An essential element of any medical practice is to assess and review accounts receivable aging, net and gross collections percentages, and how many days on average it takes to process a claim.  A practice may also want to understand their demographics, referring providers, insurance payer mix, work Relative Value Units (RVUS) and other important aspects of the business to make sound financial decisions.

MedPro Services provides custom analysis and consulting services that will provide information on how to increase revenue.  Listed are just some of the assessments MedPro Services offers:

  • Review with analysis of correct surgery coding: Are you capturing all your charges and not leaving payable CPT codes off your claims?  Are you coding to the highest RVU for services rendered?
  • Review of aging insurance claims: Are aging claims being reviewed in a timely fashion?  All claims should be reviewed no later than 45 days.  Per Industry standards all Insurance aged accounts over 120 days should be no less than 9-12% of your total revenue.
  • Net and gross collection ratio: Do you know your Gross Collection Ratio (GCR)?  An annual goal should be 100% completion of your GCR.  If your practice is not at 100%, then the goal should be to trend in that direction.  The GCR is based on your fees and allowable insurance amounts.
  • Days in accounts receivable: How many average days does it take to receive reimbursement or correspondence on claims?  According to some contracts, you are entitled to interest if a clean claim is not paid within your contracted time line.
  • Payor insurance mix: With what insurance does your practice see the highest percentage of patients?
  • Facility analysis: Does your satellite office make enough money through reimbursements to support expenses?
  • Employee evaluations: Is your staff educated and experienced enough to deliver the highest quality billing for your practice?  Have you placed employees in the appropriate positions?  Is there clarity around job descriptions, responsibilities and expectations for each staff position?
  • Use of legal and informational forms: How does your financial agreement read with your patients?  Do you educate your patients regarding financial responsibilities prior to services?  Are your patients signing HIPAA forms each visit?  Do you have your Medicare patients sign Advance Beneficiary Notices (ABN) prior to services that are expected to be denied?