“I received no formal training in medical school or residency on how to start my own practice and run it effectively.”
coding and documentation, or ensuring their practices operate optimally and make money, they need to select a quali- fied consultant who’s knowledgeable about the practice. (See “Good Advice About Consulants,” opposite page.) “What I liked about TMA Practice Con- sulting was that I knew they’d look out for my best interest. Unlike some con- sulting firms, they weren’t focused on improving their bottom line. I also spoke to physician colleagues who’d had good experiences with TMA Practice Consult- ing, and I felt confident in selecting them to set up the practice,” Dr. Shaw said.
sought professional assistance setting up their business from Texas Medical Asso- ciation Practice Consulting. “I received no formal training in medi- cal school or residency on how to start my own practice and run it effective- ly,” Dr. Shaw said. “In addition to that knowledge deficit, my partner and I didn’t have time to devote to every step of the practice setup process.” Drs. Shaw and Shashoua relied on the
expertise of a TMA practice consultant to help them screen potential employees, set up an information technology system, select an electronic health record (EHR) system, and determine how to handle billing and collections.
TMA Practice Consulting offers prac- tice setup services in three phases. In phase one, TMA consultants meet with physicians and ask about their vision for the practice and their plans and preferences for managing the business. After the meeting, consultants develop a pro forma, a financial document that includes all setup costs and start-up ex- penses, monthly operating costs, and three-year cash flow projections. TMA consultants then help physicians set up telephone and fax lines and voice mail service. They provide referrals to professional advisers such as bankers, health care attorneys, certified public accountants, realtors, and credentialing companies.
22 TEXAS MEDICINE February 2013
Phase two involves working with physicians to select equipment and nec- essary services. TMA consultants can either provide resources or request bids for insurance products, billing services, practice management software, medi- cal equipment, office furniture, copier and fax machines, telephone systems, answering services, filing systems, and transcription services. This phase also includes an information technology con- sultation.
In phase three, consultants help phy-
sicians recruit and train staff and imple- ment information technology. Before starting a practice, Dr. Shaw
worked at Austin Diagnostic Clinic for six years. Dr. Shashoua was part of a midsize obstetrical and gynecological practice in Round Rock for 13 years before going to work for Hospital Cor- poration of America in 2010. Practice ownership was a new endeavor for the physicians, but Dr. Shaw says the ar- rangement suits them. “We opened our practice in ear- ly 2011, and in 2012 we moved from a 1,400-square-foot office to a 5,500-square-foot facility. We went from five employees on staff to 10. Our prac- tice is thriving, and we’re grateful to TMA Practice Consulting for giving us a roadmap for success,” Dr. Shaw said. Whether physicians need guidance setting up a practice, improving their
Professional help pays off At times, it’s best to delegate business tasks to experts. A Texas pulmonologist, who requested anonymity, decided to hire a consultant after the Centers for Medicare & Medicaid Services notified him he’d been upcoding on some Medi- care claims. The physician says the mis- take was unintentional, and he realized he needed professional help to get his coding and documentation in line. He hired TMA Practice Consulting to conduct a comprehensive coding and documentation review. The consultant reviewed the practice’s documentation for accurate CPT coding; appropriate application of CPT and evaluation and management (E&M) coding guidelines; correct use of modifiers; encounter forms; claims; and corresponding expla- nations of benefits to help ensure accu- rate billing and reimbursement levels. The consultant determined that the physician had been incorrectly docu- menting physical exams and had only a 30-percent accuracy rate for documenta- tion. He received a formal, written report outlining opportunities for improvement, some of which included consistently list- ing diagnoses in order of importance and correcting conflicting information in some documentation. After receiving the report, the physi-
cian took coding and documentation courses and followed his consultant’s suggestions for improvement. Six months later, TMA Practice Consulting did a follow-up chart audit and found his documentation accuracy rate had im- proved to 80 percent.
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