NAVIGATION

U N I V E R S I T Y P H Y S I C I A N S ' A S S O C I A T I O N , I N C .

S O L U T I O N S T O E N H A N C E T H E   M E D I C A L P R A C T I C E

CHARTING YOUR COURSE THROUGH THE RAPID CHANGES OF HEALTHCARE

2018

Our Footprint

25 Counties

Anderson, Blount, Campbell, Carter, Claiborne, Clay, Cocke, Cumberland, Davidson, Hamblen, Hamilton, Jefferson, Knox, Loudon, McMinn, Monroe, Putnam, Roane, Sevier, Shelby, Sumner, Union, Washington, Williamson, Wilson

October 2018

Senior Executive Team

October 2018

Christy Bailey, RHIT, CPB

VP Client Strategy & Revenue OperationsMItzi Vaughn

VP Contracting

Kerrie Harless VP Physician Services

Scott A. Stucky, SHRM-CP, PHR

VP Human Resources & Chief Financial Officer

Betzaida Shands VP Regulatory Affairs & Chief Compliance Officer

Teresa A. Matherly

VP Information Systems & Chief Information Officer

Kim Friar Chief Executive Officer

Robert F. Elder, MD

President

Jerry B. Willis, MBA

VP Operations & Chief Operations Officer

Turbulent waters can change your course without ample warning.

Our JourneyCorporate Office

9000 Executive Park Drive . C200

Knoxville, TN 37923

O: 865.670.6700

Medical Staff Office

2121 Medical Center Way . Suite 100

Knoxville, TN 37920

O: 865.305.8872

That Is Exactly Where We Began.

Physician Established Since 1995 Physician Owned and Physician Trusted

Let UPA Charter Your Course Through the Rapid Changes of Health Care.

Navigating Through The Rapids

Surgical hands were shuffling papers rather than

holding sterile tools during a turbulent time in the

90's.  The East Tennessee Managed Care

Organizations were taking lead in managing the

TennCare patient population.  Hospital physicians

began a series of meetings in order to secure the

clinical practice amid these changes.  Thus, 231

multi-specialty physician members agreed, under

one signature, to oversee capitation contracts with

the MCOs further developing into a physician

health organization; University Physicians'

Association, Inc. (UPA).

Bridging the Gap

UPA is governed by a team of 19 multi-specialty

physicians that are elected by their shareholder

peers. Each year, nominations are

received from shareholders then

presented as candidates for the annual election

by ballot.  Board positions rotate under a three

year commitment. 

Keeping a steady course with a profitable

outcome earned UPA respect from both clinical

and administrative entities. During the turn of the

21st Century, it came to no surprise UPA  bravely

accept the challenge to bridge the gap between

hospital privileges, managed care and

credentialing. Therefore, in 2003, UPA contracted

with an academic hospital to manage the Medical

Staff Office with attention to physician services.

UPA continues to manage the coordination of the

credentialing process and activities between UPA

and the hospital as they relate to its Bylaws,

Policies and Procedures, The Joint Commission,

NCQA and the physician committee structures.

Governing Board of Directors

What began as a need to secure the clinical

practice over 20 years ago remains the same

today.  The health care industry continues to

bring new challenges and UPA was designed

to adapt to these unforeseen circumstances.

UPA's reputation remains solid. With continued

focus on its foundational values of integrity,

accountability, expertise, versatility and

partnership, our mission is to offer the medical

community seamless, knowledge-based

solutions by providing accountable services

customized to meet each client's specific needs

and challenges.

Insight

UPA has an abundant amount of resources and

longstanding relationships with major carriers

and entities that allow for easier access when

faced with unexpected issues.  We seek the

challenges and are prepared to move in any

direction in which health care may travel.

Overflowing Resources

October 2018

Revenue Cycle ManagementBenefits to UPA Medical Billing.

UPA Revenue Cycle Management offers a personalized approach to manage your practice revenue

and optimize your practice's financial health.  Your practice is not just an account number at UPA,

we become an extension of your practice.  We work in conjunction with the practice managers and

providers to best serve the needs of our clients.  UPA handles the complexities of medical billing

while you focus on patient care.  We offer transparent, face-to-face communication and search for

every dollar. 

UPA is Specialized in Solo Practice, Group Practice & Large Health Systems

Dedicated Account Manager.

Practice Management Software.

Automated Insurance Eligibility Verification.

AAPC Certified Professional Billers.

AAPC Certified Professional Coders.

AAPC Certified Physician Practice Manager.

AHIMA Certified Registered Health Information Technologist.

Effective A/R Management with "Smart" Claims Control Software.

Statement Generation and Patient Collections.

Monthly Dashboard Reporting.

Reoccurring Meetings with Insurance Provider Advocates to Resolve

Payer Issues.

Local Customer Service Department for Clients and their Patients.

Local Support & Onsite Set Up and Training.

Experience With Over 40 Specialties.

Curing Your Headaches

Recovering Your RevenueDecrease Denials and Reduce AR Days.

Increase Collections and Accelerate Cash Flow.

Avoid Costly Delays Due to Staff Turnover,

Vacations and Illness.

Eliminate Expenses for Training, Coding and

Billing Staff.

Prebill Claim Scrubbing to Reduce Coding

Denials.

Daily Claims Transmission.

Specialized Appeals Department.

Reimbursement Analysis.

ERA/EFT Enrollment for Faster Payments.

Christy Bailey, RHIT, CPB

VP Client Strategy & Revenue Operations O: 865.670.6161

October 2018

Co-Employment SolutionsHuman Resources, Payroll and Benefit Solution.

Web-based Human Resource Management Software.

