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Case 3: Starting a new practice


Dr. Asha Patel and Dr. Jonathan Edwards
Specialty:
Family Practice
Problems: Lack of experience and
Need for cost control.
 


Drs. Patel and Edwards, both certified in Family Practice entered into a partnership to start their own  practice. Both of them had finished their residency  within the last 3 years. Dr. Patel had completed 2  years of a service commitment after residency, and Dr. Edwards had been employed by a local hospital in the capacity of a hospitalist for 2 years. Having known each other from residency, Drs. Patel and Edwards entered a partnership and setup a Family Practice PC. As with any new business, establishing solid billing practices is the key to survival. The new practice was based in a suburb of a major metropolitan area, and as such, the overheads were high, and it was critical that credentialing was done immediately, staffing costs were kept at a minimum, and reimbursement rates were kept as high as possible. There was little room for trial and error.
 

Setting up a new practice for billing and receivables can be overwhelming. In order to setup a new practice for billing, it required credentialing for local insurance companies and developing a geographically appropriate fee schedule and a superbill. Billing software needed to be purchased (or a billing module for an EMR). Staff needed to be hired and trained in billing. Additionally, they needed to achieve a functional understanding of the billing process, including using the practice management and billing software, electronic and paper claim submission, EOB analysis, denial analysis and resolution, patient eligibility verification, secondary insurance submission and direct patient billing.

Start Script Intervention:
Using Start Script Medical Billing Service, the following measures were taken:

  • Established credentialing with local insurance companies
  • Installed a web based practice management and billing software at no cost
  • Fee schedule was developed
  • Super bill developed
  • All aspects of billing process were handled by Start Script.
     
  • Results:
    In this particular circumstance, it is not easy to quantify the benefits associated with the use of Start Script Medical Billing Service. However, consider the following
     
    • The number of employees required to manage the billing for this practice was significantly reduced,  resulting in significant savings.
    • The amount of time saved in credentialing, and not having to setup the logistical aspects of billing was  significant as well.
    • There was no loss of income due to trial and error. Reimbursements were well above 98 percent from the beginning, allowing the practice to break even at the earliest possible point, from a receivables standpoint.
    • The peace of mind was immeasurable. This allowed these two physicians to enjoy taking care of their patients, rather than getting overwhelmed with the billing and collections process