Health Care Management Consulting

The EisnerAmper health care specialists help you tackle the toughest, most time-consuming issues.

Increase Revenue Opportunities

To survive today’s healthcare challenges, your management is looking to optimize every aspect of their medical practice. Cutting costs can help your bottom line but can also negatively impact the ability to provide care or generate revenue. Our team of CPAs and healthcare specialists can help you develop a harmonious relationship between maximizing revenues and minimizing expenses.

• Pricing Procedures
• Managed Care Contract Negotiations
• Explanation of Benefits (EOB) Analysis
• Evaluate Provider’s Procedure Codes
• Develop Budgets/Projections
• Compare to MGMA and other Industry Benchmarks

Compare Your Coding Patterns for Missed Revenue / Compliance Risk

Miscoding can cost your medical practice revenue or make you vulnerable to third party reviews. By using comparative data and identifying outliers, our team can help you systematically address missed revenue in your coding and uncover hidden profit. As profit margins continue to shrink, accurate coding is more important than ever to the financial viability of your medical practice.

• Evaluation & Management (E & M) Utilization
• Evaluate E & M Utilization Guidelines
• Compare acuity to other similar specialties
• Assess Medical Necessity
• Improve Coding Efficiency
• Establish Patient Financial Protocols
• Identify Overlooked Coding Revenue Opportunities
• Address Potential Miscoding Compliance Risk Areas

Achieve a Clear Vision for Your Practice

Effective Governance and Leadership through policies, long-term strategies and the guidance to help your management team control your direction.

• Governance Structure
• Accountable Care Organization Analysis
• Employment Contract Negotiations
• Policy + Procedure Manuals
• Independence / Consolidations/Mergers
• Strategic Planning

Develop Profitable Ancillary Services

For some medical practices, survival may be dependent on diversification or expanding into additional services provided through their organization. It begins with determining the needs of the patient base, and through data we can help you identify areas where services can be improved for better patient care.

• ASC’s
• Specialized Equipment
• MRI, X-Ray, Ultrasound
• Other Specialty Specific Services
• Mid-Level’s, Laboratories, Audiology
• Physical Therapy, Doppler Studies, Stress Tests

Improve Efficiency

Developing operational efficiency is critical for balancing the profitability of a medical practice with the desired patient and employee outcomes. We apply industry best practices and our experience with numerous medical practices to help you fine-tune your business operations.

• Segregation of Duties
• Internal Controls
• Job Responsibilities
• IT Evaluation
• Flow Chart Employee Responsibilities
• Flow Chart Activities

Understand Your Patient + Payer + Competition Mix

It is critically important to understand the patient base of a medical practice, who refers patients to the clinic and the level of complexity of the patient’s required care. We create dashboards that provide clear, up-to-date insight for medical practices to understand the relationship between their patient market share, payer reimbursement and competition.

• Managed Care Contract Negotiations
• Evaluate Patient Mix
• Identify Referral Sources
• Patient Care + Satisfaction Surveys
• Identify the Competition
• Identify Territorial Demographics

Guidance During Transition

Change is essential for survival in the current healthcare system. Whatever your needs, our experienced team has the resources to help your practice strategically plan its future.

• Set up New Medical Practices and/or Entities
• Identify Integrated Delivery Options
• Physician Recruitment
• Succession Planning
• Practice valuation
• Buy/Sell Agreement

Avoid Costly Surprises

Non-compliance can create huge monetary fines and in some cases criminal charges. No other industry is undergoing the rapid change and complexity that medical practice management faces today. You need a team of experienced, connected professionals to identify areas that can potentially disrupt your business and help guide you with solutions.

• Billing + Coding
• CCI Edits
• Modifiers
• ICD-10
• HIPAA Compliance Plans
• Security Rule (Privacy)
• Business Associate Agreements
• RAC Audits