Welcome to Cornerstone Healthcare Consulting & Management

Blog

Helping Medical Practices Remain Sustainable

by

Helping Medical Practices Remain Sustainable

In an era of constant change and increasing financial pressure, many private medical practices find themselves at a crossroads. The decision to sell to a health system or private equity firm often looms large, promising relief but at the cost of autonomy. However, for those practices determined to maintain their independence, navigating the path to long-term sustainability can be particularly challenging but not impossible.

The Pressure to Sell

Private medical practices face a myriad of pressures that drive the inclination to sell. From rising operational costs to the complexities of healthcare regulations, the difficulties can seem insurmountable. Yet, the desire to retain control over their practice and continue delivering patient-centered care keeps many practices from selling out.

The Struggle for Autonomy

Choosing not to sell means taking on greater hurdles to ensure the practice remains viable and competitive. This is where turnaround consulting services come into play. We specialize in helping medical practices that recognize their unsustainability but are resolute in their decision to remain autonomous.

Comprehensive Practice Review

Our approach begins with a thorough review of every aspect of the practice. This includes:

  • Financial Analysis: We scrutinize financial records to identify areas of inefficiency and potential savings.
  • Staffing Evaluation: We assess staffing levels and roles to ensure the practice is neither overstaffed nor understaffed, but optimally staffed for efficiency and effectiveness.
  • Technology Assessment: We review the technology in use, recommending upgrades or new solutions to enhance productivity and patient care.
  • Billing and Collections: We analyze billing procedures to improve accuracy and efficiency, thus boosting revenue cycles.
  • Operational Processes: We look at the overall operations of the practice to streamline workflows and reduce waste.

Tailored Recommendations

Upon completing our comprehensive review, we provide tailored recommendations for improvement. These recommendations are designed to address the unique challenges faced by the practice and to pave the way for long-term sustainability.

Execution Support

Identifying problems and suggesting solutions is only part of our service. If preferred, we also offer our expertise in executing the necessary changes. We work alongside the practice, ensuring that improvements are implemented effectively and efficiently, leading to tangible results.

Common Problems and Solutions

Many practices we’ve helped share similar challenges. Some of the most common issues include:

  • High Expenses: Unnecessary costs can drain resources. We help practices identify and eliminate wasteful expenditures.
  • Overstaffing: More staff does not always mean better service. We optimize staffing levels to balance cost and quality of care.
  • Outdated Technology: Using outdated technology hampers efficiency and patient satisfaction. We recommend and help implement modern solutions.
  • Inefficient Billing: Errors in billing can lead to lost revenue. We streamline billing processes to enhance accuracy and speed up collections.

If you don’t require a review of all the mentioned areas, that’s perfectly fine. We can create a proposal tailored to any specific aspect of your practice that you would like us to concentrate on. For instance, some practices may choose to focus solely on expense reviews. There is no one-size-fits-all solution; we customize our approach to meet the unique needs of your practice.

Conclusion

Maintaining autonomy while ensuring sustainability is a delicate balance for private medical practices. With our turnaround consulting services, we provide the support and expertise needed to overcome these hurdles. By reviewing every aspect of your practice and offering tailored recommendations, we help you remain independent and thrive in the competitive healthcare landscape.

If you’re a healthcare professional, practice manager, or doctor looking to keep your practice sustainable and independent, contact us today to learn more about how we can help. Together, we can build a future where your practice remains a beacon of patient-centered care and operational excellence.

 

Are You Ready to Solve Your Medical Practice Challenges?

by

Are You Ready to Solve Your Medical Practice Challenges?

Every day, medical practices face a multitude of challenges—financial pressures, patient overload, and burnout are just a few of the obstacles that can hinder your practice’s success. But what if there were effective solutions to these problems? Are you willing to take that next step towards improvement?

At Cornerstone, we understand the unique struggles that healthcare professionals encounter. We believe that instead of merely complaining about these issues, it’s time to take action. Here’s how we can help you transform your practice.

