E & M codes are the most complex codes to interpret and account for more than 75% of the coding activity in many practices. Therefore they are the most likely codes to be used inaccurately. Many practitioners have a tendency to down code the patient encounter while using an ICD 9 Code specific to the diagnosis. The patient may appear to have been underserved with a Level 2 Office Visit and a complex diagnosis code.
Procedure Code Analysis :
Coding patterns of individual physicians are compared to the reported coding pattern of state specific physicians of the same specialty. High risk modifiers are isolated and codes that are outdated are highlighted.
Fee Schedule Analysis :
This analysis looks for the relational value of fee schedules for procedure codes based on the RBRVS scale. Precise methodology allows the practice to determine tolerances appropriate for the adjustments recommended in the fee schedule.
Practice Benchmarking :
Financial analysis is prepared on the performance of the practice over time. Trends in operating costs are isolated and investigated. Based on the number of FTE providers in the practice, levels of anticipated fee receipts and operating costs are determined. The practice needs to exploit its strengths while at the same time, shore up its weaknesses.
Physician Income Sharing Arrangements :
Incentive compensation arrangements can make the difference when you are recruiting a new associate. It likely will set you far apart from the competition. We can help you to determine the fee receipts necessary for the new associate to break even and also how the excess receipts would be allocated to the new associate. This illustrates to the outstanding candidate that he will be appropriately compensated for his efforts.
Recruitment Materials Preparation and Presentation :
Graphic presentations are prepared to familiarize physicians being recruited with the operating overhead structure of the practice. Graphic depictions are also prepared of the payer mix and five year trends in operating revenues and expenses. This analysis provides the physician insight into the revenue sharing arrangements utilized by the practice.
232 Regent Court
State College, PA 16801
(800) 253-3760
