Clinical Business Framework

Florence discussed her analysis of her senior PA's productivity, focusing on patient visits and working days. She noted a decrease in productivity due to the PA taking PTO and being less available. Florence calculated that the PA sees about 12 patients per day, which she considers acceptable given the complexity of their patients. She is working on getting more accurate numbers for expenses related to the PA's salary and benefits.

Florence discussed challenges with patient no-shows and scheduling, noting that while her provider has a full panel of 21 patients per week, they often see fewer due to cancellations. She decided to allow the provider to see one new patient per day from the waitlist to better utilize empty slots. Jennie suggested exploring policies around no-shows and rescheduling fees, while Florence shared that their practice currently charges a $25 fee for two no-shows or rescheduling incidents. They also discussed the limitations of online booking platforms like ZocDoc, which Florence found problematic due to high no-show rates and costly per-patient charges.

Vin discussed significant issues with billing and revenue tracking due to disconnected systems between their EHR and clearinghouse, which has made it difficult to generate accurate reports and reconcile financial data. Jennie and Florence shared their experiences with similar challenges, with Jennie noting that even large organizations can face reporting mismatches, while Florence described how she improved patient collections from 80% to 96% by implementing a real-time eligibility checking system. The discussion concluded with Florence explaining how she now pays a flat monthly fee for the eligibility checking service, which also helps generate accurate revenue reports.

Florence discussed implementing a new system called Superscript for patient check-in and insurance processing, which costs approximately $999 per month and has been operational for about nine months. The system automatically handles insurance eligibility checks and co-payment collections, though there were some initial glitches with Medicare collections in January that required manual review. Florence noted that while the system guarantees 96% accuracy in collections, the remaining 4% requires manual follow-up, and the system's accuracy has improved over time.

The group discussed billing and financial challenges, with Vinika explaining she had engaged an external bookkeeper and consultant to address issues with her EMR systems and billing processes. They discussed her plan to audit her current biller while implementing new systems to improve reporting accuracy. Florence shared her progress in analyzing profitability across different exam rooms and testing procedures, with Jennie advising her to focus first on overhead costs before diving into specific service line profitability. 

Clinical Business Framework Live Call - January 27

Jennie introduces the peer group @ 13:10

Jennie explained that the purpose of this peer group is to provide a collaborative space for the participants to learn from each other, troubleshoot challenges, and gain a deeper understanding of their independent practices. She emphasized the goal of making data-driven, intentional business decisions rather than relying on gut instinct.

Florence's practice overview @ 16:47

Florence shared that she started her solo neurology practice in the midst of the pandemic in 2020, after previously working in a multi-specialty practice for 10 years. She is now looking to expand her practice by hiring additional physicians and growing her service offerings.

Vineka's practice overview @ 23:50

Vineka discussed the recent challenges with her psychiatry practice, including issues with her billing and bookkeeping. She is currently going through a valuation process and working to clean up her financial records and processes.

Diving into service lines and profitability @ 46:00

Jennie led a discussion on the importance of understanding the profitability of different service lines within the practices, such as procedures, provider visits, and ancillary services. She challenged the participants to select one service line to analyze in depth over the next month.

Coding and billing discussion @ 1:07:22

The group discussed the use of the G2211 code for chronic care management, including the appropriate modifiers and billing considerations. Vineka and Florence shared their experiences with this code and other billing-related topics.

Next steps and communication @ 1:14:26

Jennie outlined the next steps, including providing a template spreadsheet for the participants to analyze their service lines. She also discussed the preferred communication method, deciding on using a WhatsApp group.