Common Problems Faced by Medical Practices

1. Financial Strain

Many medical practices struggle to maintain profitability. You might find that despite hard work and long hours, revenue isn’t meeting expectations. This could stem from unmonitored expenses, inefficient billing practices, or inadequate patient engagement.

Our Solution:

Cornerstone offers a thorough evaluation of your practice’s expenses to identify areas where you can save money. We usually identify annual savings of at least $25,000, with findings reaching as high as $260,000! If you suspect that the issue lies within your billing, we can examine it to identify any potential problems. Following that, we can provide guidance to your billing team for a more effective approach.

2. Patient Overload and Burnout

The increasing patient load can leave healthcare practitioners feeling overwhelmed. The pressure to see more patients often leads to burnout, impacting both your well-being and the quality of care you provide.

Our Solution:

Have you considered a Direct Care model? This approach allows you to build more meaningful relationships with your patients while managing your workload effectively. We can guide you through implementing this model, helping to reduce burnout and enhance patient satisfaction.

3. Inefficient Operations

Many practices suffer from outdated processes and technology that slow down operations. This inefficiency can lead to frustrated staff and dissatisfied patients.

Our Solution:

With our expertise, we can assess your current operational practices and recommend solutions that improve efficiency. From implementing modern electronic health record (EHR) systems to streamlining patient communication, we enable you to run a smoother operation.

The Next Step is Yours

Deciding whether to address the challenges your practice faces is crucial. You can choose to continue the cycle of complaints and stress, or you can take the courageous step toward change. Cornerstone is dedicated to helping you implement effective solutions tailored to your unique practice needs.

Don’t wait for the problems to escalate. Contact us today to learn how we can assist you in improving your practice’s financial health, reducing your patient load, and optimizing your operations. Together, we can create a sustainable future for your medical practice.

Take charge of your practice’s destiny today!

Common Front End Medical Practice Mistakes Leading to Claim Rejections

by

Common Front End Medical Practice Mistakes Leading to Claim Rejections

Medical billing claim rejections can have a significant impact on the revenue cycle of a medical practice. Unfortunately, many of these rejections stem from common mistakes made by front end medical personnel. Medical office managers and doctors must understand these mistakes to correct and prevent future denials.

Why Are These Mistakes Happening?

Before addressing specific errors, it’s essential to consider why these mistakes are occurring in the first place. Two primary factors often contribute:

  1. Speed Over Accuracy: In the fast-paced environment of a medical practice, staff may prioritize speed over accuracy, leading to errors.
  2. Lack of Training and Knowledge: Without proper training, front end staff might lack the knowledge needed to input patient demographic and insurance information correctly.

Common Mistakes Leading to Claim Rejections

1. Incorrect Patient Information

One of the most common errors is the incorrect entry of patient information, such as name, date of birth, or insurance details. Even a minor typo can lead to a claim rejection. Furthermore, if the patient is not the insurance plan subscriber, you must also obtain the subscriber’s name and date of birth. Incorrect information may lead to claim denial.

Solution: Establish a double-check system where the staff member entering the information reviews it thoroughly upon completion. Also, if staff complete eligibility ahead of the patient’s visit, many of these issues can be corrected in advance of being sent to the billing team.

2. Failure to Verify Insurance Eligibility

Not verifying insurance eligibility before a patient’s visit can lead to claims being denied due to lack of coverage. Also, as stated above, verifying eligibility ahead of the visit will allow staff to catch any information that may have been entered incorrectly, such as a wrong date of birth or insurance member ID number.

Solution: Establish a routine procedure to verify insurance eligibility for every patient visit. To allow time to address any issues, such as inactive coverage, avoid reviewing eligibility on the day of the visit.

