Practice Management Solutions. Empowering Podiatric Practices

Transcription

1 Practice Management Solutions Empowering Podiatric Practices 1

2 Where do Practices Lose Money? 25%-35% revenue loss due to improper patient handling at the front office (missed phone calls, patient no-shows, poor follow ups). Dissatisfied patients are 80% more likely to give negative referrals, adversely impacting the flow of new patients. Average revenue loss of 32% due to insurance claim rejections. 50% of rejected claims are never reprocessed. Doctors only collect 49% of patient balances owed. Doctors spend minutes a day supervising billing claims instead of seeing patients and generating additional revenue.

3 Think of a typical week at your Practice Read through an EOB letter to understand why an insurance company denied your dues Have discussed with practice staff regarding productivity and how patients must be handled Wanted to speak to the insurance company because there seems be a trend here Leafed through the coding letters that your specialty governing body keeps sending Reviewed a demo of yet another EMR system because everyone is saying you should Deciding what to do with those patients who never seem to pay Which of the above is related to taking care of patients? Yet we find practice after practice spending more time on non-patient related activities so that they could stay in business

4 Why Software Isn t the Only Solution Why can t I just buy advanced software and manage the front, EMR, and back office in-house? Technology Strategy 21% 19% Process 17% 22% 21% Governance *Source: Oracle People Your Operational Success Depends on More Than Just Technology

5 Services Turnkey Revenue Cycle Management Revenue Projection: AHCBS will project your monthly revenue at the start of every month based on payer mix, historical patient volume and revenue pending from account receivable. Timely claims submission : Upon receipt of the encounter forms AHCBS will submit claims to the insurance company within 24 hours. Claim error checking : AHCBS will check all encounter forms to ensure that all relevant information for processing the claim by insurance companies is available. Accounts Receivable Follow up: Claims that haven t been paid beyond a certain date will be flagged and followed up on to ensure collection. In general, AHCBS will keep your 60 day outstanding accounts receivable below 20% and 90 day accounts receivable below 10%. Patient statements: AHCBS will send out customized statements to patients with balances due on their accounts. Payment Posting: AHCBS will enter all of the Explanation of Benefits, patient payments and insurance payments into our patient management software to maintain accurate accounts receivable. Patient billing hotline: Patients can dial AHCBS s toll free number to speak to our collection specialists regarding their bills. Our specialists have access to each patients account and can help answer any queries that the patient may have.

6 Services Turnkey Front Office Management Manage patient phone calls: We answer and route all incoming patient calls and centrally schedule, manage and confirm or reschedule all appointments for the doctor's office Manage insurance eligibility: We obtain eligibility verification from insurance companies prior to the patient's appointment to ensure that there are no insurance denials due to patient's loss of coverage, deductibles not met, no out of network benefits etc. Manage Patient payment: We ensure that the right amount of co pays and deductibles are paid by patients. Confirm Appointment: We confirm appointments by calling patients before the set appointment to ensure that the no-show rate can be significantly reduced. Measure 'pulse of customer ': We conduct Patient surveys to understand their needs wants and sources of value. The results are shared with the practice to modify operations to match those requirements. We provide monthly reports on the health of the practice: The reports includes information on number of appointments booked, number of calls received, common complaints, issues facing patients etc. Monitoring call quality for audit and compliance: All calls made and received by the Virtual Front Desk personnel is recorded and stored for a period of 3 months. These recordings can be provided to the client on demand as and when required.

7 Services Billing and Front Office Support The services below are offered on an Ad-Hoc basis Appointment Confirmation Calls: We confirm appointments by calling patients before the set appointment to reduce the no-show rate. Pre-authorization Management: We obtain pre-authorizations from insurance companies for procedures that a provider needs to perform. Account Receivable Follow up: We follow up on outstanding insurance claims to support your existing revenue cycle management operation. Patient Bill Follow up: We make soft reminder calls to patients with outstanding balances and can even take payments over the phone. Charge Entry: We can enter billing changes and patient demographics into your billing system.

8 Typical Client Results for Billing Services Decrease 90 day Aging to less than 10% Decrease in overhead costs by 50% Get monthly projections on your revenues collected with a +-10% accuracy Get weekly transaction summaries on revenue booking and collections See how your practice is performing comparedto your peers

9 Typical Client Results for Front Office Increase in patient volume of 15%-30% Decrease in overhead costs by 10% Increased patient satisfaction by 40%-80%, hence increasing patient recall Decreased load on existing clinical staff allows better patient care Improved billing and collectionssince insurance, address and phone numbers are verified before each appointment

10 Innovation Starts Today Gary J. Mellon, DPM Empowering Podiatric Practices Your Partner In Delivering Quality Healthcare

11 Appendix

12 Certification ISMS Certification ISO Certification 1. A risk assessment of the threats to an Organizations/customer information assets 2. Selection and Implementation of effective and relevant policy and control 3. Continuous review and effective improvement 4.Total information security risk management 5. Risk allocation, mitigation, transfer, assurance and acceptance 6. Protects the confidentiality, integrity and availability of organizational/third party information 1. Reduction in possibly damaging /embarrassing information leaks and failures 2. Total risk mitigation, security of brand equity 3. Reduction in costs due to fewer security incidents 4. Common policies and control across the whole organization 5. Increased staff awareness, involvement and empowerment 6. Better monitored and audited systems and information flows 7. The risk of prosecution is significantly reduced 1.ISO 9001 is the Internationally recognized standard for the quality management of businesses 2. It applies to the business processes that create and control the products and services an organization supplies 3. It prescribes systematic control of activities to ensure that the needs and expectations of customers are met 4. It is designed and intended to apply to virtually any product or service, made by any process anywhere in the world 1. Implementing a Quality Management System will motivate staff by defining their key roles and Responsibilities 2. Cost savings can be made through improved efficiency and productivity, as product or service deficiencies will be highlighted 3. From this, improvements can be developed, resulting in less waste, inappropriate or rejected work and fewer complaints 4. Customers will notice that orders are met consistently, on time and to the correct specification 5. This can open up the market place to increased opportunity

13 Sample Front Office Report Volume Analysis :16 3:28 3:24 3:05 1:40 2:12 0:40 0:00 0:00 Avg: Spent Vs. Avg: Hold Time 0:00 3:00 3:02 3:32 3:05 2:59 2:51 0:37 0:12 0:19 0:18 1-Apr 2-Apr 3-Apr 6-Apr 7-Apr 8-Apr 9-Apr 10-Apr 13-Apr 14-Apr 15-Apr 16-Apr Call Offered Calls Answered Calls Abandoned Avg: Spent Tme Avg: Hold time before call loss 6 9 Hourly Abandonment Analysis Appointment Scheduling, 90 Dispositions Analysis Information, 281 Appointment Re- Scheduling, 33 Transfer Calls, 367 7:30 AM 8:30 AM 9:30 AM 10:30 AM 11:30 AM 12:30 PM 1:30 PM 2:30 PM 3:30 PM 4:30 PM 5:30 PM Cancellation Calls, 2 Prescription Refill Request, 1

14 Billing Sample Reports

15 Billing Sample Reports

16 Patient Satisfaction Reports

17 Thank You g a r a h c b s. c o m