of it clean, but nobody from Medac or our clients paid any fines or penalties," Memar said. "Their job is to find something, not find nothing. And we came out of it squeaky clean."
The accusations claimed more than the company's reputation.
"Everyone right away thought we were guilty. Everyone was calling us," Memar said.
His brother was driving to Birmingham, Ala., on May 1 to meet with bankers who held the company's line of credit.
"I was in Chicago that day. I got a call that your brother was killed in a car wreck today on I-20. Middle of the afternoon. Beautiful day.
"He must have taken his eyes off the road ... he didn't realize the trucks were going 15 miles per hour."
Kam's car went underneath one of the slow-moving trucks. People at the company surmise that he might have been distracted by the investigation. He was 41 years old.
Kam Memar's office hasn't been disturbed in the dozen years since his death. It is a locked room with his nameplate on the door.
"My mom comes and puts a little rose on his desk," Bijon said.
Time for more
"1998 to 2000 were hardest years of my life," Memar said.
He was acutely aware that he didn't have a family of his own.
"I was working my tail off in this business. For the longest time, being an entrepreneur, you have to wear multiple hats. I was doing sales. I was doing operations. I was putting out fires and going to trade shows. It required me being here every day," he explained. "Every relationship I had went south because I was never home."
Eight years ago he met a calculus teacher from Texas named Diana. They met through mutual friends and "it was all great after that."
They've been married four years now. They have a son, Michael, who is 3, and a daughter Madeline, who is 1.
"I turn 51 this year," Memar said. "I have a lot of time to spend with children at home."
Home is Atlanta, though he still owns at house on Kings Way in Augusta.
"There was a time when I was spending Monday through Friday here and then going home on weekends," he said.
Instead, he works from home on the phone with his executives throughout the day.
He makes the journey to Augusta to conduct board meetings and entertain clients.
He travels at least once a week as part of Medac's sales force. He's the chief representative when sitting down with potential clients.
Zinser, who is based in California, said he gets about 100 e-mails a day and 50 calls from Memar or other members of the office.
Zinser said he expects the company to continue growing at a controlled pace, about 15 percent to 20 percent a year, "to be really sure we have the resources to do the job right."
"We are well positioned to achieve that," Zinser said.
"Our reputation is outstanding because people are recognizing that we're different. We're not just a billing company, we are a business partner. And that's what we're looking for in new clients."