3. Wrong Insurance Listed

Selecting the incorrect payor when entering the patient’s insurance information can lead to claim denials. A common area of confusion we frequently encounter is staff uncertainty about which BlueCross BlueShield plan to select for patients with out-of-state Blues plans. In these cases, staff should choose the local Blues plan. However, we have observed that staff sometimes struggle to identify the correct local Blues plan. If uncertain, staff should refer to the back of the insurance card for guidance.

Solution: Make a list of payer specific information commonly encountered by your staff. Always secure a scanned copy of both the front and back of the insurance card.

How to Prevent These Mistakes

Understanding the root causes and specific errors allows you to take proactive steps in preventing claim rejections. Here are some strategies:

  1. Prioritize Training: Invest in regular, comprehensive training sessions for your staff. Cover topics like accurate data entry, current coding standards, and payer-specific guidelines.
  2. Implement Quality Control Measures: Establish procedures for double-checking information and conducting periodic audits to catch errors before submission.
  3. Use Technology: Utilize practice management software that can flag potential errors and ensure compliance with the latest coding standards.
  4. Foster a Culture of Accuracy: Encourage a culture where accuracy is valued over speed. Recognize and reward staff who consistently demonstrate attention to detail.

Conclusion

By identifying and addressing these common mistakes, medical practices can significantly reduce claim rejections and improve their revenue cycle. Training, quality control, and a focus on accuracy can go a long way in preventing these errors.

If you need further assistance or personalized training for your staff, consider booking a consultation with our experts. Together, we can help you optimize your practice’s billing processes and minimize claim rejections.

Ready to take your medical practice to the next level? Contact us today to learn more about how we can help you improve your billing accuracy and efficiency.

Reclaiming Freedom in Practicing Medicine

by

Reclaiming Freedom in Practice Medicine

With Independence Day just around the corner, it’s a fitting time to reflect on the concept of freedom—particularly in the practice of medicine. Medical professionals often find themselves ensnared in a web of corporate control, whether it be from health systems, insurers, or private equity groups. These entities frequently dictate how doctors should perform their duties, restricting their autonomy and altering the doctor-patient relationship.

The Current Landscape

Today’s healthcare landscape is increasingly dominated by corporate ownership. This setup can impact physicians in several ways:

  • Health Systems: Larger health networks can impose strict guidelines and protocols, sometimes at the expense of individualized patient care.
  • Health Insurers: Insurers often dictate treatment plans based on cost-efficiency rather than optimal care.
  • Private Equity Groups: The focus on financial returns can sometimes overshadow patient-centric care.

All these factors leave many medical professionals feeling like cogs in a machine, rather than independent practitioners.

The Case for Private Practice

One potential solution to this dilemma is to consider private practice. While there are significant barriers, such as staffing issues, financial stability, and payor reimbursement challenges, the benefits often outweigh the drawbacks. In private practice, physicians have the freedom to:

  • Provide Personalized Care: Tailor treatments to individual patients without external pressures.
  • Enjoy Greater Autonomy: Make decisions that align with their professional judgment and ethical standards.
  • Build Stronger Patient Relationships: Develop long-term relationships that foster trust and continuity of care.

Overcoming Barriers

We understand that transitioning to or maintaining a private practice comes with its own set of challenges:

  • Staffing Issues: Recruiting and retaining skilled staff.
  • Financial Concerns: Managing overheads and ensuring financial viability.
  • Payor Challenges: Navigating complicated reimbursement processes and dealing with reluctant payors.

Solutions with Cornerstone Healthcare Consulting

This is where Cornerstone Healthcare Consulting comes into play. We aim to be your strategic partner in overcoming these hurdles. Here’s how we can help:

  • Staffing Solutions: Evaluate your current staffing model to determine if adjustments are necessary. Many private practices tend to be overstaffed. Should you consider adopting a hybrid model of remote and in-office work for some positions? We can provide assistance in all these areas.
  • Financial Management: Our specialized expense consulting services have helped medical practices save up to $260,000 annually.
  • Medical Billing Consulting: – Are you facing issues with the payor or the billing process in your practice? We can review your system and help optimize it.

