|Practice Assessment & Analysis
|At MedBridge Medical Solutions, an initial practice assessment looks at the following practice components:
A practice often is broken out into workflow units to determine how an operational unit moves from one point to another. Workflow units are separated into four areas:
• Patient Flow: How a patient enters the lobby, receives services from the physician, exits the office and maintains a high level of service satisfaction concerning the experience. This flow process examines the following:
⌈ Lobby image
⌈ How the receptionist greets the patient and presents organizational skills upon patient entry
⌈ Patient scheduling
⌈ How the nurse greets the patient and prepares the patient for the physician
⌈ How the physician enters and exits each encounter
⌈ How patient care instructions are carried out by the staff
⌈ How referrals for testing or specialists are generated
⌈ How well the staff performs patient checkout, (Requesting payment for services rendered).
• Paper Flow: This process examines the utilization of all forms in the practice. It determines if all forms are being utilized and with what consistency. It also makes recommendations on forms to be created, eliminated or updated to meet legal standards.
• Medical Record Flow: This process examines how charts are pulled, made available to the physician or other professional personnel, and returned to the medical record area with documentation completed. The review also examines time lost looking for charts or missing information.
• Telephone Flow: This process examines how calls are answered and how the call is transferred to the party who needs to respond to the inquiry. This area is generally where most practices fail patient expectations due to the inability to answer calls professionally. A telephone matrix is often developed to obtain agreement on the type of calls that will be transferred to office personnel or the physician. There is also an agreement on calls in which messages are taken as well as a system for returning those calls. Practices often respond to telephone flow problems by purchasing a larger telephone system or obtaining a voice mail system. If you cannot answer a telephone matrix questionnaire, you have just wasted a great deal on money.
REVENUE CYCLE OPERATIONS:
• Coding: This review examines the coding patterns of the practice and looks at improving revenue through appropriate coding enhancement. This review notes codes that are not being utilized, as well as the method of how codes are documented via an office superbill/encounter form, hospital/nursing home charge ticket or procedure charge ticket. The individual actually doing the coding is reviewed and education is provided. It is generally recommended that the physician perform the actual coding function.
• Billing Procedures: Procedures are reviewed to determine the timelessness of the billing process. The entire billing process comes down to filing accurate information that meets payor guidelines as well as filing charges in a standard time period. This review examines this process.
• Account Receivable Analysis: Following the physician, accounts receivable is generally the next greatest asset in the practice. However, it is often treated as an after thought by the practice. If you have concerns with an ever increasing balance or a decreasing collection percentage, this area needs to be examined.
• Payor Mix: This analysis examines where revenues come from within the practice. It is important to understand the importance of various payors to the practice and the effect of a lost contract or reduction in payment rates on the practice.
• Management Reports: Practice management is all about the collection of information and placing it into formats that allows for the review of trends and indications of downward areas. The trick is to become aware of a downward trend early and make the appropriate adjustments. The creation of these reports allows for understanding a practice’s financial situation.
MANAGED CARE SERVICES:
• Contract Review and Negotiations: The objective in this area depends on the practice’s leverage position in the market. If you have a new practice in an area with many physicians, leverage is minimal and attracting contracts is a means to creating patient volume. Pricing although important is secondary to receiving the contract. The strategy is often to insure that 60-90 day contract outs are available. Once a practice is established, the practice becomes more selective. Contracts are reviewed to protect the practice from such things as solicitation clauses, gag clauses, reassignment of patients following termination, billing and payment cycles as well as compensation.
• Fee Schedule Matrix: the development of a fee schedule matrix allows a practice to determine how much it makes from each payor by procedure. It attempts to create an apples to apples comparison. This allows a practice to create a scheduling scheme that enhances revenue but also informs the practice about which contracts to continue with if accessibility is limited. The physician ultimately needs to determine at what price he/she is willing to render services. This type of analysis allows the physicians to make an informed decision.
• Managed Care Strategy: The development of a managed care strategy is obviously based on many market variables as well as the current status of the practice. A practice must determine what leverage it has in the market and where it wants to grow. A new practice trying to create volume should not be too selective while the practice with little accessibility should be only looking for contracts that will enhance revenues or provide market protection.
• Demographic Studies: A market assessment is conducted to learn about the population that the practice services. Where do patients come from as well as many other attributes are collected in order that a marketing strategy can be developed. This demographic study also becomes valuable in assessing the establishment of a satellite office. Practices can no longer afford to make an error in selecting an office location or allowing a competitor to come into a specific market without knowing the possible consequences.
• Referral Sources: This service is geared more towards specialist looking to monitor current referral patterns as well as expanding those patterns. This study not only examines current referral patterns but also develops an assessment of why certain referrals have dropped. It exams where competitors have been successful and assist in implementing a referral program for the specialist.
• Satisfaction Survey: This service conducts surveys of patients to exam what patients like and dislike about the practice. Patient input will provide valuable insight into how services are being perceived about the practice. Patient input will provide valuable insight into how services are being perceived.
• Whether we are to serve as your sales and support vendor, billing service or management consultant, MedBridge Medical Solutions, Inc. will work hard to minimize disruption to your office during the transition from your current support vendor, billing service or software system.