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Practice Management SolutionsEmpowering Podiatric Practices

Where do Practices Lose Money?

� 25%-35% revenue loss due to improper patient handling at the front office (missed phone

calls, patient no-shows, poor follow ups).

� Dissatisfied patients are 80% more likely to give negative referrals, adversely impacting the

flow of new patients.

� Average revenue loss of 32% due to insurance claim rejections.

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� 50% of rejected claims are never reprocessed.

� Doctors only collect 49% of patient balances owed.

� Doctors spend 75 -100 minutes a day supervising billing claims instead of seeing patients and

generating additional revenue.

Think of a typical week at your Practice

Read through an EOB letter to

understand why an insurance

company denied your dues

Wanted to speak to the

insurance company because

there seems be a trend here

Have discussed with practice

staff regarding productivity and

how patients must be handled

Leafed through the coding

letters that your specialty

governing body keeps sending

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Which of the above is related to taking care of patients? Yet we find practice after

practice spending more time on non-patient related activities so that they could stay in

business

Reviewed a demo of yet

another EMR system because

everyone is saying you should

Deciding what to do with those

patients who never seem to pay

Why Software Isn’t the Only Solution

“Why can’t I just buy advanced software and manage the front,

EMR, and back office in-house?”

StrategyTechnology

19%19%21%21%

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People

Process

21%21%

22%22%

17%17%

Governance

Your Operational Success Depends on More Than Just Technology

*Source: Oracle

Services – Turnkey Revenue Cycle Management

Revenue Projection: AHCBS will project your monthly revenue at the start of every month based on payer mix,

historical patient volume and revenue pending from account receivable.

Timely claims submission : Upon receipt of the encounter forms AHCBS will submit claims to the insurance company

within 24 hours.

Claim error checking : AHCBS will check all encounter forms to ensure that all relevant information for processing the

claim by insurance companies is available.

Accounts Receivable Follow up: Claims that haven’t been paid beyond a certain date will be flagged and followed up

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Accounts Receivable Follow up: Claims that haven’t been paid beyond a certain date will be flagged and followed up

on to ensure collection. In general, AHCBS will keep your 60 day outstanding accounts receivable below 20% and 90

day accounts receivable below 10%.

Patient statements: AHCBS will send out customized statements to patients with balances due on their accounts.

Payment Posting: AHCBS will enter all of the Explanation of Benefits, patient payments and insurance payments into

our patient management software to maintain accurate accounts receivable.

Patient billing hotline: Patients can dial AHCBS’s toll free number to speak to our collection specialists regarding their

bills. Our specialists have access to each patients account and can help answer any queries that the patient may have.

Services – Turnkey Front Office Management

Manage patient phone calls: We answer and route all incoming patient calls and centrally schedule, manage and

confirm or reschedule all appointments for the doctor's office

Manage insurance eligibility: We obtain eligibility verification from insurance companies prior to the patient's

appointment to ensure that there are no insurance denials due to patient's loss of coverage, deductibles not met, no

out of network benefits etc.

Manage Patient payment: We ensure that the right amount of co pays and deductibles are paid by patients.

Confirm Appointment: We confirm appointments by calling patients before the set appointment to ensure that the

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Confirm Appointment: We confirm appointments by calling patients before the set appointment to ensure that the

no-show rate can be significantly reduced.

Measure 'pulse of customer’': We conduct Patient surveys to understand their needs wants and sources of value. The

results are shared with the practice to modify operations to match those requirements.

We provide monthly reports on the health of the practice: The reports includes information on number of

appointments booked, number of calls received, common complaints, issues facing patients etc.

Monitoring call quality for audit and compliance: All calls made and received by the Virtual Front Desk personnel is

recorded and stored for a period of 3 months. These recordings can be provided to the client on demand as and when

required.

Services – Billing and Front Office Support

Appointment Confirmation Calls: We confirm appointments by calling patients before the set appointment to reduce

the no-show rate.

Pre-authorization Management: We obtain pre-authorizations from insurance companies for procedures that a

provider needs to perform.

Account Receivable Follow up: We follow up on outstanding insurance claims to support your existing revenue cycle

management operation.

The services below are offered on an Ad-Hoc basis

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management operation.

