Do you know about - heighten Your Practice's Financial condition - Focus on the Four Ps in a Pod
Cigna Health! Again, for I know. Ready to share new things that are useful. You and your friends.This is the second in a series of articles on the financial condition of your practice. In the first article, "Conducting a convention Financial Analysis: Three significant Calculations," we discussed three significant ratios you should infer regularly in order to know where your convention stands from a financial perspective.
What I said. It isn't outcome that the real about Cigna Health. You read this article for facts about an individual wish to know is Cigna Health.How is heighten Your Practice's Financial condition - Focus on the Four Ps in a Pod
In today's article, we will discuss credentialing and contracting with managed care clubs to achieve the right payer mix for your practice's good financial health. The right outpatient mix boils down to knowing significant data on what we call the "Four Ps in a Pod: Payers, Payments, physician Productivity and Patients."
Payers
Before you can analyze your payer/patient mix, you need to decree what percentage of gross charges each of your payers represents.
Start with your Total Gross Charges for a period of time (month, quarter, or year). Make a list of all of your payers (you may choose to limit the list to your top 5-10 payers) Determine your gross charges for each payer over the same time frame as #1 (month, quarter, or year). Determine the percentage of Total Gross Charges by Payer (#3 divided by #1).
After completing such an analysis, you may end up with a breakdown as follows:
Medicare - 35 percent Medicaid - 12 percent
Blue Cross - 15 percent
United Healthcare - 12 percent
Aetna - 10 percent
Cigna - 10 percent
Other - 6 percent
Payments by payer
Next, you need to analyze payments by payer for your top Cpt Codes.
Make a list of the top 30-35 Cpt codes you bill. Put them in a spreadsheet with the Cpt codes down the left hand side and your top payers (determined above) across the top. Determine your repayment for each code by payer. The best way to do this it to reveal Eobs from each payer to decree their "allowed" estimate for each code. For diagnosis purposes, it is leading that you focus on the "allowed" estimate and not the "paid" estimate as the paid estimate doesn't contain any co-pays or deductible payments made by the patient.
Physician Productivity
For purposes of this analysis, you want to look at the estimate of patients seen per working hour per physician per payer. This will take a microscopic investigative time, but, the data will be invaluable.
Take the estimate of patients the physician sees each day. Divide this by the estimate of hours worked each day by the physician. (For example: 30 patients seen per day divided by 7 hours per day equals 4.3 patients per hour). This will give you a baseline from which to begin your analysis. Next, take a closer look at several typical days. Break the estimate of patients down by payer to see if a distinct outpatient profile requires more physician time. (For example: You will probably decree that physicians find it significant to spend more time with older patients who are more than likely Medicare patients.)
Patient Mix
Analysis of the data captured above is often an eye-opening experience for convention managers. Many decree that the majority of their gross charges come from payers with the bottom permissible amounts per Cpt code for patients who require more than the median estimate of the physician's time per encounter.
What Can You Do?
Consider revamping your outpatient scheduling law by blocking off new outpatient appointment times by payer in order to keep your payer/patient/payment mix in balance. For example: You may decree that you only want to accept a distinct estimate of new patients per month from distinct plans and so you block off the proper estimate of new outpatient appointment slots for that payer in your schedule. [Note: Make sure you reveal your ageement to make sure this doesn't violate anything you have agreed to do in terms of accepting new patients.] Are there distinct patient/payer ratios you would like to growth for your practice? institute referral relationships with physicians/practices that have a greater likelihood of referring patients from those plans. Shop to local businesses who offer those plans as part of their worker Benefits Package. Use this data while your next ageement negotiation with a payer. You may find that you are able to negotiate small increases in distinct Cpt codes even if you aren't able to negotiate an widespread increase. If you are prosperous in doing so with your most common Cpt codes, this could create significant added earnings for your practice. See how you portion up. Benchmarking yourself against other physicians/practices is a great way to decree if you are doing all you can to maximize convention revenue/profits. Here are some resources to help you benchmark your practice's performance:
The Mgma - www.mgma.com/physcomp The Ama - http://search0.ama-assn.org/search/search?database=public+amnews&query=benchmark+your+practice
© 2010 Efficiency in Practice
I hope you obtain new knowledge about Cigna Health. Where you can put to use within your evryday life. And most importantly, your reaction is Cigna Health.Read more.. heighten Your Practice's Financial condition - Focus on the Four Ps in a Pod. View Related articles related to Cigna Health. I Roll below. I actually have recommended my friends to help share the Facebook Twitter Like Tweet. Can you share heighten Your Practice's Financial condition - Focus on the Four Ps in a Pod.
No comments:
Post a Comment