Q3 2021 Newsletter
Pacific Vision Eye Institute
For this month’s client spotlight, PMRG is proud to feature Pacific Vision Eye Institute (PVEI). PVEI’s state-of-the-art facility and new surgery center in San Francisco provide comprehensive eye care for any patient who needs it, regardless of income. Their business model is inspired by the Aravind Eye Care System in India, an innovational model that makes it possible to provide a high volume of affordable, high quality eye care to all who need it.
One of the cornerstones of their program is providing instruction to eye professionals in training through a 40-plus-year partnership with the CPMC Department of Residency Program and Retina Fellowships.
Maria is one of the many people PVEI has helped. She had rapidly developing cataracts that prevented her from driving and made even walking difficult. To make matters worse, she was the sole driver in her household; her mother was recovering from surgery and her father had been hospitalized.
“I saw my doctor in my hometown, who gave me very little hope for treatment or recovery, since I was unable to pay for the surgery I needed,” she said.
Maria was able to get the surgery she needed at the Pacific Vision Surgery Center at PVEI. Her surgery was paid for by the Patient Assistance Fund, made available through tax-deductible donations to the Pacific Vision Foundation. After a successful surgery performed by 2021 Chief Resident Gena Damento, MD with the guidance of Attending Physician Kevin Denny, MD, Maria was able to go back to driving and to work.
“My surgery gave me back my life!” she said.
PVEI is powered by the Pacific Vision Foundation, a non-profit organization whose mission is to provide “excellent eye care for all regardless of ability to pay.” The Pacific Vision Foundation is able to provide this service through tax-deductible donations to their Patient Assistance Fund. To learn more about their program or to donate, go to pacificvisionfoundation.org.
KEY PERFORMANCE INDICATORS (KPI’s) FOR YOUR PRACTICE
It can be difficult to know what data your practice should be tracking. Most current practice management systems have such in depth reporting capabilities, it can be challenging to find a report or reports to quickly summarize your practice’s data to analyze your metrics and ensure business goals are being met. So how can we drill down into the data that is most useful to our practices?
One way to concentrate on the data that is most important to your practice is to establish Key Performance Indicators (or KPI’s) for your practice. You should begin by looking at your goals in four key areas—Financial KPIs, Patient KPIs, Services KPIs and Employee KPIs.
- Total Encounters
- Total Charges
- Total Collections
- Outstanding A/R
- Average Days in A/R
- Revenue per charge category
- Average revenue per encounter
- Device revenue
- Injectable medication cost and revenue (by medication)
- Number of appointments
- Number of new vs. established patients
- Average wait time
- Number of patients that purchase products at appointment
- “Missed Opportunity” appointments (no-shows, cancellations without rescheduling)
- Number of new patients referred by other providers
- Number of new patients referred by internet services
- Number of new patients referred by existing patients
- Number of cancellations within 24 hours of scheduled appointment
- Patient satisfaction (via survey)
- Wait time to work up/testing/exam
- Total patients managed per hour by employee and/or provider
The right Practice Management and EHR software can do much of the work for you with robust reporting and analytics tools. If you would like PMRG’s expert practice management consultant to work with you on establishing KPI’s for your practice, please get to either Curt (at firstname.lastname@example.org) or Jana (at email@example.com ) for more information on how we can support you.
Meet the Biller: Cynthia Gilbert
Cynthia is a team lead in our billing department and has worked at PMRG since 2019. She has worked in medical billing for more than 20 years in several different specialties before landing in ophthalmology, including orthopedics, interventional cardiology, and obstetrics and gynecology. Although initially she went to Malcolm X College to be a sign language instructor, she got hooked on the feeling of successfully helping patients get payments from their insurance companies in medical collections. She has thoroughly enjoyed her job ever since.
“I still feel the same way as I did when I first started,” says Cynthia. “I can’t see myself doing anything else.”
When she’s not working, Cynthia enjoys spending time with family and friends and making the most of her life. She’s always called Illinois home and is excited to resume travel once the pandemic ends.
Cynthia loves working at PMRG for several reasons, including access to upper management and the company’s dedication to getting employees what they need to succeed, which recently included all necessary resources to transition to working from home during the pandemic.
“Communication is a key component to what makes PMRG great,” Cynthia says.
We’re glad to have Cynthia on our team!
I’ve been working in Medical Billing for 20 plus years I started working Medical Collections as a patient representative I found that patients complained about insurance payments or the lack of. I found that I was speaking with insurance companies a lot and was successful with getting claims paid. I loved it and was hooked. I had to learn more which I have done. I’ve worked as a biller in several specialties Orthopedics, Interventional Cardiology, OB/Gyne and at this time Ophthalmology. I still feel the same way as I did when I first started, I can’t see myself doing anything else. I still love what I do. I’ve lived in Illinois all my life I went to Malcolm X College ( I previously wanted to be a sign language teacher) I’m almost divorced (living my best life) and I enjoy spending time with my family and friends also traveling (can’t do much of either due to the Pandemic) once this over I will be excited to start my world adventures again.
I love working with PMRG the open dialogue is amazing the ability to speak with Upper Management regarding any issues that you might be having is great and is extremely helpfully and keeps down stress. The transition to working from home was a smooth process this was attributed to the quick response from management to make sure that you have every tool that you needed to make the transition smooth. Communication is a key component to what makes PMRG great
Knowing Your Insurance Allowables
Building, updating, and maintaining your contracted allowables for the major insurance carriers you are contracted with is a crucial aspect of managing a well-run practice. Having this data on hand and available for your staff:
- Ensures you’re being paid at your contracted rates.
- Informs your staff on the correct patient deductible and co-insurance amounts.
- Reduces the number of patient statements being sent out because you’re collecting at the time of service.
This is much easier said than done, however. Many practices don’t know what their allowed amounts are or how to access them from the various insurance carriers with which they’re contracted, and don’t have the extra staff time to do the research to track down the amounts. This is costly to you as collecting from your patients AFTER the time of service can be a difficult and frustrating proposition at best! By knowing what your contracted rates are, you can be collecting this money before a single statement is sent out.
PMRG has now worked with a couple of our clients to build and maintain an online spreadsheet with the allowables for major carriers and major procedures. If this is something you’d be interested in having us do for you, please get to us. In our experience, it pays for itself very quickly.