On-site Comprehensive Financial Analysis and Operational Assessment

During our on-site analysis and assessment, a PPR senior consultant completes a detailed financial analysis and operational assessment of the entire practice. Several sources of data are used to complete each practice assessment. These include:

Financial Analysis

Service Analysis - Assesses the mix and volume of services being provided to determine whether current services are in line and/or whether additional services may be offered to increase profitability.
Productivity - Several measures of service and financial volumes are compared to national norms.
Payer Mix Analysis - Evaluates percentage of total charges attributable to each patient financial class.
Contract Analysis - Analyzes allowable payments and other terms of managed care contracts to evaluate their profitability.
Charge Capture - Determines if each clinical service is captured as a charge and appropriately billed.
Coding - Analyzes the accuracy of procedure (CPT) and diagnosis (ICD-9) coding to evaluate where better coding can increase collections.
Fees - Assesses the practice's fee schedule to identify under priced and overpriced services A recommended fee schedule will be provided that maximizes collections and allows patients to receive maximum benefit from their insurance.
Billing and Receivable Management - Examines the collection performance of the billing operation against an established target.

After requesting, receiving, and analyzing practice data, we interview each physician to assess charge-capturing, meet with key staff, review a sample of medical record encounter notes and the corresponding charges, and review the workflow of the billing process. We prepare a report of our findings and recommendations and present that report in a meeting with the physicians and key staff.

With this detailed report and analysis in hand, the managing staff of the practice has metrics that allow them to easily determine if they are as profitable as they should be for the clinical services they provide. Additionally, they have new management tools that enable them to take the corrective actions indicated.

Operational Assessment

Non-Medical Office Staff - An analysis of productivity, training, skill level, job descriptions, and staff levels of non-physician personnel.
Materials Management - Assesses inventory, ordering policies and procedures, as well as storage and accessibility of supplies.
Appointment Scheduling - Reviews patient flow process in order to increase overall productivity for office staff; and increase patient satisfaction by minimizing wait time.
Medical Office Facility - Identifies whether the facility is adequately meeting the needs of the practice (e.g. attractive appearance, enough exam rooms, etc.) .
Computerization - Analysis of typical office systems (e.g. electronic record and receivables management, appointment scheduling, word processing, telephones, facsimile, etc.)
Policies and Procedures - Review of the practice's policies and procedures for all office functions.
Marketing- An analysis of the practice's referral sources and patient origin, marketing materials, and practice building activities.

An off-site comprehensive financial analysis and operational assessment.