| Revenue Enhancement Professionals REP's focus has been to enhance the Medical Practice's Fiscal Health through matematical models such as Six Sigma, Chi-Square equations insurance data replication and historical submissions to the carriers and products that are or have an artifical intelligence to them to emulate or learn as the practice delivers it's daily processes. The approach to enhancing The Medical Practices Fiscal Health is not lost as we may think. If we were to build a building with the intent to lease out the suites, we would know how much the square footage is financially in order to be profitable. REP has the unique ability to Cost Account each and every CPT4 code in any Medical Practice today. Ask any Physician what it cost there practice to perform any procedure in there practice and they can not tell you. So if that is true how can they cost justify the purchase of new equipment, new software ie: a non-templated EMR, Practice Management Systems etc; Managed Care contracts that are presented to the Practice could be a loss in the practice and therefore we have for that plan or any other plan with simalar results we have a waiting room full of non- profitable patients. How can that cost justify any expenditure in their in their medical practice. REP focuses on the following areas to assist Physicians through the maze of: A: E/M Coding Analysis B: Cost Accounting per CPT4 code C: Managed Care Contract Analysis D: Procedure Code Compliance Analysis E: Modifier Code Analysis F: Fee and Reimbursement Analysis G: Physician Productivty Analysis H: |
| Physicians lose between 14% to 22% of Income to Insurance Carriers |
| What does it cost your practice to perform any procedure code? |
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Recently a contract we reviewed showed what the carrier was willing to pay the provider. The fee they were offering was $40.00 the practices cost to perform the procedure was $53.43 losing the practice $13.43 each time they performed it,also in the very fine print it stated that the co-pay was to be deducted from the $40.00..... we need to arm ourselves with the tools necessary to combat the insurance carriers!!! It makes good fiscal sense.
When given a managed care contract do we know we can be profitable by participating, or will we have a waiting room full of non-profitability and high acuity? If we know what our cost is we can either accept or deny participating. Without knowing our break-even we run the very high risk of loosing money but we are very busy..........
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| Analyzing Data is key to making critical business decisons for the Practice. Data is also a reflecion of the Compliance that any practice has, data also holds a very important key to the profitability of the Practice. |
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