BR Healthcare Services would provide the client with a complete operational evaluation and assessment of the clinic operations and systems. This evaluation will cover all expense areas, financial reporting, an analysis of current costs, an assessment of general operations, individual physician productivity, levels of service coding by physician, clinic staffing, all physician contracts, organization chart, billing and collections, and internal controls. This in-depth evaluation of the practice would result in performance improvement recommendations which would act as a blueprint for additional cost savings. Some of the areas of review are:
- Review and recommend revisions, as necessary, of Business Office policies and procedures to optimize performance and accuracy of staff
- An evaluation of billing and collections
- A staffing and expense review and analysis
- A comparison of provider productivity against MGMA standards
- Conduct a comprehensive practice reimbursement review, working with the physician(s) and office manager
- By physician review of fee schedules, Superbills, charge/encounter forms, adjustments, payments, Usual and Customary charge schedules, CPT-4 code frequency utilization, and service mix
- Perform level of service coding audit and analysis by physician to evaluate accuracy and optimize reimbursement
- Analyze fee schedule of each physician - make recommendations for adjustments.
- Validate ICD-9-CM and CPT-4 codes by physician to increase reimbursement and reduce liability and denials
- Evaluation and Management Coding (Levels of Service Coding)
- Fee Schedule Analysis (Professional Fees for ER, Surgery, and Inpatient Care)
- CPT-4 Frequency Review
- ICD-9 Frequency Review
Upon completion a written report will be presented to the client outlining potential problem areas, recommending solutions to the problems, and quantifying the financial impact of the solutions.
Practice Review Sample Results
9 Provider Clinic $450,000*
4 Provider Clinic $380,000*
9 Provider Clinic $400,000*
3 Provider Clinic $186,000*
* These results were achieved through a combination
of Revenue Enhancements & Cost Reductions.