Practice Management Capabilites

The scope of our management capabilities and responsibilities as medical group administrators is delineated below. Our administrative roles for the various physicians and other health care professionals in our client population include the responsibility to administer the total managerial and operational functions of a medical practice. We also perform work for physicians on isolated or a "project" basis. We have summarized below our administrative roles in each managerial function.

General Practice Management Role
We perform practice assessments to enable physicians and others to define problem areas and practice needs. These assessments are communicated to the physicians and staff members as appropriate. The recommendations from this assessment are discussed in detail and prioritized into an Action Plan. We strongly recommend that we provide "hands-on" implementation of recommendations.

We have, on a start-up basis, implemented both laboratory and ancillary services in the medical office setting. Initiating these services includes negotiating contracts, purchasing medical equipment, developing procedural and quality control policies and meeting licensure requirements.

Human Resource Management
We have extensive experience with human resource management. These capabilities are as follows but are not limited to:

Financial Analysis and Reporting
Our financial analysis experience includes developing annual budgets, cash flow reports, capital budgets, and preparing and analyzing financial statements. In addition, we investigate and prepare special financial studies as requested by our clients. We are functional with all financial reports, including computer-formatted documents, and establish various policies and procedures. We also work with banks to establish favorable terms for the practice's needs.

Marketing and Practice Development
It is imprudent to seek growth simply to earn more dollars. Your practice's values, mission and resources must be clearly defined and understood by everyone. Only then can a practice development program succeed.

Computers and Technology
We have experience in evaluating, selecting and implementing medical office computer systems. The various medical office functions with which we are familiar include controls on accounts receivable, accounts payable, appointment scheduling, appointment reminders and recalls, accounts payable/general ledger, insurance and patient billing and adjustments, demographic statistics, and other financial reporting. We have evaluated many computer systems and directly selected and implemented at numerous computer systems over the years. We also remain sensitive to the ongoing and future IT needs of medical practices; EMR, interfaces with clearing houses, security issues, and the impact of IT investment on the practice's productivity, people, finances and operations. Additionally, we are functional and articulate with various IT infrastructure designs, and can prepare RFP's toward this end. We have conducted due diligence activities in this area.

Accounting and Bookkeeping Systems and Controls
We are familiar with the generally accepted accounting principles that are essential in the medical office. Most of our clients have computerized accounts payable/general ledger systems. We review and supervise internal systems for handling cash receipts, cash disbursements, and adhere strictly to audit control systems devised by our accountants. In addition, we are familiar with organizing and implementing manual systems and converting them to computerized systems.

Accounts Receivable Maintenance
We develop and implement financial controls that ensure the proper administration of accounts receivable. In all our physician offices, we have implemented systematic methods of handling delinquent accounts by utilizing collection letters and payment plan letters. In difficult collection cases, we personally handle the financial issue and appropriately try to resolve the problem. We are experienced at small claims filing procedures to collect unresolvable delinquent accounts.

Materials Management
We have been successful in negotiating favorable medical and supply group purchasing agreements for our physician clients. This arrangement has enabled many clients to realize substantial savings in supply costs. We can arrange to have a customized inventory order form which ensures standardization of ordering practices and maintenance of desirable inventory supplies. Overall, we have established for our clients a functional inventory maintenance program.

Physical Plant
We have been involved with planning, organizing and implementing office renovation plans of varying magnitudes, from small renovations through new building projects. This has entailed architectural design of the office, negotiating contractor and vendor contracts, licensing, monitoring and supervising labor progress and budgeting of the office project. Renovation and construction projects frequently require extensive monitoring and inspection.

Third Party Billing Regulations and Requirements
Our knowledge of third-party regulations and requirements include Medicare, Blue Shield, Blue Cross, Medicaid and Commercial insurance coverages. We strive to stay abreast of the dynamic regulatory environment through continuing education seminars and by reading materials regarding these issues. In addition, we have attended advanced courses in ICD-9-CM and CPT Coding. Third party revenue comprises 60-70% of our clients' income, and we must therefore stay abreast of regulations.

We are capable of establishing compliance programs for both Fraud & Abuse and HIPAA. We establish audit programs, process models, and compliance plans that all may help avoid fraud and abuse issues. Productivity and Operational Analysis We are very experienced in the practice analysis of production, Relative Value Based analysis, overhead control, staff and physician compensation formulas. The financial integrity of medical practices is at the heart of survival in today's medical climate and we can offer many suggestions for improvement and enhancement.

Managed Care Contracting and Negotiating
We have negotiated numerous contracts with payers and are well versed in the strategies and tactics attendant to this activity. Contract language and reimbursements, including payments, are very dynamic and require due diligence to ensure that the physician's strategic and tactical interests are optimized.

Medical Group Mergers and Buyouts
This area is where perhaps we can boast of significant accomplishments more so than in any other. Our contributions to such efforts have resulted in many practices' performance improving measurably. We have been directly involved in several single specialty mergers covering 10-30 physicians. Additionally, we have also affected the outright sale or purchase of specific medical practices. We recognize that each one of these cases must be handled on an individual basis due to its unique nuances that require a tailored approach. We always strive for simplicity and balance. We seek to neither exploit nor subsidize the parties involved.

Business and Strategic Planning
We frequently serve as a facilitator for Business and Strategic Planning efforts of many medical practices. These services are most frequently performed with our client base, but can be extended to those simply interested in facilitating the planning process without an ongoing consultative relationship.

Medical Practices Utilizing Our Management Services
We can provide you with numerous references who will attest to our abilities.

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