Business Situation: 

Mid-sized hospital-based physician group in Southern CA 60k patient visits/year 

Challenges: 

- Due diligence on billing solution 
- Needed solution specific to emergency medicine 

Phycon Results:

- Increased revenue 20 percent in the first 6 months 
- Two year revenue increased over 25 percent. 
- No revenue loss in billing transition 
- Over $1 million more in first year collections 
- Customized Reports 
- Improved customer service

 “This is a company set up and run by emergency doctors – that makes it a perfect experience for us. We know ER docs are good at running businesses and getting things done. PhyCon understands we live on the edge, off the pennies we’re able to gather at the end of the bill.” 
-- Emergency Physician Group President

Billing Due Diligence

With recent tightening in specialty billing restrictions, physician groups have been forced to become more creative and proactive in managing the business of their practices. More often groups are initiating regular interval audits of their billing systems to ensure they are meeting established benchmarks and to uncover revenue opportunities. A hospital-based physician group in Southern California opted to outsource an audit of their billing system as a means of doing due diligence to ensure they were getting the most out of their billing process.

The president of the emergency physician group is in charge of making sure they are getting the most out of their billing system. “We consider it good business practice to review billing contracts and performance every 5 years or so – just to see how are we doing what other companies offer to improve. When physician groups have a good experience, word gets out – that’s how PhyCon came into the picture.”

PhyCon is a billing and consulting company out of Oklahoma City, OK, specializing in emergency medicine billing. Founded by an emergency physician, the company has over 30 years in emergency billing expertise. Their goal is to evaluate current patient charts and billing for accuracy, collection rates and when possible, to uncover hidden revenue potential.

In this case, PhyCon audit results showed a large potential increase in revenue. “After start up, we realized the audit is very conservative – it’s not a sales number followed by a lesser reality. The audit number was 10-12 percent under our actual collections. You have to appreciate that you can trust the process and understand your numbers will be accurate or even a little better.”

Focus on Emergency Medicine 

In addition to the audit projections, the physician group was also drawn to the company background and particular focus on emergency medicine. PhyCon provides services specifically to emergency physician groups and urgent care facilities. 

“This is a company set up and run by emergency doctors – that makes it a perfect experience for us. We know ER docs are good at running businesses and getting things done. Our previous big billing company dealt with medicine in general. From a business standpoint, it wasn’t profitable for them to put more money into our collections. PhyCon understands we live on the edge, off the pennies we’re able to gather at the end of the bill.”

PhyCon Solution 

PhyCon transitioned the group over to a new billing system and was able to improve revenue as well as improve billing operations. Their service includes on-site personnel to coordinate the billing process, to ensure accuracy and efficiency to complement the billing software. 

“One of the fundamental problems before PhyCon was lack of accountability. We had several people managing our account, but no one who owned the process. With PhyCon on-site, if any questions or small issues come up – such as documentation or charts that need finished – I’m made aware of it immediately and can jump in when needed.” 

A new billing company can also bring issues of account knowledge and customer service. PhyCon’s on-site personnel helps to build the relationship and the designated customer team at PhyCon provides custom service to each account tailored to their individual needs. “The PhyCon team has been very positive and understanding, very personable in our business relationship. Not to mention customizing reports as we need them and being responsive to our needs.” 

One of the most difficult parts of the decision to change billing companies is the actual transition of services. It can take months to get the new company up-to-speed in doctor credentialing and chart coding. PhyCon minimizes the business interruption by sending an advanced team on-site to prepare for the actual move in billing. Prior to the implementation, PhyCon personnel contacts each customer’s major payers to create a unique and efficient billing process. 

“We anticipated a significant, palpable variance for six months. But after the first month, we saw almost nothing reduced, followed by an immediate increase. We prepared for a significant hit and that just didn’t happen.”

PhyCon Results 

Within six months of making the billing transition, PhyCon was able to improve practice billing collections by 20 percent. There was a total improvement in the first year by over $1 million and by year two the collections were up 25 percent over the previous system. 

The physician group attributes the increase in collections to the persistency in which accounts receivable are managed. “PhyCon facilitates more communication in collections and that has resulted in reduction in AR. I have not found anyone that’s done a better job in collections. I am impressed by the bottom line as well as the service they provide.”