Transcript Doing It Right The First Time

Small shifts that make a big difference in finance
12 month plan to lower your overhead
Steven A. Adams, CPC, CPC-H, CPC-I, CPC-P, CCS, CCS-P, PCS, FCS, COA
Because
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So What’s
Wrong?
Because
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Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Inman Equation
4 - 5 = -1
R - OH = P
It’s not 1’s fault
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
What Can You
Do?
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Object of the Game
Average practice with a
60%
Overhead
Has a
5%
Increase in Revenue
5%
Reduction in Overhead
Or a
Results in a
10% Gain in Profit
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 / 10 Rule
2008
2009
Revenue $ 500,000.00 ## $ 512,500.00
OH $ 300,000.00 ## $ 292,125.00
Profit $ 200,000.00
$ 220,375.00
A Small Change Makes a Huge
Difference
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Before We Begin
On the financial statement, there are more
than 30 lines showing us how we spend our
money. But there’s only one line that focuses
on how much we make. Increasing revenue
while decreasing overhead is the key to
financial success.
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Top Line Stuff
• A/R < 18% > 90 days
• Patient Debt < 20% of
A/R
• PQRI
• E-Rx
• EMR bonus
• Stimulus Package ’09
• Coding Correctly
• CCI Edits
• Fee Schedules /
Contracts
• Preventive Services
-
G0101
Q0091
G0372
99406
99407
G0102
G0179
G0180
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Now Your 12
Month Plan to
Reduce OH
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Month 1
Staffing Needs
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Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
II.
Largest expense 23-30%
List what you believe to be
the problems in the office
III. Can you outsource to save
money?
IV. Have staff list top 5 things
they do - look for overlaps
V. Look for high paid people
doing low pay work
mgma.com
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Month 2
Employee Salaries
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
Don’t just count FTE’s consider
a budget for staffing
II. Create a grid with positions and
create maximum salary
III. Consider raises based on
incentives plans for each
position
IV. Make your money their
money
V. Show employees their entire
benefit package annually
I.
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
salary.com
Month 3
Health Insurance
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
II.
III.
IV.
V.
Does everyone at your office need
their coverage?
Drop the dental and vision and/or
charge a percentage of the
premium to your employees
Consider a high deductible HSA /
HRA catastrophic plan
Partially or fully fund the
deductible with an “HRA”
Watch the person making this
decision
ehealthinsurance.com
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Month 4
Retirement Plan
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
II.
III.
IV.
V.
Pay yourself before anyone
else – look out for you
IRA income limits abolished in
2010 for converting to a Roth
IRA but stay for contributing
Take your 401K/201K and
diversify and reallocate
Invest in an IRA through MAG
with a 7% guaranteed growth
rate
The average doc will need
$3,000,000 in retirement to live
on 12,000 per month
cbpp.org
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Month 5
Sick Leave and
Overtime
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Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
Average sick is 5 days, average
vacation is 10 days
II. Update policy manual to reflect
separation pay and unused time
III. Just switch to CAL time 17 work
hours for 1 CAL hour
IV. Make your time their time
V. Why are your employees working
over time
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Month 6
Lease Agreements
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Patients
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patients
come
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your
patients
comefirst.
first.
5 Things to Consider
I.
II.
Operating stop provisions
Net rentable space and net
usable space
III. Is the insurance necessary
IV. Would it be cheaper in the
long run to own a building
than to rent office space
V. Look at the leases and
interest on your equipment –
you’re killing me
officefinder.com
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Month 7
Medical, Lab and
Office Supplies
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
Make a budget and stick to
it – Tie it into a staff bonus
– Make your money their
money
II. Consider ILS through MAG
III. Have one person
responsible for supplies
IV. If pass through billing for
labs check the bills
V. Requisitions forms work
and should be reconciled
by you
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
magmutual.com
Month 8
Outside Services
Because
Your
Patients
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First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
II.
Usually overlooked
Outside services CAN save
you money and help
ensure compliance:
I.
(coding and documentation, payroll,
bookkeeping, billing, collections,
budgeting, yard, janitorial, hardware,
software, HR management)
III. Inquire about free services
available from vendors,
IPA, Malpractice
IV. You’re paying for advice,
so listen
V. Always ask for a discount
[email protected]
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Month 9
Postage and
Telephone Calls
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
Stop sending indefinite
statements
II. Use a system like MD
Messages to confirm
patient appointments and
for lab results
III. Look at having statements
done off-site by your billing
vendor
IV. Look at stamps.com
instead of a meter
V. Put in a 900 line for rx
refills
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
mdmessages.com
Month 10
Advertising
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
How did your patient find
you in the first place?
II. Satisfaction survey helps
show you what works
III. Did the color add in the
yellow pages work?
IV. Are you on the web?
V. Its always cheaper to
keep an existing patient
than to find a new one.
Marketing never stops
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
masseyeandear.org
Month 11
Patient Refunds
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
Refunds are not a good
thing
II. Patient refunds should be
researched to find out what
went wrong?
III. Refunds to governmental
and private payers must be
made immediately
IV. Make sure you find out why a
plan requested money back
V. Take corrective action – keep
that cash
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
magmutual.com
Month 12
Petty Cash, Bank
Charges and Other
Things That Cost You
Money
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
5 Things to Consider
I.
II.
III.
IV.
V.
Make sure all petty cash is
accounted for with receipts
Make sure you only have one
receipt book at the front desk
Call the bank and ask if there is
another option for your primary
account based on your activity
If you use a credit card do you
have one with points that can be
used for future purchases
Call your mobile carrier and find
a way to reduce costs
magmutual.com
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Remember…
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Object of the Game
Average practice with a
60%
Overhead
Has a
5%
Increase in Revenue
5%
Reduction in Overhead
Or a
Results in a
10% Gain in Profit
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.
Any Questions
Office:
888.624.6474
Direct:
770.241.4344
E-Fax:
404-848-8661
E-mail:
[email protected]
Facebook:
facebook.com/people/Steven-Adams/1154124331
Because
Your
Patients
Come
First
Because
patients
come
Becauseyour
your
patients
comefirst.
first.