Patient Bill Follow up: We make soft reminder calls to patients with outstanding balances and can even take payments

over the phone.

Charge Entry: We can enter billing changes and patient demographics into your billing system.

Typical Client Results for Billing Services

� Decrease 90 day Aging to less than 10%

� Decrease in overhead costs by 50%

� Get monthly projections on your revenues collected with a +-10% accuracy

� Get weekly transaction summaries on revenue booking and collections

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� See how your practice is performing compared to your peers

Typical Client Results for Front Office

� Increase in patient volume of 15%-30%

� Decrease in overhead costs by 10%

� Increased patient satisfaction by 40%-80%, hence increasing patient recall

� Decreased load on existing clinical staff allows better patient care

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� Improved billing and collections since insurance, address and phone numbers are verified

before each appointment

Innovation Starts Today

Gary J. Mellon, DPM

gary@ahcbs.com

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www.ahcbs.com

Empowering Podiatric Practices

Your Partner In Delivering Quality Healthcare

Appendix

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Appendix

Certification

1. A risk assessment of the threats

to an Organizations/customer

information assets

2. Selection and Implementation

of effective and relevant policy

and control

3. Continuous review and effective

improvement

4. Total information security risk

1. Reduction in possibly damaging

/embarrassing information leaks

and failures

2. Total risk mitigation, security of

brand equity

3. Reduction in costs due to fewer

security incidents

4. Common policies and control

across the whole organization

1.ISO 9001 is the

Internationally recognized

standard for the quality

management of businesses

2. It applies to the business

processes that create and control

the products and services an

organization supplies

3. It prescribes systematic control

of activities to ensure that the

1. Implementing a Quality

Management System will motivate

staff by defining their key roles and

Responsibilities

2. Cost savings can be made

through improved efficiency and

productivity, as product or service

deficiencies will be highlighted

3. From this, improvements can be

developed, resulting in less waste,

ISMS Certification ISO Certification

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4. Total information security risk

management

5. Risk allocation, mitigation,

transfer, assurance and

acceptance

6. Protects the confidentiality,

integrity and availability of

organizational/third party

information

across the whole organization

5. Increased staff awareness,

involvement and empowerment

6. Better monitored and audited

systems and information flows

7. The risk of prosecution is

significantly reduced

of activities to ensure that the

needs and expectations of

customers are met

4. It is designed and intended to

apply to virtually any product or

service, made by any process

anywhere in the world

developed, resulting in less waste,

inappropriate or rejected work and

fewer complaints

4. Customers will notice that

orders are met consistently, on

time and to the correct

specification

5. This can open up the

market place to increased

opportunity

Sample Front Office Report

2479 2398 23402132 2259

20691753 1861

15682005 2070 2261

2250 2235 22191986 2151 2007

1711 18351542

1945 20212222

229 163 121 146 108 62 42 26 26 60 49 39

0

500

1000

1500

2000

2500

3000

Volume Analysis

Call Offered Calls Answered Calls Abandoned

3:16

0:00

3:28 3:243:05

0:00

3:023:32

3:05 2:59 2:51

0:00 0:00

1:402:12

0:400:00

3:00

0:370:12 0:19 0:18

1-A

pr

2-A

pr

3-A

pr

6-A

pr

7-A

pr

8-A

pr

9-A

pr

10

-Ap

r

13

-Ap

r

14

-Ap

r

15

-Ap

r

16

-Ap

r

Avg: Spent Vs. Avg: Hold Time

Avg: Spent Tme Avg: Hold time before call loss

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Appointment

Scheduling, 90

Appointment

Re-

Scheduling, 33

Transfer Calls,

367

Cancellation

Calls, 2

Prescription

Refill Request,

1

Information,

281

Dispositions Analysis

6

911

3 2 1 13

27

14

3

7:30

AM

8:30

AM

9:30

AM

10:30

AM

11:30

AM

12:30

PM

1:30

PM

2:30

PM

3:30

PM

4:30

PM

5:30

PM

Hourly Abandonment Analysis

Billing Sample Reports

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Billing Sample Reports

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Patient Satisfaction Reports

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Thank You

g a r y @ a h c b s . c o m