Royal Pains: Billing Edition

- Medical billing provider increases revenue for house call doctor by 40 percent while freeing up 50 percent of time spent on operations -

Background

On the TV show the Royal Pains Dr. Hank Lawson started a concierge medical practice for the rich and wealthy living in the Hampton’s. The show’s premise seems a perfect for TV and Hollywood but in Utah has become a reality as Dr. Mark Cacciamani has created House Call Doctors of Utah, a family practice based solely on house calls for those that are unable to leave their homes for doctor visits.

Dr. Cacciamani began his career as a resident at the University of Utah, but, much like Dr. Lawson, the main character on Royal Pains, soon became disenchanted with the clinic approach of seeing a patient every fifteen minutes.

“Mark felt like that approach limited him in his ability to really care for a patient,” said Amy Archuleta, his wife and business manager.  “He became a doctor because he wanted to help people and build long-lasting relationships with his patients.  He really has a passion for helping the underserved and the typical clinic approach didn’t allow him to do that.”

In 2004, Dr. Cacciamani was convinced there was a better way to run a practice, one that would allow him to spend quality time with his patients as opposed to simply churning out patients assembly line style.  He created a practice that would enable him to make house calls to patients who for one reason or another couldn’t get out of their homes to go to a doctors office. In this model, Dr. Cacciamani sees an average of eight – 10 patients a day.  His practice covers an area in Utah of roughly 75 miles, stretching through three counties from Provo, Utah, South of Salt Lake City to Layton, North of Salt lake City, Utah.

The majority of Dr. Cacciamani’s patients are elderly and disabled. “What we find is that there is a large population of elderly and disabled that can’t get themselves to a doctors office,” said Amy.  “Some have families, but by the time they pick them up, take them to the doctors office, wait for the doctor to see them, pick up any prescriptions and return home it becomes an all day affair and many don’t have family that can spend an entire day on one doctors appointment.”

Challenge

The last thing Dr. Cacciamani wanted to do was spend his time on billing and operations.

Amy worked for a time at the University of Utah and is familiar with running a medical practice, including the billing side of the business.  She agreed to manage the operational side of the practice.

“ I figured I could handle the operational side of the business,” Amy said.  “However, once we started growing and needing to add doctors to our staff to accommodate the growth, I found myself pushing billing to the side to make sure I accommodated other, more pressing and urgent operational issues.  This was a mistake as billing is a critical part of running a medical practice and the neglect greatly reduced our income and was an problem that just kept getting worse.”

In an effort to stop the bleeding, Amy decided to find a billing agency to help her out and take that responsibility off her plate.  In 2006 she contacted a billing company that was associated with the EMR system she was using.

“That was a mistake but it was partly my fault,” admits Amy. “I didn’t know what to ask a potential billing company and didn’t know exactly what I needed and as a result I had a bad experience with this first billing company.  I terminated our relationship with them and was determined to not let that happen again and started working with a new billing company that turned out to be even worse.  Shame on me for trusting others and not doing my homework.”

Solution

In her first two experiences, the company’s Amy contracted with were both based in another state.  Amy felt like working with a company in her same state would be beneficial, especially as she was still trying to understand exactly what she needed out of her relationship with a billing company.

“I did some research and came across Claim Resolutions which is headquartered in Utah,” explained Amy.  “This time, I interviewed them several times before signing on with them.  I knew more of what I wanted and expected, including the fact that I wanted to be more hands on and wanted to be able to track them better than I had in my previous two experiences.”

Claim Resolutions saves medical practices time and money by streamlining the billing process, expediting accounts receivable, reducing denial rates, and providing insightful reporting. The company professionally administers medical billing, coding, and practice management functions so that medical professionals can focus on patient care.

To date, Claim Resolutions has collected tens of millions of dollars for physicians, facilities, and healthcare providers in behavioral health, family practice, cardiology and neurology. They have reduced claim rejection rates from 20+% to less than 1%, reduced reimbursement times from greater than 21 days to less than 7 days, and reduced physician staff phone time by more than 70%.

“Going into the relationship I wanted to ensure that I had a hand in everything Claim Resolutions did on our behalf,” said Amy.  “I was surprised to find that I didn’t need to worry or have a hand in all their activities.  The difference I noticed working with Claim Resolutions was immediate.  They fought for us and treated our practice as if it were their own. “

From the start Claim Resolutions came in and took control.

“The Claim Resolutions team asked me for all my old EOB’s and began working those to ensure we were getting what we deserved,” said Amy. “Their efforts immediately freed up at least 50 percent of my time and I quickly stopped worrying about billing and focused on other aspects of growing the practice.

Conclusion

Since contracting billing with Claim Resolutions, House Call Doctors of Utah has hired a second physician and by the end of 2013 will hire a third doctor to join its burgeoning practice.

“I never thought that a billing company would care as much as I care about our business, but I’ve found that Claim Resolutions does,” concludes Amy. “They have increased our revenue by 40 percent and fight for our money just as hard as I would. I recommend Claim Resolutions to everybody.  I used to think it mattered that my billing company was based in the same state as me, but with Claim Resolutions I no longer believe that.  What’s more important is their expertise and ability to collect on outstanding billings.  I recommend them to practices around the country with confidence and know that they’ll get the same level of service as we’ve gotten.”

For more information about House Call Doctors of Utah visit http://www.housecalldoctorsutah.com/.  For more information about Claim Resolutions visit http://claimresolutions.com/.