Deciding the Future of Your Practice, Managing Director, Richard L. Tamburello

Let’s assume the following negative financial consequences: increased taxes, more regulations and reporting requirements, rising indirect and direct employment costs and declining reimbursements. 

Introducing: CMS issues proposed rules impacting reimbursements: http://www.healthcarefinancenews.com/news/cms-issues-proposed-rules-impacting-payment-rates

Should one or a combination of any of these financial burdens directly affect your medical practice, it could experience significant declines in cash flow and profitability. These concerns are present in the minds of both physicians and administrators. Many practices, regardless of size, are not sure which course of action to take or how to overcome and deal with these expected additional rising costs and cash outlays. Some practices might close within the next year or two and some physicians might decide to retire early.

What viable alternatives and solutions should medical practices take? The first step is to objectively assess the efficiency of the office. Do any employee’s responsibilities overlap? Are employees maximizing their talents? Is absenteeism a problem?  Are insurance follow-up, payment postings, charge entries and scrubbing accurately and timely conducted? Should your practice display any of these key operation weak points, revenues, profits and cash flow will negatively impact the bottom line.

Lastly, the ideal way to reduce costs and increase revenues is to utilize the medical billing professionals. “The American Medical Association (AMA) reports that an average of $30,000 from a $300,000 practice is spent annually on in-house billing. This amount can effectively be cut in half, when contracting the expertise of a proven billing service. “ source

There are several professional medical billing services which provide cost effective results-driven A/R management solutions. Outsourcing billing operations can be a viable alternative to medical practices seeking increased revenues, timely charge scrubbing, payment posting and effective insurance follow-up.  A highly functional medical billing service will accomplish these objectives and more. One additional key financial component URS Billing Services, LLC delivers to clients is `Increasing the Value of The Practice’.

   

Bad Debt Syndrome by Richard L. Tamburello, Managing Director

Given the unfortunate economic circumstances for millions of Americans, more and more medical practices are finding it increasingly difficult collecting deductibles and self-pay balances.  This situation is not only impacting cash flow for practices, but negatively affecting bottom lines.  According to a recent study published in the American Journal of Medicine, 2007, “Medical bills are the cause of more than 60% of all bankruptcy filings in the United States…” Many patients ask, “Why aren’t insurance plans covering more of the medical expenses”? As a result, medical practices are now dealing with the uncomfortable task of asking patients for payments after treatments and before they can be seen on the following appointments.

URS recommends the following to minimizing bad debt losses and maximizing cash flow:

1. Inform patients of payment policies prior to being treated. Office policies should include a list of accepted credit cards and a credit agreement which is to be signed by patients/guarantors who do not have insurance or high deductibles (HSA).
2. Select patients for collections using these criteria: Minimum of 3 statements and no contact from patients indicating willingness to arrange payment plans; balances > $49.99; mail is returned.
3. Contact with patients should be geared to `motivating’ patients to pay, not via intimidation tactics.
4. Patients with insurances should have their policies (including secondary insurance) validated prior to the office visit date.
5. Surgical practices need to call insurances for eligibility, authorizations based upon Diagnosis codes presented in ascending order.  This should be completed a minimum of 48 hours prior to the scheduled surgery date.

Keep in mind these are some basic procedures by which medical practices can minimize the Bad Debt Syndrome in today’s economy and in the future.

Efficiency = Increases Cash Flow, Bottom Line & Practice Value

Many medical practices find difficulty identifying inefficiencies or implementing corrective actions identified as inefficiencies. Many medical practices fail to establish `Key Financial Indicators’ (KFI’s) or operations benchmarks for such areas as: Average Revenues/Patient Visit, Revenues to Total Procedures, Fluctuations in Procedure Code Levels, Average Days Revenues (ADR), Days Revenue Outstanding (DRO), Days in A/R and Delinquency Tolerance Ratios (DTRs) and tracking amounts allowed and reimbursement levels by ALL contracted insurance payers.

These critical financial measurements are absent in many practices having 7 and fewer physicians. URS Billing Services provides these and much more key data to all of its clients.  The success of today’s medical practice requires pinpointing weaknesses and taking necessary corrective actions. Measure! Evaluate! Take Action!