Payr

oll

Recruiting assistance including online job posting, resume management, and candidate screening.

Online onboarding system, including I-9 documentation and E-Verify to streamline the process for new hires and

clients.

Conducts orientation for all new hires including background check, drug screening, required compliance training,

benefit and policy review.

Facilitates online annual review of compliance materials, including quizzes on each topic to ensure understanding

and track completion by all team members.

Conducts monthly checks for licensure and exclusion from CMS participation.

Administers and tracks FMLA to ensure compliance with Federal guidelines.

Provides Employee Relation expertise to assist with all situations that arise and help ensure they are handled legally

to minimize risk, including but not limited to corrective action assistance and termination administration.

Workers Comp coordination with injured team member and carrier to ensure team members receive any treatment

needed and return to work as directed.

HR legislation monitoring.

Provides all clients with UPA Handbook and Policies to help serve as a guideline.Hum

an R

esou

rces

Administers and provides benefit plans including Medical, Dental, Vision, Life, Disability, Critical Illness, Flexible

Spending Account, 401k, PTO, Sick, Other Leave.

Ensures compliance with regulations including ACA.

Provides team members with support on benefit related questions.

Offers a robust wellness program to encourage healthy living which can reduce absenteeism, improve productivity

and help lower insurance premiums.

UPA team members and members of their household have access to EAP 24/7 and have access to three five visits

with a counselor if needed.

Recognizes all team members at five-year anniversary dates.

Provide retirement planning advice through a third-party financial service.

Bene

fits

O: 865.670.6110Scott A. Stucky, SHRM-CP, PHR

VP Human Resources & Chief Financial Officer

Helping Clients and Team Members Achieve a Competitive Advantage.

Online timekeeping system with a built-in time off calendar that includes leave balances and requisition process

allowing for future dated time off tracking.

Web and Mobile App access to payroll, benefits, open enrollment, reporting, direct deposits, and W-2's.

Includes Federal, State and local tax filing on our clients' behalf.

Provide training for client payroll supervisor to maximize the functionality of the payroll system.

Payroll reports breaking down employer costs for client's financial records.

Monitoring and implementation of DOL Wage and Hour Division changes in legislation.

UPA reviews and balances payroll for accuracy and proper payment.

UPA is a registered and licensed PEO in the state of Tennessee.  We maintain certification in Human Resources and provide knowledgeable

staff to assist in all areas of human resources, payroll and benefits.

October 2018

Practice ManagementO: 865.670.6711

Sandra Jones

Director Practice Management

Reaching Beyond Clinical Care to Enhance Patient Experience.

At UPA, we have a proven track record of success in managing all sizes of complex practices across specialties. 

We can remove your worry out of practice management while allowing you more time to focus on patient care. 

Quality practice management requires a detailed understanding of your priorities coupled with competence,

professionalism and loyalty.

We begin with a complete emersion

into the practice to get a complete

understanding of the staff and

operations.

We collaborate with physicians and

clinical staff to address patient care

needs and issues.  From front office

to providers, we evaluate your

current staffing levels and patient

volumes to ensure you have optimal

productivity while ensuring an

appropriate work-life balance.

The patient experience is critical to a

successful practice.  Studies have

shown that patients evaluate the

quality of care based on everything

they encounter with the office from

the first phone call to when they

leave the appointment.

Throughput is critical to

maximizing revenue. We want

to make sure that you are paid

for your efforts; and paid

quickly.  We conduct monthly

reviews of each physician's

financial report and follow up on

improvement strategies as

needed.  We will work in

partnership with your billing

service through the denial of

claims, appropriate fee schedule

and timely/accurate

submissions of claims; while

investigating new ancillary

services for added revenue

stream.

There are a variety of projects that

we can undertake to address your

key priorities.  We have experience

with a wide range of practice sizes

and specialties,  Through our years of

experience, we hold a very

broad knowledge base with all

aspects of practice management. 

We can offer support during

implementation of new services

(such as billing/EMR) ; and be the

point person for office renovations or

expansion.

Our Pillars of Strength.

We understand that practice management has become complicated and time consuming.

Project Management:

Organizational Structure:

Clinical Workflow: Revenue Optimization:

Policy Development:

October 2018

ComplianceO: 865.670.6117

Betzaida Shands

VP Regulatory Affairs & Chief Compliance Officer

Is Your Practice Ready If The Government Comes Knocking?

UPA Compliance: A Partner You Can Trust!

Compliance Program Start-up.

Compliance Program Assessments.

Compliance Risk Assessments.

Development and Monitoring of a Compliance Training Program.

Development of Policies and Procedures and Code of Conduct.

Assistance with Internal Investigations.

HIPAA Privacy and Security Program Implementation.

With the increase in regulatory scrutiny, health care providers must navigate through countless

regulations imposed by government and payers to avoid civil and monetary penalties.

Here at UPA, we are committed to a culture of compliance. Our knowledge and skills provide support to

our clients to achieve compliance and stay ahead of this ever changing regulatory environment.

UPA can assist your organization in the following compliance functions: 

October 2018

Essential Services O: 865.670.6179Mitzi Vaughn

VP Contracting

Timeliness of Credentialing Affects Your Bottom Line.Failure to become credentialed is the most crippling mistake that any provider can make. 

Completion of credentialing.

Applications with various health plans and

timely follow-up until credentialed.

Assistance with obtaining NPI.

Coordination with the hospital for your

updated documents.

UPA's Essential Services Includes:

Application Fees:

Without being

credentialed, providers

will not be paid with the

health care plans whom

are regulated by the State

and Federal Regulatory

Agencies and the National

Committee for Quality

Assurance.

October 2018