This year has been a big year for Medical Practice Success! We received the amazing Stacy Calvaruso as our new CEO and co-owner, and we’re pleased to announce another industry expert is joining the team: Patrice Pash! She has been named the Director of Client Operations here at MPS. In this role, Patrice brings a wealth of healthcare consulting experience with over 200 successful engagements, which include facilities in the U.S and abroad. Prior to joining Medical Practice Success, she was the Director of Consulting Services for DocuTap and prior to this, she led the consulting team of NMN…

This month we will be providing you with a series of posts related to your top KPIs that will assist you with monitoring the financial health of your organization. In this post, we will be discussing average revenue per visit, front desk collection average, ancillary revenue per visit, and E/M code distribution and how all of these affect your practice. Average Revenue Per Visit – This is the total amount received from both the patient and payor on a single date of service. Shows you the cash that you put in the bank and is used to help forecast upcoming cash flow. • It is usually best to…

Are you having trouble with getting Hydration services paid? Are you billing for each increment correctly? Well, no worries, you are not a dummy you are just a part of a much larger group of folks who are very smart but don’t really know how to bill for Hydration service in their clinic. So, I have asked DeInda Castellano, our Supervisor of Coding (aka Coding Rockstar), to explain this to us in simple terms. Below are the guidelines that she shared with us. Please remember that you should always confirm with your specific payors regarding any additional instructions and/or special processes…

Like many aspects of modern life, the healthcare industry depends upon the ability of the organization to obtain and process information at a very fast pace. In an environment with such a tight-margin, the ability to acquire necessary data quickly and efficiently can mean the difference between success and financial failure. Many believe the long-standing business rule of profit being made of pennies is even more accurate in healthcare. Therefore, the continued push to look for ways to come up with new technologies and/or processing methods, however small, exists prominently in the industry.

What should my A/R balance look like? Why are we not collecting all our A/R? Typically, when speaking with a client, these are the most common questions I’m asked. You should be getting an A/R balance sheet that shows your monthly A/R and what it looks like at least once a month. Whenever you look at your accounts receivable, you are typically going to be looking at it from an aging perspective. So, 0-30, 31-60, 61-90 days, and so on. Generally, you want 85% of your A/R to be under 90 days. This ensures you have a consistent cash flow and you’re not waiting for the payers to pay you on a…

Join us at Urgent Care Centers Congress at the Paris Hotel in Las Vegas on June 21 from 12:45 to 2:45 pm! Our very own Stacy Calvaruso and Timothy Reynolds, M.D. will be leading a workshop on How to Incorporate a Strategic Business Model to Ensure a Viable Urgent Care Center! Visit the UCCC website for more information!

It all starts at the beginning! When 20% of the services of a typical medical practice are considered self-pay and should be collected at the time of service, why do you have so much debt? It just doesn’t make sense… It’s often difficult for your front desk team members to know how much to collect. There’s a difference in a co-payment and co-insurance, as we have discussed before. When you’re looking at your cash flow this is often the one area where you can make a quick impact. However, be careful you don’t scare away or alienate your patients by being…

Are you experiencing payor recoupments or refund demands? Did you know that the Department of Insurance for your state actually has guidelines on how far back a payor can go to recoup a payment that they paid in error? Some payors call these "Adverse Benefit Determinations (ABD)." The good news is that you have some rights! My first suggestion is to know what your state's guidelines are regarding payor recoupments/refund requests. Second, you should immediately reply back to all recoupment and/or refund requests in writing asking for an appeal and that the payor provides you with a complete…

You’ve seen it before. A payment comes in. Your staff manually posts the payment and the corresponding contractual allowance. Without a detailed understanding of contracted rates, terms, and conditions, the staff member who posts the payment may or may not get it right. It’s never audited … but it works its way through the system. You end up with a zero balance on the procedure. It falls off everyone’s workload. Without you knowing, it’s written off. A recent review performed by our office found that on one particular plan, our new client was underpaid an…

This is it! We’re going to learn the final piece of the puzzle to fix the poor financial performance of your practice. Last time, we discussed the billing and collections process, but this week we’re going to talk about managing receivables. Managing Receivables … The next area for improving the revenue cycle is accounts receivable management. We recommend that an organization segregate its aged trial balance by major third-party payers to determine the number of delinquent accounts over forty-five days old. It is easier to contact one insurer regarding twenty accounts, for…