Key Operation Benchmarks Which Are Monthly Tracked Per Physician:
-    Charges
-    Revenues
-    Adjustments
-    Net Ending A/R including net change from previous month
-    Percent Revenues to Gross Charges
-    Total Patient Visits
-    Average Revenues Per Visit
-    Establish / Measure Delinquency Tolerance Ratios for A/R
-    Establish / Measure Revenue Sources to Total Revenues
-    Establish / Measure ADR Targets
-    Establish / Measure NDRO Targets
-    Establish / Measure Days in A/R
-    Establish / Measure Revenues For Top 15 CPT Codes
-    Establish Solid Relationships With ALL contracted Insurance Providers

Once these Key Operations benchmarks are established, correctly monitored and managed, along with `alert algorithms’, profits and cash flow will begin to rise. Physicians will be able to draw paychecks the same day as employees.
The URS management team’s principle fiduciary responsibilities to ALL of its customers are not only optimizing revenues and controlling costs but increasing the value of the client’s practice.

The URS management team’s principle fiduciary responsibilities to its customers are not only optimizing revenues but increasing the value of our client’s practice.

Sitting Is Killing You

Via: Medical Billing And Coding

How to Increase the Value of Your Practice, by Managing Director, Richard L. Tamburello

Increase the Value of Your Practice

In today’s economy many physicians are fearful of seeing the value of their practices evaporate. Two primary reasons are stagnate and declining insurance reimbursements.  Other reasons include uncertainty with respect to federal tax policies, mandatory insurance coverage, higher employee payroll taxes, etc.  These can all have a direct effect on valuing your medical practice.

If you were to draw two lines on a graph, one showing gross revenues the other employee costs, the two will likely show trends of moving closer or worse, intersecting, hence impacting cash flow, your bottom-line and the value of your practice.  In past years, the area between the two was likely much greater.

Medical practices should consider and evaluate the financial benefits of contracting with a proven medical billing service organization.  This is the best way to effectively manage and control most billing and collection related costs.  URS Billing Services, LLC has the proven method of ensuring the area between revenues and billing costs never intersect, resulting in improvement in cash flow and profitability. URS takes great pride in servicing its clients medical billing needs and making sure financial goals are met each for each reporting period.

The Importance of Conducting Insurance Follow-Up by Richard L. Tamburello

Insurance follow-up is a billing function for ensuring optimal revenues, minimizing bad debts, reducing patient complaints and accelerating revenue cycles. Over the past 15 years, I have conducted numerous A/R analyses for various-sized medical practices and have found this key aspect is often overlooked. In some cases unpaid claims are re-filed without determining and correcting the cause of denial resulting in an endless cycle of rejections. When the watchful eye of the doctor or administrator is omitted from this vital task, valid charges are written off.    

How does a physician or practice manager know when denied claims are promptly addressed, corrected and re-filed?

I recommend the following method: 

•    Run a 'Total A/R Aging Report' using the parameter 'Date of Service'
•    Do not run reports showing 'Insurance Re-billing or Billing Dates'
•    Generate a 'Patient Balances A/R Report' using the same parameter 'Date of Service' 
•    Subtract Patient Balances A/R data from the 'Total A/R Report' and it will provide accurate data on unpaid insurance charges

These reports should be run twice a month and provide information as to which insurance companies and patient charges are not meeting timely adjudication.

Tell Us: How often do you conduct insurance follow-up? Is it on your top priority list? 


Questions? Contact Richard @ Rtamburello@e-urs.com 

Who Moved My Cheese? by Lauryn E. Tamburello

In college, one of my professors instructed our class to read the motivational piece, “Who Moved My Cheese” by Spencer Johnson. Its purpose was to invigorate the class into thinking about the concept of 'change'. The book’s theme focused on learning and understanding the benefits of being proactive, accepting change, getting excited about change and more importantly, not accepting change could seriously jeopardize the future success of any business.

The reason for me highlighting this book is to urge those who are hesitant, reluctant to change and fearful of losing control through outsourcing should keep in mind `change’ is necessary to preparing and experiencing ongoing success. Here are a few reasons why many medical practices hesitate to outsource certain aspects of their businesses:

-          Is the work getting done?

-          Is the billing company’s staff really concerned about my revenues?

-          Is the billing company looking out for my reimbursements?

YES! YES! and YES!

URS Billing Services, LLC is the fiduciary agent for its customers. It is incumbent upon us to complete all of our assigned billing responsibilities, including filing charges within 24 hours of receipt and matching procedure code reimbursements according to existing insurance contracts.

Financial Benefits

URS' financial benefits can be summed up in two words: Cost Efficient

Now is the time to evaluate for yourself and ask, “are there real obvious and clear benefits to seeing more patients and leaving the billing to URS Billing Services”? Call today and receive a free, no obligation analysis of your practice.