Your Practice 5 ways to regain financial control

1. Steven A. Adams, CPC, CPC-H, CPC-I, PCS, FCS, COA Your Practice 5 ways to regain financial control

2. Five Ways to Increase Your Income Step 1: Understand the Reimbursement Process Step 2: Reduce denials Step 3: Understand Revenue, Collections, and Overhead Step 4: Deal with Accounts Receivable Step 5: Implement

3. What’s Going On? 20

4. 1. Reimbursement Process 3

5. To Evaluate Reimbursement Key Points • Find out what you are doing • What you are getting paid • If not or not enough why • Either way, correct it

6. 9 What Are You Doing?

7. 10 What Are You Getting Paid

8. Are You Doing Everything Right? Is Anything Missing From Your List?

9. 9

13. It's Your Money Don’t overlook ANY POSSIBLEsource of legitimate revenue

14. To Evaluate Reimbursement Key Points • Find out what you are doing • What you are getting paid • If not or not enough why • Either way, correct it

15. 2. Reducing Denials 4

16. Reducing Denials Key Points • Your staff hates working denials • Working denials costs you PROFIT • Denial reports should be mandatory • When you find something wrong, fix it

17. Nearly 20% Of all claims are returned because of missing information of CMS 1500 form

18. How They Occur Usually a claim fails to pass a computer edit

19. Top 6 Denials • Duplicate Charge - Processed / Processing • Not Medically Necessary • Patient not Identified • Code No Longer Recognized • Incomplete CLIA Number • Information Does Not Support Number of Services Provided

20. 10

21. Reducing Denials Key Points • Your staff hates working denials • Working denials costs you PROFIT • Denial reports should be mandatory • When you find something wrong, fix it

22. 3. Revenue, Collection, and Overhead Ratios 6

23. Ratios Key Points • Establish Goals • Work to meet goals • Monthly physician meetings are to be mandatory • When you find something is wrong, fix it

24. Revenue, Collections & Overhead • You Need 5 Pieces of Information • Total Charges, Adjustments, Receipts, Aged A/R, and a Financial Statement • Collection Ratios - Gross & Net • Office Overhead and Profit Percentage • Months in A/R

25. Establish Practice Goals to Measure Success

26. Receipts $348,668 61% Charges $575,831 $348,668 12 $575,831

27. Receipts 94% $348,668 Charges - Adjustments $575,831 - $205,421 $348,668 12 $370,410=

28. Be very careful about staff making Adjustments

29. Financial Information 20

30. High Overhead 77% • Low Revenue • Poor Management • High Staff Salaries • Poor Contracts • Lack of Budgeting 20

31. Ratios Key Points • Establish Goals • Work to meet goals • Monthly physician meetings are to be mandatory • When you find something is wrong, fix it

32. 4. Accounts Receivable 8

33. “Every dollar you earn, but fail to collect, is a cost to your practice.”

34. A/R Balance $91,101 Average Monthly Charges $47,985 2.0 $91,101 12 $47,985 =

36. What’s a Dollar Worth? US Department of Commerce

37. 0-30 days 31-60 days 61-90 days 91-120 days 120 + days $42,636 $6,542 $4,424 $5,510 $31,989 What is A/R Worth? $91,101

38. 0-30 days 31-60 days 61-90 days 91-120 days 121 + days $42,636 $6,542 $4,424 $5,510 $31,989 What is A/R Worth? $42,636 $5,887 $3,539 $3,857 $12,795 $15,987 Loss

39. 5. Just Do It!!

40. Revenue - Overhead =Profit

41. Cuts Expenses & Codes & Collects The Same 20

42. Doesn’t Cut Expenses But Codes & Collects Appropriately 21

43. Think About This On the financial statement, there are more than 30 lines showing us how we spend our money. However, there is only one line that focuses on how much we make. To me, that’s the most important number on the financial report, yet nobody acts like they know how it is to be addressed. Now You Do!

44. Work Smarter, Not Harder Because . . . 50% Overhead (average practice) With a 5% Increase in Revenue Or a 5% Reduction in Expenses Will result in 10% Gain in Your Salary

45. If All Else Fails, One Pill, That’s All…

46. Any Questions Office: 888.624.6474 Direct: 770.241.4344 E-Fax: 404-848-8661 E-mail: sadams@magmutual.com Facebook: facebook.com/people/Steven-Adams/1154124331