Conclusion

As we celebrate Independence Day, let’s also contemplate the importance of independence in practicing medicine. Reclaiming your freedom to provide the best possible care is not just beneficial for you, but also for your patients.

At Cornerstone Healthcare Consulting, we’re committed to helping you regain control over your practice. With our support, you can navigate the complexities of private practice and focus on what you do best—caring for your patients.

Ready to reclaim your freedom? Let’s get started today.

Call to Action

Contact us at Cornerstone Healthcare Consulting to learn more about how we can help you achieve your goal of independent practice.

What Makes Our Healthcare Consulting Services Unique

by

What Makes Our Healthcare Consulting Services Unique

In the fast-paced and multifaceted world of healthcare, choosing the right consulting firm can feel overwhelming. The landscape includes diverse sectors such as life sciences, pharmaceuticals, hospitals, and private practices. Amid this breadth, it’s crucial to find a healthcare consultant who specializes in your specific area of need.

Our Specialized Focus on Medical Practices

While many healthcare consulting companies offer a broad range of services, our focus is clear and precise. We specialize in consulting for medical practices, providing a depth of expertise that sets us apart:

Starting New Practices

Launching a new medical practice is no small feat, and it requires a nuanced understanding of both medical and business operations. We offer end-to-end support to ensure your start-up is successful from day one. From choosing the right location and negotiating leases to setting up electronic health records (EHR) systems and ensuring compliance with all regulatory requirements, we cover every aspect to get your practice off the ground smoothly.

Fixing Existing Practices

Even well-established practices encounter challenges. Whether it’s inefficiencies in workflow, financial struggles, or patient retention issues, we bring targeted solutions to the table. Our team conducts thorough assessments to identify problem areas and implements strategies tailored to your needs, ensuring your practice operates at its full potential.

Running Practices Efficiently

Running a practice efficiently requires ongoing attention to detail and strategic planning. We don’t just offer one-time fixes; we can provide continuous support to ensure long-term success. Our services include:

  • Operational Management: Enhancing day-to-day operations to improve patient flow and staff productivity.
  • Financial Oversight: Implementing robust billing and coding systems to maximize revenue and ensure timely reimbursements.
  • Regulatory Compliance: Keeping your practice updated with the latest healthcare regulations to avoid costly penalties.

Medical Billing Expertise

Efficient medical billing is the backbone of any successful practice. We offer comprehensive billing services that reduce administrative burdens and improve cash flow. Our team is proficient in handling all aspects of billing, from claim submissions to follow-ups and appeals, ensuring you receive timely and accurate payments.

Why Private Medical Practices Need Our Expertise

Private medical practices face unique challenges that require specialized support. Today’s healthcare environment is more complex than ever, with increasing regulatory demands, financial pressures, and competition. Bringing in a consulting firm like ours doesn’t imply a failure of your Practice Manager. Instead, it provides an ally who can take on tasks they may not have time for or areas where they lack complete expertise.

Supporting Practice Managers

Practice Managers are the unsung heroes of medical practices, juggling multiple responsibilities daily. By partnering with us, they gain access to:

  • Expertise in areas they may be less familiar with, such as advanced data analytics or marketing strategies.
  • Time to focus on their core responsibilities without being overwhelmed by additional tasks.
  • Resources and tools that enhance their ability to manage the practice effectively.

Conclusion

In conclusion, partnering with our consulting firm can transform the operation of your medical practice. We bring a wealth of experience, specialized knowledge, and the latest resources to bear on your unique challenges. This collaboration not only alleviates the administrative and operational burdens on your Practice Manager but also positions your practice for sustained growth and success. In an increasingly competitive and regulated healthcare environment, having a knowledgeable ally can make all the difference. Let us help you navigate these complexities with confidence and peace of mind, ensuring that you can focus on providing outstanding patient care.

