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Background
Academic physician practice associated with a state health science center, with
more than 700 FTE physicians providing a multitude of services through multiple
points of access with many challenges and difficulties with their revenue stream
and collection policies and procedures was experiencing almost crippling cash
flow problems.
Need
The project was designed for cash flow improvements, with a significant focus on
days in Accounts Receivable reduction.
Initially, GroupOne was charged with the redesign, implementation, management and oversight of the Universitities’ Medicaid billing and reimbursement division.
Recently, the University retained GroupOne to consult with their Medicare and Commercial insurance departments to duplicate efforts of the Medicaid department.
Results
Days in Accounts Receivable has decreased by 72.5% or by 233 days.
Total Medicaid Accounts Receivable has been reduced by 49.5%
Medicaid payment for the first quarter of 2000 has increased by 38% over the same period of the prior year, noting that gross revenues for the Medicaid department has remained steady during that time period.
Other departments have adopted many of the policies and procedures implemented by GroupOne.
Rectified a systematic problem with coding for Medicaid childhood preventative visits, resulting in an immediate cash flow of $2.9 million increase and incalculable future residual.
Training and education of staff, both front end and the consolidated collection staff members, as well as, the administrative personnel.
Creation and continual development of stringent tracking, trending, benchmarking and productivity reporting.
Background
A healthcare delivery system with a 98 physician multi-specialty group located in Southwest, Texas.
Need
Purpose and focus of engagement was to develop and service central business
office, accelerate immediate cash flow and build infrastructure for future
physician recruitment.
Physician group was in need of management expansion and implementation for
consistent and constant administration of group.
Results
Net Collection rate grew from 27% in 1996 to over 90% in 1997 after GroupOne
began consulting engagement with physician group.
Physician group currently has a net collection rate of over 95%.
84% of all physicians currently practicing in this MSO benchmark in the upper 10% of the MGMA Best Practices statistics for compensation.
Physician group grew from 31 physicians to 1996 to over 95 physicians in 2000.
Central Business Office redesign and departmental organization established.
Design and implementation of monthly financial reports for physicians, administration and accounting department.
Immediate recruitment of new specialties into MSO.
Implementation and maintenance of productivity standards with tracking and trending tools throughout operations.
On-going staff training and educational sessions implemented for physicians, office personnel and Central Business Office employees regarding coding and compliance, billing operations, reimbursement management and front office protocols.
Established standardized fee schedule for entire group. Established new encounter forms/superbills for clinics and hospital charge capturing.
Standardization of forms and protocols for Central Business Office and physician offices.
Development of coding and nomenclature resource venues for physicians and Central Business Office personnel.
Physician referral line set-up and implemented.
GroupOne serves as the Chief Administrative Officer, Chief Operating Officer, Practice Management Team and the Central Business Office director.
Background
A healthcare delivery system with approximately 150 multi-specialty group
physicians located in Hawaii. The Central Business Office is responsible for
both physician and hospital billing.
Need
Purpose and focus of engagement was to redesign and departmentalize Central
Business Office and to accelerate immediate cash flow.
GroupOne serves as the interim Central Business Office director to assure
consistent and constant oversight of project.
Results
$28 million cash flow increase over a 7 month period.
Average monthly increase in cash collections during the engagement was $4
million.
Central Business Office redesign and departmental organization established.
Implementation and maintenance of productivity standards with tracking and trending tools throughout operations.
On-going staff training and educational sessions implemented for Central Business Office employees regarding coding and compliance, billing operations and reimbursement management.
Standardization of forms and protocols for Central Business Office.
Cash acceleration strategies implemented by gathering, tallying and working through “back-log” to decrease accounts receivable and increase revenue.
Outsourcing of all physician accounts receivable over 90 days old to GroupOne for follow-up and expedition of cash flow.
Background
A 420 Multi-Specialty group affiliated with a not for profit health system.
Geographically dispersed throughout the southern Midwest, the system has a
complex infrastructure providing management services for physicians and allied
health professionals. The Central Business Office was experiencing sub optimal
collections during a time of transitioning physician compensation structure.
Need
GroupOne’s focus was the redesign and implementation of the Central Business Office and cash flow acceleration. The goal was to regain physician confidence in the centralized processes and procedures and to educate staff involved with the billing and reimbursement process.
Results
Increase in cash during the 8 month engagement as compared to the prior 8 month
period was $22.8 million dollars.
Average monthly increase in cash collections during the engagement was $3.26
million.
Days in Accounts Receivable significantly reduced.
Comparing the period of 9/98 through 2/99 through 2/00, average monthly charges increased only 14.26% while the average monthly collections increased by more than 45%.
Eliminate backlogs in rejected claims by streamlining the electronic claims “scrubbing” module.
Restructured the cash posting and processing area to reduce overall Central Business Office costs.
Eliminated unbilled charges bottleneck and backlog of appeals and reviewable claims.
Background
A healthcare delivery system with 40 participating multi-specialty physicians
located in the Midwest.
Need
Purpose and focus of engagement was to reorganize the Central Business Office,
create a central registration department, and accelerate immediate cash flow.
The Fee Schedule needed to be restructured and standardized for entire group of physicians.
Performance based contracts for the member physicians needed to be established to maintain cohesiveness and unity of the group.
Results
25% cash flow increase over the first seven month period.
Central Business Office established and departmentalized. Processes and procedures established and entry of physician charges decreased from approximately 8.5 days after date of service to 1 day after date of service.
Central registration department established which resulted in a dramatic decrease in error rate due to wrong demographic information.
Billing software updated and operational levels for CBO personnel redefined.
Established productivity standards with tracking and trending tools throughout the operation.
Mentored management at all levels and acted as a resource for inquiries and concerns.
Developed internal controls: tracking/trending and balancing procedures for all departments throughout the operation.
Collection of cash payments from patients in the physician offices increased by 50%.
Reimbursement management team established and trained to follow-up on all denied and open claims for all payors to expedite cash flow.
Increased physician satisfaction and outlook of group by providing accurate financial information based upon their performance and by demonstrating ways to increase productivity and compensation.
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| “Our practice overhead went from 59% down to 47% in 3 months” |
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