Knoxville, TN (PRWEB) June 24, 2014
The days when doctors were paid for their services without question seem like a distant memory for many providers. While some discernment provides value, government agencies and third-party insurance payers are getting quite aggressive about auditing medical reimbursements. They are insistent that providers justify the claims submitted for services delivered to patients. In addition to more stringent regulations, these organizations are using sophisticated data mining tools to target healthcare systems for claims audits. Physicians feel intimidated and ill-prepared to defend themselves. This is just one of numerous catalysts causing many providers to exit life-long careers in healthcare.
DoctorsManagement, a Knoxville-based medical practice consulting firm, is equipping practices of all sizes with a powerful offensive strategy. The firm recently hired data analytics expert, Frank Cohen, as Director of Analytics and Business Intelligence. Cohen has provided meaningful assistance to healthcare organizations in the areas of process improvement, compliance, quality and profitability since 1988, and is nationally recognized in the industry.
Cohen empowers facilities of all sizes with affordable, user-friendly analytics solutions that are tailored to the needs of medical practices and provide the same insight as the tools used by government agencies and payers. Practices haven’t had easy access to reliable business data which left them vulnerable to making poor business decisions that are costly in the long-run. Cohen’s solutions, however, provide aggregated data and a business-decision dashboard specific to practices of their size and in their region, enabling practices — whether they are small or large — to assess their own situation and take actions to help avoid costly business mistakes and audits.
“We’re leveling the playing field,” states Paul King, President and CEO of DoctorsManagement, a company that has worked exclusively with healthcare facilities for over 50 years. “Regardless of their size, practices with access to someone like Frank Cohen can mitigate the risks of audits.”
When a practice faces an audit, it must either pay back over-payments plus potentially stiff penalties or spend significant resources appealing the claims. The burden of proof is shifted to the practice to show that it provided proper codes and documentation for the reimbursement received for services rendered to patients.
“Compliance audits place an incredible burden on medical facilities,” King continues. “It requires time and resources that practices simply do not have. “
An audit does not necessarily mean the practice is at fault. DoctorsManagement regularly performs claims appeals for healthcare systems that have been audited, and they have reduced clients’ repayments from as much as $1.9 million down to $245.
The data analytics division of DoctorsManagement advances the firm’s ability to help ensure that clients remain profitable with no compromise in patient care. Practices are already benefiting from this joint effort with the recent release of DoctorsMetrics.com, an affordable solution that delivers Mr. Cohen’s cutting-edge electronic analytic tools in a user-friendly, web-based package. Practices of all sizes use this analytic tool to help improve revenue and reduce the risk of non-compliance.
“It is an honor to add Frank Cohen and his associate, Scott Buchanan, to our team of healthcare experts,” states King. “We will continue to do all we can to ensure that healthcare facilities have access to solutions that help them remain profitable while delivering quality patient care.”
About DoctorsManagement, LLC:
DoctorsManagement, a full-service medical practice consulting firm, helps large and small healthcare organizations increase practice profits, reduce compliance risks, improve patient satisfaction and reduce stress for physicians and staff. Our team is results-oriented and comprised of nationally recognized industry experts in compliance, coding, auditing, financial services, patient retention, human resources and more.