9780471299646

Written by one of the foremost experts in the field, this book-the first of its kind-provides expert guidance on how to perform an operational and strategic assessment of a medical practice. It includes proven suggestions and ideas on how to maximize the operational efficiency of a practice, enhance the medical office revenue stream, position the practice for future success, and maintain and increase income. Contains evaluation and assessment forms, as well as sample financial reports.

CASEY TEFERTILLER is a former writer for the San Francisco Examiner with a keen interest in the American West.

The Financial Analysis

1

(30)

Defining the Payer Mix

1

(2)

Summarizing Practice Financial Performance

3

(6)

Analyzing Practice Financial Performance

9

(2)

Explanations for Claim Filings Problems

11

(14)

The Initial Analysis of Accounts Receivable

25

(2)

Analyzing the Comparative Worksheet

27

(1)

Summary of Financial Benchmarks

28

(1)

Conclusion

29

(2)

Accounts Receivable Review

31

(14)

Establishing Accounts Receivable Ratio

31

(1)

Benchmarking

32

(2)

Payer Class Analysis

34

(1)

Collectibility Analysis

35

(1)

Accounts Receivable Aging

36

(9)

Reviewing Explanation of Benefits (EOBs)

45

(18)

Look for Denied Charges

46

(3)

Analyze How Quickly Claims Are Being Paid

49

(4)

Initial Review of the Practice's Fee Schedule

53

(6)

Cursory Review of Managed Care Reimbursements

59

(1)

Conclusion

60

(3)

Analysis of the Billing and Collection Processes

63

(38)

Patient Scheduling

64

(7)

Patient Check-In

71

(4)

Patient Checkout

75

(8)

Billing

83

(9)

Collections

92

(8)

Conclusion

100

(1)

Fee Schedule Analysis

101

(10)

Methodology

102

(1)

EOB Review

103

(8)

Reviewing Charge Tickets

111

(8)

The Office Charge Ticket

111

(7)

Hospital and Surgical Charge Tickets

118

(1)

Overhead Analysis

119

(14)

Prior Year Comparisons: A Quick Look at Overhead

120

(4)

Performing a Detailed Overhead Comparative

124

(3)

Take a Look at Staffing

127

(2)

The Importance of Understanding Practice Revenue

129

(1)

A Quick Look at Other Overhead Categories

130

(2)

Summary

132

(1)

Coding and Compliance Plan Analysis

133

(12)

Review Physician Production

135

(4)

Refer Back to the EOB Analysis

139

(1)

Scan the CPT Frequency Report

140

(1)

Compare CPT Utilization to Other Practices

140

(1)

Reviewing Practice Compliance Readiness

140

(1)

Compliance Plan Questions

141

(2)

Should the Assessment Include a Chart Review?

143

(2)

Physician Analysis

145

(14)

Physician Full-Time Equivalents

145

(1)

Production Analysis

146

(4)

Physician Compensation

150

(3)

Physician Compensation/Production

153

(2)

Governance Issues

155

(2)

Summary

157

(2)

Internal Controls Review

159

(6)

Separation of Duties

160

(1)

Managing Write-offs

161

(1)

Daily Balancing

161

(1)

Charge Tickets

162

(2)

Check Signing

164

(1)

Putting It All Together: Report Writing

165

(74)

Practice Review Report

165

(18)

Sample Medical Practice Analysis

183

(56)

Appendix

239

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Performing an Operational and Strategic Assessment for a Medical Practice

0471299642

Summary

Author Biography

Table of Contents

Supplemental Materials

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