A more efficient medical billing system helps an Ohio practice make sure the money it spends on physician recruitment doesn't go to waste.
Many physician practices spend a significant amount of time on what they think is really important: recruiting new talent—specifically, physicians—to contribute to growth of the practice. But there are significant limits to how much they can contribute if the practice's business systems aren't up to snuff. If you're running the practice, the question you have to ask yourself is: Are you spending your time and money on the wrong initiative?
Jeff Fox is executive director of business development for Riverside Radiology Associates in Columbus, OH. The 70-physician practice has seen considerable growth in recent years. In 2004, Riverside had 36 physicians and did 360,000 procedures annually. Now, with 70, it does more than 800,000. But Fox was disappointed that shortcomings with the practice's previous outsourced billing system were causing patients to view their experience with Riverside negatively.
"We spend a lot of money, time, and effort recruiting the most talented physicians in the country who are board-certified and subspecialty-trained," he says. "What we were finding was that the patient had good clinical experience but we were getting a lot of complaints regarding our billing. If that's what the patient remembers, you've wasted that effort on recruiting and talent."
Riverside "closed that gap," he says, by bringing its billing back in house—going against the grain for many physician practices that simply want the headache of billing gone.
Riverside uses Zotec Partners' medical billing system, which it chose after a 10-vendor RFP process because of its ability to provide automated claims processing, proprietary claims editing systems, automated secondary claims processing and appeals, and comprehensive carrier requirement databases, among other features.
Over time, Riverside has cut its costs associated with billing in half.
"When I put together the pro forma and built the model to open our billing company, doing 360,000 procedures annually was going to take 20 FTEs," Fox says. "We only hired 12 for that volume once we realized the software's capability. Now we employ 22 for the current volume, and we're more than double the national average for procedures per FTE. I didn't expect that level of productivity gain."
Fox says the billing division at Riverside allows physicians and employees to spend more time on the front end making sure the claim goes out correctly the first time to the clearinghouse—reducing the practice's costs by eliminating data entry, for example.
"Billing groups typically spend a lot of time in accounts receivable, which is collecting money on the back end," he says. "That's expensive because the statements have already gone out, you're paying a rep to call the patient, you're sending out three statements, and postage continues to go up."
The system has allowed Fox to put more resources on the front end to make sure the claim goes out correctly in the first place to the clearinghouse. "That really reduces our cost by going electronic and eliminating jobs like data entry."
The transition has allowed Riverside, and Fox specifically, to develop a plan for further expansion. Over the next 10 years, Riverside will diversify outside traditional radiology into lines of business such as teleradiology and image storage. "That way, through Central Ohio PACS, a number of community hospitals can utilize us for storage," he says. "They can pay on a per-click basis so it saves them a lot of capital outlay. We've got a long way to go, but in another five years, our goal is to double again organically."