Ideas for Hospitals, Centers, and Practices

Beating the Burdens of Billing
Improve Your Purchasing Power

Beating the Burdens of Billing

In general, radiologists would prefer to devote their time to focusing on patients? health rather than collecting payments. Yet, to ensure their ability to maintain a practice, some resources must be devoted to this complex process, whether they are employee time, payment to third-party firms, and/or the purchase of software. The most successful methods often combine the three elements to maximize the return on investment, both economically and efficiency-wise.

However, this can be difficult for independent and hospital-based practices to achieve, particularly in tight economies with limited resources. In response, Medical Management Professionals Inc (MMP), of Kennesaw, Ga, has launched a new product and services brand, MMPact, which includes a set of tools called MMPact Billing Service.

MMPact Billing Processes

Medical Management Professionals Inc (MMP), Kennesaw, Ga, has created a billing service with a step-by-step architecture that can be tailored to an individual practice. The program is designed to teach radiologists about the billing process, while helping them to streamline their own efforts. It features eight steps:

  1. MMPact Coding Optimize: routing of specific dictated reports to coding specialists;
  2. MMPact Charge Reconciliation: automation and identification of missing charges;
  3. MMPact Claims Management: filing of claims with automated technology;
  4. Payment Process: a payment posting service;
  5. MMPact Denial Management: identification and reports on denials;
  6. MMPact Reimbursement Tracking: identification and reports on third-party underpayments;
  7. MMPact Eligibility Verification: determination of whether patients have third-party coverage; and
  8. MMPact Analytics: external reporting and information tool.

MMPact Billing applies a logical naming architecture to the tangible front-end and back-end billing processes. Each step has been translated into a product, and the entire solution offers a blend of technology and personnel. ?This allows MMP to work more efficiently for its clients and puts more focus on the parts of the revenue cycle where needed,? said Kelly Neumeier, MMP?s marketing director.

Customer reaction has been positive. ?This launch was due in part to our clients? needs for education on the process [presented] in a well-defined fashion,? said Neumeier.

Each step in the MMPact Billing process uses a unique combination of vendor-partner and proprietary technology as well as MMP experts, and each solution is tailored to the specifics of a practice. When MMP contracted with Radiology Associates of Tallahassee to manage its billing challenges, MMP reviewed the models at its two facilities and developed a solution to address the specific issues identified at each facility. One focused on coding and charge processes; the other addressed aged receivables and high staffing levels.

?MMP not only administered a smart new billing system within Radiology Associates and TDI [Tallahassee Diagnostic Imaging], it also employed staff, assumed all office costs, and supplied new technology with no out-of-pocket expense incurred. It also provided critical guidance during our negotiations with our payors, which has improved our contracting results and reduced my time related to billing matters by 50% or more,? said John Detelich, CEO of Radiology Associates.

MMP believes a key element to the program?s success is the blend of technology and expertise. ?Processes, like MMPact Denial Management and MMPact Charge Reconciliation, require both technology and professionals to assure optimum radiology practice revenue reimbursement,? said Neumeier.

Physicians may have personnel to handle these processes, but it may still be difficult to keep up with changes. ?You need a compliance department to manage changes and a coding department that?s regularly educated,? said Neumeier. MMP absorbs these costs.

In turn, MMP charges based on a program?s specifics and the facility?s revenue. ?MMP reviews each individual practice?s unique number of annual procedures and revenue and, from those numbers, structures a fee-based percentage. Because MMPact Billing is not a tangible, packaged product and because it is so unique to each practice?s revenue goals, it cannot have a fixed price tag,? said Neumeier.

The MMPact Billing process is composed of eight steps that are tailored to an individual practice.

?Renee Diiulio

Improve Your Purchasing Power

Making a big purchase can seem a little intimidating at times. How can you be sure that you are getting the best deal? I used to bring my friends and family along whenever I was planning on making a huge purchase, such as a car. I always felt like I was benefiting from their collective knowledge and skills when it came to bargaining on price and understanding all the technical and contract details. My entourage made sure that I was well taken care of and got the best deal possible.

In the arena of large expenditures, such as CT scanners and MRI equipment, wouldn?t it be nice to have skilled and informed people on your side, looking out for your interests? Well, that is one of the many benefits that Premier membership offers.

Premier, a health care performance improvement alliance, is made up of more than 2,300 US hospitals and 64,000-plus other health care sites working together to improve health care quality and affordability. Premier offers data, technologies, consulting, and purchasing to help hospitals provide higher-quality, more cost-effective care.

Being a part of a large health care alliance can improve your purchasing power when it comes to the specific medical products you have on your shopping list. When asked to describe the mechanics of such a process, Mike Georgulis, Premier?s vice president of Strategic Sourcing, explained how Premier organizes member committees or task forces to evaluate products and services to be placed on contract.

?We take our member input and then use that in terms of writing specifications for bids and negotiating terms for our bids, and costs with suppliers,? said Georgulis.

Premier?s role is to leverage the aggregate volume of the entire group of hospitals to help negotiate the contracts, which are then approved by the member committees. Premier does this through interaction with member hospitals, learning what they need, taking that and refreshing contracts that may be in place or negotiating new contracts, and conducting group-buy opportunities to drive prices down in the marketplace for their members. ?It?s a dynamic process. It?s always alive. Always something going on,? said Georgulis.

So just how strong is this purchasing power? ?On capital equipment, things like CT scanners, MRIs, other large modality products, we do group buys on an almost continuous basis,? said Georgulis. ?We target purchase opportunities in volume. ? We drop the price from our contract price even further and allow those people who would like to buy during a specific 3- to 4-month period to save even more money. ? We see anywhere from 20% to 40% off list as a place where our contracts land.?

A recent example of such a purchasing opportunity is the one just offered by FUJIFILM Medical Systems USA Inc to members of the Premier alliance on its line of Fujifilm Computed Radiography (FCR) products. The 3-month group-buy program that ran from April through June 2010 provided Premier members with additional incentives to adopt Fujifilm?s line of FCR readers and accessories. This is in addition to the company?s existing 3-year contract, which provides FCR readers, FCR imaging plates, CR cassettes, and accessories to Premier members at cost-effective prices. The contract, which runs through December 2012, also includes Fujifilm?s digital mammography system, the Aspire™ ClearView, warranties, training tuition, and service.

In addition to operating a leading health care purchasing network, Premier maintains a comprehensive repository of clinical, financial, and outcomes data. Health care facilities have the opportunity to join the Premier alliance by becoming either an equity owner or affiliate member. To find out more about Premier, visit

?Carol Dawson