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Case 1
Low Revenue
It is estimated that annually, third party payers withhold between $7.5 billion and $13.5 billion in physician payments. Existing problems inherent in the fee-for-service market are magnified even more by managed care payers, many of whom have stringent guidelines and limits. Often it's just too time-consuming and cumbersome for practices to keep track.
Solution:
A complete Revenue Practice Analysis (RPA). Our analysis takes into account all aspects of your practice's revenue base so you can optimize your income, comply with all billing standards, increase efficiency and be better able to negotiate with third party payers. The six main areas of our RPA include:
- Procedure Code Analysis
- Fee/Reimbursement Analysis
- Evaluation & Management Utilization Analysis
- New Procedure Pricing
- Relative Value Scale Analysis
- Cost Accounting/Break Even Analysis
Our RPA, however, goes well beyond identifying the problem. We provide specific solutions such as addition of procedure codes, revising the way certain codes are used, fee recommendations. In addition, we can identify utilization patterns that are either unprofitable or place the practice in jeopardy of a Medicare audit.
Case #2: Potentially risky and unprofitable managed care contracts
