Practice Consulting

Professional Practice Resources provides a number of consulting services that are customized to match the needs of each practice. With over twenty years of national consulting experience for practices and hospitals for most physician specialties, PPR has developed a unique approach for assessing the true performance of a practice.

PPR’s services include but are not limited to electronic record consulting, financial audits, training of in-house medical billing staff and reception area, training of physicians, providers and all facility staff on medical billing and medical coding issues as well as proper processes and methodology. We offer two levels of assessment:

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.

Financial Performance Data Review

The off-site data review provides a diagnostic analysis of your business performance and includes the following assessments:

  • Analysis of electronic record and practice management systems
  • Analysis of fee schedules
  • Analysis of charges by CPT code and provider
  • Analysis of current payer-mix
  • Collection performance
  • Practice expenses