Using Data to Manage Your Medical Practice: A Comprehensive Guide

by

Using Data to Manage Your Medical Practice

In today’s fast-paced healthcare environment, managing a medical practice efficiently requires more than just medical expertise—it demands strategic use of data. By leveraging data analytics, healthcare professionals can streamline operations, enhance patient care, and drive practice growth. This guide delves into the transformative power of data in medical practice management and offers practical insights for healthcare professionals, practice managers, and doctors.

Why Data Matters in Healthcare Management

Improving Patient Care

Data-driven decision-making can significantly enhance patient outcomes. By analyzing patient records, treatment plans, and outcomes, healthcare providers can identify trends, uncover areas for improvement, and ensure that each patient receives personalized, evidence-based care.

Enhancing Operational Efficiency

Efficient practice management hinges on understanding and optimizing operations. Data analytics allows practice managers to monitor workflow, identify bottlenecks, and allocate resources more effectively. This results in reduced wait times, improved staff productivity, and better resource utilization.

Financial Management

Data plays a crucial role in financial planning and management. By tracking billing, revenue cycles, and expenses, healthcare practices can identify patterns, forecast future financial performance, and make informed budgeting decisions. This helps in maintaining financial health and ensuring sustainable growth.

Key Data Sources for Medical Practices

Electronic Health Records (EHRs)

EHRs are a goldmine of patient information. They contain data on patient demographics, medical history, medications, lab results, and more. Analyzing EHR data can help practices improve patient care, identify risk factors, and ensure compliance with medical guidelines.

Practice Management Systems (PMS)

PMS software manages the daily operations of a medical practice, including scheduling, billing, and reporting. Data from PMS can provide insights into appointment trends, cancellations, and no-shows, enabling practices to optimize scheduling and improve patient flow.

Patient Feedback

Patient surveys and feedback forms are valuable sources of data on patient satisfaction and experience. Analyzing this feedback can help practices identify areas for improvement, enhance patient engagement, and build a loyal patient base.

Practical Applications of Data in Medical Practice Management

Workflow Optimization

By analyzing data on appointment scheduling, patient wait times, and staff productivity, practices can identify inefficiencies and implement changes to improve workflow. For instance, data may reveal peak times that require additional staffing or highlight processes that need streamlining.

Patient Population Health Management

Data analytics can help practices manage patient populations more effectively. By segmenting patients based on demographics, chronic conditions, or risk factors, practices can develop targeted care plans, preventive measures, and outreach programs to improve overall population health.

Revenue Cycle Management

Analyzing billing and payment data can uncover issues in the revenue cycle, such as delayed payments or denied claims. By addressing these issues, practices can improve cash flow, reduce outstanding receivables, and ensure accurate billing practices.

Strategic Decision-Making

Data-driven insights support strategic decision-making at all levels of a medical practice. Whether it’s expanding services, investing in new technologies, or hiring additional staff, data can provide the evidence needed to make informed, confident decisions.

Best Practices for Data Management in Healthcare

Ensure Data Accuracy

Accurate data is the foundation of effective data management. Implement robust data entry protocols, regularly audit data for accuracy, and provide training for staff to ensure that data is entered correctly and consistently.

Maintain Data Security

Protecting patient data is paramount. Ensure compliance with HIPAA and other relevant regulations, implement strong cybersecurity measures, and educate staff on best practices for data security.

Foster a Data-Driven Culture

Encourage a culture of data-driven decision-making within your practice. Provide training and resources to help staff understand the importance of data, how to interpret it, and how to apply insights to their daily work.

Conclusion

The integration of data analytics into medical practice management is not just a trend—it’s a necessity. By harnessing the power of data, healthcare professionals and practice managers can improve patient care, enhance operational efficiency, and drive sustainable growth. Start by identifying key data sources, implementing best practices for data management, and fostering a data-driven culture within your practice. The future of healthcare is data-driven, and embracing this shift will position your practice for success.

Ready to revolutionize your practice with data analytics? Begin your journey today and see the transformative impact data can have on your medical practice management.