Is It Time For A Business Assessment?

It begins with “How’s the business doing?” and the proverbial answer is something like “fine”, “pretty good”, “not bad”, “holding our own” etc.  But, I ask again – “no really, how are you doing?”  Do you know?   Many private practice owners really don’t know how their business is doing – whether things are really going well or not.  Sure, you’re doing your best to pay your bills every month and make payroll – seems like everyone is working hard including you – money is tight, but isn’t that the way it is suppose to be?  No, not necessarily.

As a private practice owner, you should know exactly how your business is doing – how your staff is doing, whether or not you are in compliance with insurance guidelines for which you are a provider, how many patient visits you have in a week, month, or year, what your cancel/no show rate is.  Are you HIPAA compliant? Are you getting the maximum reimbursement for the services you provide? Are you charging and documenting correctly?  Is your staff maximizing your billing system? Is your staff well trained and highly productive? 

The list goes on and on and if you don’t know the answers to all of these questions then maybe you’re assuming that your office or clinical manager knows – or maybe your front desk specialist – but then how do you know if what they know is valid – after all it is your business and in the end, it’s your responsibility.  Let’s take a look at what an assessment can uncover and offer you in return for your investment.

In this economy it is of the utmost importance to run a high functioning seamless operation.  Hiring the right administrative staff, training and developing, and understanding the value of what that staff can and should be doing is key to your success.  
 

To begin, choose a consultant who has specific experience in assessing physical therapy practices.  Get references and check them out.  Physical therapy private practices are different than other private practices and you want to be sure your consultant clearly understands how all aspects of a physical therapy practice runs. 

Assessments are best done with the consultant coming in to your facility or facilities and spending time at each site.  Being on site allows the consultant to observe staff and patients, their interactions and skills, and to better understand the environment.  Getting to know the staff and seeing the flow of operations in action- front desk, therapist, billing and collections - gives a much better understanding of the practice culture.  The assessor needs to know how much staff turnover you have experienced, clinical and administration.  Is your staff happy - do they care how you are doing?  Have you given them a purpose?  Do they understand compliance guidelines – do they know what that means?  Do they know and support you and your business goals and vision?  This can be very telling in understanding the overall health and well-being of your clinic.   

Let’s take a closer look at the nuts and bolts of a good assessment and how it can be beneficial to you.

Assessments usually begin with a list of questions that are given to the owner and all management and staff members – full or part-time, administrative and clinical.  The consultant will spend time with the owner to understand their short and long term goals and vision and their current business management abilities.  Staff members are given a week or so to think about the questions, answer them and send them back to the consultant.  The questions focus on what management and staff think about the company, their job responsibilities, their position with the company, growth opportunities, policies and procedures and what they might do if they could change some things.  A response to the questionnaire opens a door for the consultant to expand on in individual interviews.  

Individual interviews help to identify a clinic’s culture, communication issues, skill levels and overall commitment to the business.  One on one with the managers and staff members really helps to understand their issues and identify their goals and loyalty to the business.  The results of interviews usually surprise owners mostly because it is difficult to ascertain this information on their own.

Other areas explored in an assessment include the overall operations of the business. Your technology – billing, scheduling and documentation systems – how they are used and the outcome reports they can provide to help you better understand “how your clinic is doing”.  A review of job descriptions, performance measurements, and personnel policies and procedures help indicate the level to which you can hold your staff accountable. 

Hiring procedures are critical to making sure you are staffing your organization with the best, most highly qualified individuals.  Those are the people that will help you improve productivity and add to your bottom line success. 

Evaluation of the front desk to the therapist to the biller to the collector will indicate how effective your internal communications are and whether or not you are running a seamless operation or a fractured operation?  A review of front desk processes -scheduling patients appropriately, processing new patients, collecting co-pays, deductibles, and co-insurance as well as referral/authorization management and file maintenance - are all part of the overall outcome of a positive bottom line, not to mention a positive patient experience. 

Part of a positive patient experience outside of the exceptional patient care is your staff’s ability to understand the ins and outs of billing and collecting.  For each insurance that you are a provider for the biller must understand each provider agreement – how to bill correctly, what the reimbursement fee schedules are and what the patient’s responsibility will be.  They must be able to effectively communicate to the patient what their responsibilities are and what your company’s policies are on collecting at time of service, charging for cancellations and/or no shows and managing referrals and authorizations.

The collection function must work seamlessly with the billing function – an assessment will bring to light any issues with current procedures, reasons for denials and the overall management of the accounts receivable functions. 

The communication between the administrative staffs and the therapist’s must also be running at the highest efficiency to keep the patient experience at an outstanding level.  Knowing issues that patients may be having regarding their financial responsibilities helps the therapist to create a treatment plan that will help the patient when making decisions as to how often they may be able to come in or when their benefits will be exhausted. 

Understanding the importance of each position in your organization will result in your being able to raise the bar and improve productivity at all levels.  Implementing accountability systems and learning the value of running a flawless operation and will help you build on your foundation and ultimately improve your bottom line.  Today providers are consistently driven by insurance mandates that impose new requirements and require more time from the therapist but with little or no increase in benefits or reimbursement.  This is one more reason why it is of the utmost significance to run a highly efficient practice.
 

Upon completion of the assessment which could last one or more days depending on the size of the practice and the number of employees, you should expect a complete overview of the findings along with a strategic plan for improvement.  Based on the owner and staff interviews and the overall outcome of the assessment, this plan will address the businesses strengths and weaknesses and recommend changes that are aligned with the owner’s objectives and ideas for a winning future.  Whether it is a change in staff deployment, technology, or current operational practices, it is an opportunity for you to look at your business from a different perspective – embrace the advice given and begin planning for the implementation of a new and thriving future.

A great consultant will give you an outline of their proposed implementation plan and will have the tools necessary to execute their recommendations.  The investment you make in hiring your consultant to complete the project will be made up in short order.  Their value is results driven.  Your success is their success.

So, take a look at your physical therapy practice and ask yourself is it time to have a business assessment?

Diane McCutcheon, President

DM Business Management Consulting Services, Inc.

Account Matters – Billing & Collection Services

4 Charlesview Road, Suite 4

Hopedale, MA 01747

P: 508-422-0231  F:  508-422-0234

diane@dmbmcsi.com