What Does a Medical Practice Consultant Do?

The Medical Practice Consultant

Medical practices have a growing need for specialized services. The healthcare industry in most parts of the country is volatile and constant change is the norm these days. This change presents acute business problems for all medical practices. Physicians need help increasing revenue and containing costs. They also need help adapting to a changing marketplace, because it will impact revenues and costs. This is why medical practices need more input and expertise from their advisors, especially a medical practice consultant. The medical practice consultant can be a healthcare CPA or an independent consultant.

So what does a medical practice do to help and assist a  physician medical practice?

Be a Resource

Not everyone knows every answer when managing and running a  medical practice - this is where a medical practice consultant comes in. I tell all of my clients that there is no such thing as a dumb question. If the physician owner or administrator has any question on a daily basis about the management or operation of the practice, call, email, or text me. For example, it could be a question about a human resource, billing, coding, compliance or strategic alliance matter, just to name a few. A medical practice consultant is an asset to the physician practice to provide information if and when needed.

Be Proactive

A medical practice consultant doesn't just sit there waiting for a client to call with a question, he or she is constantly looking for ways to improve the the physician medical practice he or she is working with. This can take many forms, such as a change in reimbursement the client might not be aware of or making sure the client is HIPAA and OSHA compliant. These are just a few of many, many examples.

There is only one financial metric that matters for physicians - is the practice doing better this year than last and if not, why not? The medical practice consultant is constantly monitoring the financial performance of the medical practice on a comparative basis and providing proactive ideas on how to increase the bottom line.

Provide Consultative Services

The medical practice consultant provides an array of services for physician medical practices. The following is a sample of just a few:

• Complete practice assessments/reviews Periodically, a medical practice needs a complete review and assessment. The goal of this service is to evaluate the overall efficiency of the practice and to determine if it is losing revenue. A review attempts to improve the bottom line. For example, if a practice's cash flow decreases, it may want to hire a professional or healthcare consultant to conduct an independent assessment of its practice operations to determine the cause of the decrease. Think of a practice assessment like getting the doctor’s car “tuned up” every year. The objectives are the same: To make sure each are running and operating as efficiently as possible each and every day.
• Coding analysis A coding analysis determines if the practice is coding all of its services correctly. If the office members do not code the services correctly, the practice may lose revenue. The analysis covers both procedural coding and diagnosis coding. A practice should be constantly reviewing the coding practices of its physicians.
• Office policy and procedures manuals A medical practice’s efficiency can be traced directly to its internal operational systems. A lack of systems will often result in lost revenue. Thus, every medical practice should have a policy and procedures manual detailing how, when, and by whom certain office functions are to be performed.
• Mergers of medical practices Physicians who are contemplating merging their practices should seek someone to guide them through the process.
• Negotiation with managed-care plans Medical practices need to increase their own reimbursement from managed-care plans. This need is accomplished by negotiating an increase in price from these plans. This process includes the development of a managed care strategy for the practice. A medical practice consultant helps with this process and negotiation.
• Interviewing and hiring personnel The success of most medical practices depends on their personnel. Many physicians do not have experience with hiring and neither do their office managers. Poor hiring decisions can hurt any office.
• Implementation of internal controls Most medical practices are vulnerable to embezzlement. All medical practices must implement and monitor a basic system of internal controls.
• Embezzlement review Fear of employee theft warrants an embezzlement review for some medical practices. This should be performed by an independent third party, such as the practice’s medical practice consultant.
• Design of physicians’ compensation arrangements Because the medical industry is changing, old compensation systems may no longer be viable. Practices may need help revising their current compensation systems or developing new systems. Also, governmental regulations, such as the Stark laws, often require changes to current physician compensation systems.
• Purchase or sale of a medical practice Issues such as valuation, negotiation, taxes, contract development, and practice transition demand careful attention.
• Billing service review Many physicians use outside billing agencies to bill and collect their services. These agencies are often left unaccountable. The physician’s agency should be reviewed periodically to make sure services are billed out correctly and that the agency puts in the time and effort required to collect these services.
• Strategic planning A medical practice needs help strategically placing its practice in a position to take advantage of a changing healthcare marketplace. How to do this requires careful planning. Today’s successful practices are using strategic planning initiatives to their advantage.