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New Jersey2222 Morris Ave. 2nd Floor,Union, NJ-07083
Phone : 908-834-1608Fax : 877-600-9390SalesPh: (908)-834-1608Email: [email protected]
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@Clinicspectrum
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PRACTICE REVENUE GROWTH
1© Copyright 2014. Clinicspectrum, All Rights Reserved.
An Internal Medicine/Primary Care office located in Union, NJ wasquite overwhelmed with the overbearing costs, administrativehassles, staff issues and gross collection deficits.
An administrative decision to sell the group was earnestlydeliberated.
With an average monthly collections between the 2 providerstotaling less than $60,000 while estimated hospital based physiciansalary is nearly $220,000, a quick resolution was necessary.
PRIMARY PROBLEM
2© Copyright 2014. Clinicspectrum, All Rights Reserved.
In 2011, in an attempt to save the group, Clinicspectrum was hired by theadministrative team.
RESOLUTION
Immediately, imperative key issues were discovered, and a revenue maximization strategy for cost efficiency was implemented.
3© Copyright 2014. Clinicspectrum, All Rights Reserved.
SOLUTION STEPSFollowing three steps were implemented :
Step 1: Operational Restructure through Hybrid Workflow Model
Step 2: Medically Necessary Tests/Procedures for better Outcomes and Risk Management
Step 3: Monthly Audit
4© Copyright 2014. Clinicspectrum, All Rights Reserved.
SOLUTION STEP 1Operational Restructure through Hybrid Workflow Model
Clinicspectrum immediately identified all the office tasks including:inventory management, cleaning of exam rooms, scanning of documents,
appointment confirmation, eligibility services, preparing patient in exam room beforephysician walks in, and many others.
We assigned those tasks/activities between LOCAL EMPLOYEES in the office andOFFSHORE employees in our back-office operation.
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SOLUTION STEP 1
Our back-office employees took over eligibility verification, indexing of scanneddocuments; follow up on outstanding claims, transcription services, appointmentconfirmation, missed appointments management and procedure recalls.
The group’s local team members were then separated into an administrative team,billing team and clinical team combined with DAILY REPORTING to build self-accountability.
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RESULT STEP 1
With the above planning in place the practice is running smoothly and seeing 55+patients’ on a daily basis without depending on an “Individual Team” member to run theoffice. Step 1 took care of operational efficiency and cost reduction through our backoffice team members.
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SOLUTION STEP 2Medically Necessary Tests/Procedures for better Outcomes and
Risk Management
Clinicspectrum introduced a concept of collaborative medicine by joining an IPA(Independent Physician Association) which has turned into an ACO now.
By joining an IPA, we participated in several incentive programs for Risk Managementand reducing cost of care for payers.
We created a clinical team that went through each patient’s clinical notes. Based onmedical necessity and evidence based medicine we recommended TESTS/Proceduresthat were urgently needed.
This resulted into better care for patients.Utilization of clinical resources/teams and diagnostic equipment made a difference inpatients’ lives and saved money for Insurance companies.
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RESULT STEP 2
The implementation of Step 2 has resulted in significant revenue growth averaging an additional $30,000 per month over the last 4 years. At present the practice collects $1.1M per year.
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SOLUTION STEP 3Monthly Audit
Every task/office function gets audited randomly across the practice. A knowledgeable audit team focuses on the following areas:
End of week supplies inventory check, Daily closing report for co-pay/co-Insurance/deductibles, Outstanding balances,Patient clinical non-compliance,Reminders for tests/procedures,Follow up with insurance companies with outstanding claims,Medical necessity compliances, Proper documentation, Complaint resolution and voice message tracking.
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RESULT STEP 3
Efficiently checks and balances mechanism in place lessened errors, and improvedefficiency.
© Copyright 2014. Clinicspectrum, All Rights Reserved.
CONTACT US
2222 Morris Ave. 2nd Floor,Union, NJ-07083
Website
http://clinicspectrum.com/
Phone Number908.834.1608
Clinicspectrum is a healthcare services company providing outsourcing and back office solutions for medical billing companies, medical offices, hospital billing departments, and hospital medical records departments.
