Most physicians today need specialized consulting services for medical practice management, because making a profit in today’s medical environment is increasingly an uphill struggle.
“Doctors need help today because of all the drastic changes going on, and the economic pressures they are facing from falling reimbursements and rising overhead,” said Joey D. Havens, director of The Horne Group’s Physician Services. “They are being squeezed very hard, and are faced with challenges like they have never had before. That comes on top of the fact that physicians need to invest more in technology such as practice management systems. So, they are having profitability squeezed at the same time they need to put more capital into their business.”
The Horne Group practice management consulting covers issues such as new practice startups, strategic planning, coding chart reviews, buy/sell agreements for partners, compensation models for partners, operational reviews to improve efficiency, technology solutions as well as accounting, financial planning and tax services. Physicians from solo practitioners up to large, multi-specialty practices with more than 100 physicians are served by The Horne Group’s Physician Services, which does work across the Southeast in both rural and urban areas.
“In Mississippi, you have a lot of rural health clinics,” Havens said. “We assist them with getting qualified as rural health clinics, provide advice on operations and also help them with their cost reports for reimbursement on their services.”
Another important service provided is joint venture facilitation that allow physicians to work with hospitals in partnership on an ambulatory surgery center or other ancillary services.
“With many physicians unable to obtain malpractice insurance, they are being employed by hospitals directly or in an affiliated practice model,” Havens said. “We help develop compensation models, provide compensation opinions for fair market value to meet regulatory requirements, as well as strategic planning for practice management and growth.”
Another company providing services to Mississippi physicians is Medical Management Associates (www.medicalmanagement.com) based in Atlanta, Ga.
“We provide advice to physicians in private practice, and also with larger institutional organizations such as hospitals that affiliate with physicians,” said Charles Y. Thomason, III, president, Medical Management Associates, whose firm does quite a bit of work in the Meridian area. “Our firm has an advocate relationship. Healthcare has gotten much more complex over the years. We are a highly analytical resource. Almost any physician will tell you revenue is going down. They are getting paid less. In the meantime, there are inflationary pressures from increasing overhead. In many cases, malpractice premiums have doubled. Physicians have to be much more efficient to be viable.”
Thomason said they use a team approach with various advisors including attorneys and CPAs to provide assistance. One of the most vital members of that team is the physician.
“Our most successful practices are those which have well-educated physicians who take a hands-on approach to business while using outside advisors to provide them with the detailed technical knowledge that is necessary to optimize their medical practice in the current environment,” Thomason said.
Medical Management Associates focuses on four primary areas:
• Long range, strategic planning regarding big decisions such as the location of the practice, lease costs, fee schedules, hiring right staff, starting off the practice on a solid footing and hiring staff and associates.
• Practice management that helps physicians operate an efficient and successful practice from one month to the next. This includes patient scheduling, third-party reimbursement, compliance, billing, accounts receivable management, personnel management, fees and coding, managed care contracting and examining the financial bottom line.
• Facility planning and design. The physical facility is important to the medical practice because it impacts efficiency, marketing and cost effectiveness. Services include helping physicians plan, design, equip and finance a functional medical office.
• Technology consulting includes an evaluation of practice management software systems, electronic medical records system and Web consulting services including how to use the Web site to give patients information and allow them to schedule appointments.
Bob Bridgman, marketing director of American Medical Software (www.americanmedical.com) based in Edwardsville, Ill., said special medical practice software for patient chart keeping is not only the most efficient way to run the business, it can also help the doctors provide better patient care while helping avoid malpractice lawsuits.
“Electronic patient charts afford doctors better documentation and storage of patient files,” Bridgman said. “There aren’t handwritten files everywhere. One reason why some malpractice lawsuits go as far as they do is the lack of good documentation. Doctors keeping better notes is helpful for litigation, plus it provides documentation to insurance companies and allows better patient care. Software templates have certain criteria or areas they cover that for example, can remind a doctor to check in with a patient to cover something that may be an issue for them. Doctors can carry around a laptop or tablet PC and fill out the information while seeing patients. Or they can complete their notes at the end of the day.”
Electronic filing for reimbursement from Medicaid, Medicare and insurance companies in most cases is now a requirement — not an option.
“This is the electronic age, and most of those payers are requiring claims be filed electronically,” Bridgman said. “A system like ours helps with submitting forms.
“A physician might have claims going to 40 or 50 insurance companies in a week. A clearinghouse takes those batches of claims, sorts them, and if the claim is filed right, you can get reimbursement in 10 to 14 days.”
If vital information is missing on a claim filed electronically, it gets kicked back quickly before being passed on to the payer. That allows it to be refilled in a timely manner. That is critical because many insurance groups require timely filing, or they won’t pay a claim.
“A system like ours not only helps get claims out and tracks that they are all being sent in, but keeps up with accounts receivable,” he said. “If a claim or a patient bill is not paid in a timely manner, you can check on it. In a nutshell, what it will do for the office on the financial side is improve cash flow and make an office more efficient. There is more peace of mind. It is less stressful than the staff having to scramble to find out why the claim wasn’t paid. It is all automated on the computer, and that makes life a lot easier. And a system like ours will typically pay for itself in a relatively short period of time because it does get you more streamlined and efficient.”
Contact MBJ contributing writer Becky Gillette at email@example.com.