Practice Revenue Growth Case Study

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PRACTICE REVENUE GROWTH
New Jersey2222 Morris Ave. 2nd Floor,Union,
NJ-07083 Phone [phone]Fax
877-600-9390 SalesPh (908)-834-1608Email
info_at_Clinicspectrum.com
Facebook.com/Clinicspectrum
_at_Clinicspectrum
YouTube.com/Clinicspectrum
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PRIMARY PROBLEM
An Internal Medicine/Primary Care office located
in Union, NJ was quite overwhelmed with the
overbearing costs, administrative hassles, staff
issues and gross collection deficits. An
administrative decision to sell the group was
earnestly deliberated. With an average monthly
collections between the 2 providers totaling less
than 60,000 while estimated hospital based
physician salary is nearly 220,000, a quick
resolution was necessary.
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RESOLUTION
In 2011, in an attempt to save the group,
Clinicspectrum was hired by the administrative
team.
Immediately, imperative key issues were
discovered, and a revenue maximization strategy
for cost efficiency was implemented.
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SOLUTION STEPS
Following 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
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SOLUTION STEP 1
Operational 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 before physician
walks in, and many others. We assigned
those tasks/activities between LOCAL EMPLOYEES in
the office and OFFSHORE employees in our
back-office operation.
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SOLUTION STEP 1
Our back-office employees took over eligibility
verification, indexing of scanned documents
follow up on outstanding claims, transcription
services, appointment confirmation, missed
appointments management and procedure recalls.
The groups 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 the office. Step 1 took care
of operational efficiency and cost reduction
through our back office team members.
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SOLUTION STEP 2
Medically 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 Management and reducing cost of care for
payers. We created a clinical team that went
through each patients clinical notes. Based on
medical necessity and evidence based medicine we
recommended TESTS/Procedures that were urgently
needed. This resulted into better care for
patients. Utilization of clinical
resources/teams and diagnostic equipment made a
difference in patients 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 3
Monthly 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/deduc
  tibles,
• 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 improved efficiency.
Less Errors
More Efficiency
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CONTACT US
2222 Morris Ave. 2nd Floor,Union, NJ-07083
Website http//clinicspectrum.com/
Phone Number 908.834.1608
Email info_at_Clinicspectrum.com
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.
Copyright 2014. Clinicspectrum, All Rights
Reserved.