Practice Start-ups

We are able to provide you with all aspects of practice development including some of the following: incorporation, obtaining provider numbers, site selection, equipment purchase, staff selection, managed care contracting, office policy/procedures, marketing and business plan development.

Managed Care Contracting

For many organizations, dealing with managed care related issues such as contract negotiations or claims denial management can be a complex, time consuming and often a daunting task. Staff members are rarely dedicated to devote full-time efforts on only this type of work. Our staff members provide you with the expertise and resources to handle all of your managed care issues on your behalf.

Billing and Collections

For busy medical offices, the best thing they can do to maximize their reimbursement is to put their medical billing in the hands of the experts. We have been billing insurance carriers for over 25 years. We are specialists in third party reimbursement, and medical practice management. Health care reimbursement has become more complex over time. Medical practices are increasingly turning to professional medical billing companies to handle their third party reimbursement. Many groups have found that it is cost effective to outsource their medical billing with the added benefit of saving money on constantly changing technology in addition to the various payor rules and regulations of medical billing.

Business Plan Development

The development of a business plan is the key for practice development. Too often, a practice is too busy reacting to situations without a clear business plan designed with one year, two year and five year business objectives. A business plan attempts to not only incorporate professional objectives but also personnel, economic, and lifestyle concerns. A well-designed business plan that has been signed off on by the physicians then allows a strong administrator to move forward with objectives and allow a practice to grow. A Business Plan is required when seeking financial assistance.

Policy/Procedure Development

The development of policy/procedures is a key component for organizations especially if they are seeking to contract with Managed Care plans and/or will be seeking any type of accreditation. Everyone needs to know the rules. A source document allows staff to review policies and make decisions without the frustration of misaligned interpretation by staff members, the office manager, or physicians. It allows issues to be handled fairly, consistently, reduces legal liability, and lowers staff turnover due to frustration over unknown job duties.

Credentialing

Credentialing is one of the most important aspects of new office start-ups. The process of "signing up" with carriers for the first time can be tedious and overwhelming, especially when an organization is just starting out. We have experienced staff members who can help you either obtain credentialing if you are starting a new practice or get you re-credentialed if necessary. We will fill out each application, submit it to the insurance companies and follow up until credentialing is achieved. We will provide you with a biweekly update of your credentialing status to help you know when you can expect to be done with the process.

Coding

This service conducts chart audits using HCFA’s new Evaluation and Management Guidelines as well as NCQA chart format standards. The coding process not only looks to enhance coding opportunity but trains physicians and staff on appropriate coding methodology.

EMR/EPM System Evaluation

The increasing demands on practices to provide information has created an increasing demand for organizations to evaluate their technology partners and the actual products themselves. This evaluation process creates a RFP for vendors to respond to as well as outlining exactly what is currently needed in computer services as well as develop an action plan based on anticipated growth.